Kazan medical journalKazan medical journalКазанский медицинский журнал0368-48142587-9359Eco-Vector30360710.17816/KMJ303607ReviewsОбзорыReview ArticleChildren’s heart and prematurity: a current view of the problemДетское сердце и недоношенность: актуальный взгляд на проблемуhttps://orcid.org/0000-0002-3081-94776507428859P-8477-20165794-3627PavlyukovaElena N.ПавлюковаЕлена Николаевна
Russian Federation

M.D., D. Sci. (Med.), Prof., Head of Depart., Depart. of Atherosclerosis and Chronic Coronary Heart Disease, Research Institute of Cardiology

докт. мед. наук, проф., зав. отд., отд. атеросклероза и хронической ишемической болезни сердца, НИИ кардиологии

pavluk@cardio-tomsk.ruhttps://orcid.org/0000-0002-5550-59251982-4987KolosovaMarina V.КолосоваМарина Владимировна
Russian Federation

M.D., D. Sci. (Med.), Prof.,Depart. of Children's Diseases

докт. мед. наук, проф., каф. детских болезней

kolosova_mv@inbox.ruhttps://orcid.org/0000-0002-7556-93799958-8105NeklyudovaGalina V.НеклюдоваГалина Владимировна
Russian Federation

PhD Stud., Research Institute of Cardiology

аспирант, НИИ кардиологии

lv-gal@mail.ruhttps://orcid.org/0000-0003-0335-9126AlexeevaEvgeniya O.АлексееваЕвгения Олеговна
Russian Federation

PhD Stud., Research Institute of Cardiology

аспирант, НИИ кардиологии

alexeeva_777@mail.ruhttps://orcid.org/0000-0002-7011-43168263-2641KarpovRostislav S.КарповРостислав Сергеевич
Russian Federation

M.D., D. Sci. (Med.), Academician of the Russian Academy of Sciences, Scientific Supervisor, Research Institute of Cardiology

академик РАН, научный руководитель, НИИ кардиологии

karpov@cardio-tomsk.ruResearch Institute of Cardiology, Tomsk National Research Medical Center of the Russian Academy of SciencesНаучно-исследовательский институт кардиологии, Томский национальный исследовательский медицинский центр Российской академии наукSiberian State Medical UniversityСибирский государственный медицинский университет0104202410522842981205202315022024Copyright ©; 2024, Eco-VectorCopyright ©; 2024, Эко-Вектор2024Eco-VectorЭко-Векторhttp://creativecommons.org/licenses/by-nc-sa/4.0https://kazanmedjournal.ru/kazanmedj/article/view/303607

Improved survival of children born with low, extremely low and very low body weight in modern conditions due to increased nursing capabilities, optimization of treatment and increased efficiency of resuscitation measures has led to the need for greater understanding of the importance of assessing the cardiovascular system’s state beyond the neonatal period. With approximately 10% of infants worldwide being born preterm, there is an increasing need for further research into optimal regimens, lifestyle and clinical interventions that can benefit and modify cardiovascular morphology and function in this growing population. Modern theoretical postulates on the physiology and pathophysiology of the child’s heart include ideas about the key process of cardiac biomechanics — diastole, during which the earliest disturbances, that precede the formation of systolic dysfunction, occur. Assessment of the pumping properties of the left ventricle in systole and diastole is a fundamental methodological technique for an in-depth understanding of the pathophysiological mechanisms of cardiovascular system’s emerging diseases, their early diagnosis and assessment of the complex therapy’s effectiveness. However, despite the widespread use of standard echocardiography to assess systolic and diastolic function, its traditional parameters have limitations in terms of diagnostic accuracy and effectiveness in practice. Expanding knowledge about new pathogenetic mechanisms of the cardiac dysfunction formation in conditions of prematurity at the current stage of cardiology development using the “trace spot” technology (two-dimensional speckle tracking echocardiography) will be very useful for scientists studying the mechanics formation of the child’s heart after premature birth, and for doctors of various specialties in early diagnosis of heart diseases.

Улучшение выживаемости детей, рождённых с низкой, экстремально низкой и очень низкой массой тела, в современных условиях вследствие повышения возможностей выхаживания, оптимизации лечения и повышения эффективности реанимационных мероприятий привело к необходимости большего понимания важности оценки состояния сердечно-сосудистой системы за пределами неонатального периода. Около 10% детей во всём мире рождаются недоношенными, следовательно, возрастает необходимость дальнейших исследований оптимальных режимов, образа жизни и клинических мероприятий, которые могут благотворно влиять и изменять морфологию и функционирование сердечно-сосудистой системы в этой растущей популяции. К современным теоретическим постулатам по физиологии и патофизиологии детского сердца относятся представления о ключевом процессе биомеханики сердца — диастоле, в ходе которой происходят наиболее ранние нарушения, предшествующие формированию систолической дисфункции. Оценка насосных свойств левого желудочка в систолу и диастолу — основополагающий методологический приём для углублённого понимания патофизиологических механизмов возникающих заболеваний сердечно-сосудистой системы, ранней их диагностики и оценки эффективности комплексной терапии. Однако, несмотря на широкое использование стандартной эхокардиографии для оценки систолической и диастолической функций, её традиционные параметры имеют ограничения в плане точности диагностики и эффективности использования в практике. Расширение знаний о новых патогенетических механизмах формирования дисфункции сердца в условиях недоношенности на современном этапе развития кардиологии при использовании технологии «след пятна» (двухмерной спекл-трекинговой эхокардиографии) будет весьма полезно научным работникам, изучающим вопросы становления механики детского сердца после преждевременных родов, и врачам различных специальностей при ранней диагностике заболеваний сердца.

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