vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2022-4-145-151vtio-1558Research ArticleСмежные дисциплиныRelated DisciplinesКоронарный парадоксСoronary paradoxЧестухинВ. В.ChestukhinV. V.

Москва

Moscow

БляхманФ. А.BlyakhmanF. A.

Бляхман Феликс Абрамович

620028, Екатеринбург, ул. Репина, д. 3

Тел. (343) 214-86-96

Felix Blyakhman

3, Repina str., Ekaterinburg, 620028, Russian Federation

Phone: (343) 214-86-96

feliks.blyakhman@urfu.ruГБУЗ «Научно-исследовательский институт скорой помощи имени Н.В. Склифосовского Департамента здравоохранения Москвы»РоссияSklifosovsky Research Institute of Emergency CareRussian FederationФГБОУ ВО «Уральский государственный медицинский университет» Минздрава России; ФГАОУ ВО «Уральский федеральный университет имени первого Президента России Б.Н. Ельцина» Минобрнауки Российской ФедерацииРоссияUral State Medical University; Ural Federal UniversityRussian Federation202229082022244145151Copyright © Честухин В.В., Бляхман Ф.А., 20222022Честухин В.В., Бляхман Ф.А.Chestukhin V.V., Blyakhman F.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/1558

Работа представляет собой научно-образовательный аналитический обзор, предназначенный для практикующих кардиологов. Цель обзора – обратить внимание врачей на роль сократительной функции миокарда в регуляции коронарного кровотока. Рассмотрен фундаментальный феномен компрессии (сдавливания) артерий в стенке левого желудочка, создающий препятствие течению крови в систолическую часть сердечного цикла. Это явление формально напоминает функциональный стеноз коронарных артерий. На основе анализа литературы дано толкование позитивному вкладу компрессии артерий в коронарную гемодинамику. Понимание механических взаимоотношений сократительной и коронарной систем в сердечной стенке может быть полезно практикующим врачам при выборе тактики лечения пациентов, оптимизации левожелудочкового обхода при операциях на сердце, а также повышения эффективности адаптации трансплантированного сердца.

This work is a scientific and educational analytical review intended for practicing cardiologists. The purpose of the review is to draw physicians’ attention to the role of myocardial contractility in the regulation of coronary circulation. We consider the fundamental phenomenon of arterial compression (squeezing) in the left ventricular (LV) wall, creating an obstruction to blood flow during cardiac systole. This phenomenon formally resembles functional coronary artery stenosis. Based on a review of the literature, the positive role of arterial compression in coronary hemodynamics is interpreted. Understanding the mechanical relationship between the contractile and coronary systems in the cardiac wall may be useful for practicing physicians when choosing treatment tactics for patients, optimizing LV bypass during heart surgeries, and improving the efficiency of adaptation of the transplanted heart.

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The authors declare that there are no conflicts of interest present.