Гипертиреозы и фибрилляция предсердий: клубок междисциплинарных проблем на фоне пандемии COVID-19


DOI: https://dx.doi.org/10.18565/therapy.2022.8.95-106

Л.А. Руяткина, Д.С. Руяткин

ФГБОУ ВО «Новосибирский государственный медицинский университет» Минздрава России
Аннотация. Варианты гипертиреоза, как эндогенного (болезнь Грейвса, деструктивные тирео­идиты, функциональная автономия щитовидной железы), так и экзогенного (в результате супрессивной или чрезмерной заместительной терапии левотироксином натрия), даже при субклинической его форме нередко сочетаются с фибрилляцией предсердий (ФП) вследствие участия тиреоидных гормонов в электрофизиологии сердца. Взаимосвязи гипертиреоза и ФП лежат в основе различных клинических ситуаций, встречаемость и ургентность которых увеличивается в условиях пандемии COVID-19. В статье освещены возможные механизмы ассоциации гипертиреозов и COVID-19. Рассматриваются факторы риска и последствия ФП на фоне гипертиреоза, роль его ранней диагностики в прогнозе ФП. Обобщены основные принципы терапии явного гипертиреоза с учетом сердечно-сосудистого статуса, включая амиодарон-индуцированный тиреотоксикоз. Также анализируется дискуссия о целесообразности лечения субклинического гипертиреоза в зависимости от его степени, возраста пациента и наличия коморбидной патологии.

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Об авторах / Для корреспонденции


Людмила Александровна Руяткина, д.м.н., профессор, профессор кафедры неотложной терапии с эндокринологией и профпатологией факультета повышения квалификации и профессиональной переподготовки врачей ФГБОУ ВО «Новосибирский государственный медицинский университет» Минздрава России. Адрес: 630091,
г. Новосибирск, ул. Красный проспект, д. 52. E-mail: larut@list.ru
Дмитрий Сергеевич Руяткин, к.м.н., доцент, доцент кафедры неотложной терапии с эндокринологией и профпатологией факультета повышения квалификации и профессиональной переподготовки врачей ФГБОУ ВО «Новосибирский государственный медицинский университет» Минздрава России. Адрес: 630091, г. Новосибирск, ул. Красный проспект, д. 52. E-mail: dr79@mail.ru


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