Кардионеврология и нейрокардиология — две стороны одной проблемы

Актуальность. Сердечно-сосудистые и цереброваскулярные заболевания остаются ведущими причинами инвалидизации и смертности. В последние годы накапливаются убедительные данные о тесной двусторонней связи между сердцем и головным мозгом, опосредованной вегетативными, нейрогуморальными и воспалительными механизмами. Эта взаимосвязь рассматривается в рамках концепций кардионеврологии и нейрокардиологии.
Цель. На основе современных научных представлений о новом междисциплинарном взаимодополняющем направлении медицинской науки — кардионеврология/нейрокардиология — познакомить читателя с основными нозологическими единицами, ответственными за формирование патологической двунаправленной оси головной мозг–сердце и продемонстрировать актуальность междисциплинарного подхода к изучению этой сочетанной патологии.
Методы. Проведён нарративный обзор публикаций в базах PubMed, Scopus и eLIBRARY преимущественно за последние 20 лет, посвящённых патофизиологическим и клиническим аспектам кардионеврологических и нейрокардиологических взаимодействий.
Результаты. В первой части обзора рассмотрены инсульт-опосредованные патологические нарушения функциональной активности сердца (изменения ЭКГ, аритмии, инфаркт миокарда, сердечная недостаточность, неврологическая внезапная смерть и синдром Такоцубо), во второй — кардиальные факторы риска, инициирующие нарушение мозгового кровообращения (фибрилляция предсердий, артериальная гипертензия, хроническая сердечная недостаточность, ишемическая болезнь сердца и кардиомиопатии, в том числе алкогольная).
Заключение. Интеграция знаний о двусторонней оси «мозг–сердце» открывает новые возможности для разработки комплексных терапевтических подходов, направленных на одновременную защиту обоих органов. Дальнейшие исследования должны быть сфокусированы на выявлении специфических биомаркеров и мишеней для персонализированной терапии.

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