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Современные возможности прогнозирования клинического течения и исхода тромбоэмболии легочной артерии

[Обзоры]
Кочмарева Елена Анатольевна; Кокорин Валентин Александрович; Волкова Анна Леонидовна; Матюшков Никита Сергеевич; Гордеев Иван Геннадьевич;

Стратификация риска летального исхода является одним из ключевых этапов выбора тактики ведения пациентов с ТЭЛА. Рекомендованный Европейским обществом кардиологов (2014) алгоритм стратификации риска обладает рядом недостатков в отношении идентификации пациентов промежуточно-высокого риска летального исхода. В связи с этим актуальным остается поиск новых предикторов неблагоприятного течения ТЭЛА. Данный обзор посвящен наиболее значимым клиническим, лабораторным и инструментальным маркерам неблагоприятного течения ТЭЛА. Приводится описание и разбор предложенных клинических шкал и прогностических моделей. Отдельно обсуждается сердечный белок, связывающий жирные кислоты, как один из перспективных маркеров повреждения миокарда ПЖ у больных ТЭЛА.

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Список литературы:
1. Altinsoy, B. Prognostic value of renal dysfunction indicators in normotensive patients with acute pulmonary embolism / B. Altinsoy, İİ. Öz, T. Örnek [et al.] // Clin. Appl. Thromb. Hemost. – 2016. – Jan. 1. – eP. 1–8. pii:1076029616637440. doi: 10.1177/1076029616637440
2. Ates, H. A novel clinical index for the assessment of RVD in acute pulmonary embolism: Blood pressure index / H. Ates, I. Ates, H. Kundi [et al.] // Am. J. Emerg. Med. – 2017. – Apr. 12. pii: S0735-6757(17)30283-8. doi: 10.1016/j.ajem.2017.04.019
3. Aujesky, D. Outpatient versus inpatient treatment for patients with acute pulmonary embolism: an international, open-label, randomised, non-inferiority trial / D. Aujesky, P. M. Roy, F. Verschuren [et al.] // Lancet. – 2011. – Vol. 378. – P. 41–48. doi: 10.1016/S0140-6736(11)60824-6
4. Bajaj, A. Risk stratification in acute pulmonary embolism with heart-type fatty acid-binding protein: A metaanalysis / A. Bajaj, P. Rathor, V. Sehgal [et al.] // J. Crit. Care – 2015. – Vol. 30 (5). – P. 1151. doi: http://dx.doi. org/10.1016/j.jcrc.2015.05.026
5. Bajaj, A. Prognostic value of biomarkers in acute nonmassive pulmonary embolism: a systematic review and meta-analysis / A. Bajaj, P. Rathor, V. Sehgal [et al.] // Lung. – 2015. – Vol. 193 (5). – P. 639–651. doi: 10.1007/ s00408-015-9752-4
6. Bajaj, A. Prognostic value of troponins in acute nonmassive pulmonary embolism: A meta-analysis / A. Bajaj, M. Saleeb, P. Rathor [et al.] // Heart &Lung. – 2015. – Vol. 44 (4). – P. 327–334. doi: 10.1016/j. hrtlng.2015.03.007
7. Becattini, C. Multidetector computed tomography for acute pulmonary embolism: diagnosis and risk stratification in a single test / C. Becattini, G. Agnelli, M. C. Vedovati [et al.] // Eur. Heart. J. – 2011. – Vol. 32. – P. 1657–1663. doi: 10.1093/eurheartj/ehr108
8. Becattini, C. D-dimer for risk stratification in patients with acute pulmonary embolism / C. Becattini, A. Lignani, L. Masotti [et al.] // J. Thromb. Thrombolysis. – 2012. – Vol. 33 (1). – P. 48–57. doi: 10.1007/s11239-011-0648-8
9. Becattini, C. Prognostic value of troponins in acute pulmonary embolism: a meta-analysis / C. Becattini, M. C. Vedovati, G. Agnelli // Circulation. – 2007. – Vol. 116 (4). – P. 427–433. doi: 10.1161/circulationaha.106.680421
10. Beer, J. H. Outpatient treatment of pulmonary embolism is feasible and safe in a substantial proportion of patients / J. H. Beer, M. Burger, S. Gretener [et al.] // J. Thromb. Haemost. – 2003. – Vol. 1. – P. 186–187. doi: 10.1046/j.1538-7836.2003.00005.x
11. Berghaus, T. M. Renal biomarkers and prognosis in acute pulmonary embolism / T. M. Berghaus, M. Schwaiblmair, W. von Scheidt // Heart. – 2012. – Vol. 98 (16). – P. 1185–1186. doi: 10.1136/heartjnl-2012-302298
12. Casazza, F. Echocardiographic evolution of pulmonary artery pressure after acute pulmonary embolism. Results from IPER registry / F. Casazza, A. Bongarzoni, C. Forgione [et al.] // Thromb. Res. – 2014. – Vol. 134 (6). – P. 1224–1228. doi: 10.1016/j.thromres.2014.09.026
13. Choi, K. J. Prognostic implications of computed tomographic right ventricular dilation in patients with acute pulmonary embolism / K. J. Choi, S. I. Cha, K. M. Shin [et al.] // Thromb. Res. – 2014. – Vol. 133. – P. 182–186. doi: 10.1016/j.thromres.2013.11.020
14. Chow, V. Right atrial to left atrial area ratio on early echocardiography predicts long-term survival after acute pulmonary embolism / V. Chow, A. C. Chwan, T. Chung [et al.] // Cardiovasc. Ultrasound. – 2013. – Vol. 11. – P. 17. doi: 10.1186/1476-7120-11-17
15. Coutance, G. Prognostic value of brain natriuretic peptide in acute pulmonary embolism / G. Coutance, O. Le Page, T. Lo [et al.] // Crit. Care. – 2008. – Vol. 12 (4). – P. 109. doi: 10.1186/cc6996
16. Dahhan, T. Echocardiography in the risk assessment of acute pulmonary embolism / T. Dahhan, F. Alenezi, Z. Samad [et al.] // Semin. Respir. Crit. Care Med. – 2017. – Vol. 38 (1). – P. 18–28. doi: 10.1055/s-0036- 1597563
17. Davies, C. W. H. Early discharge of patients with pulmonary embolism: a two-phase observational study / C. W. H. Davies, J. Wimperis, E. S. Green [et al.] // Eur. Respir. J. – 2007. – Vol. 30. – P. 708–714. doi: 10.1183/09031936.00140506
18. Elias, А. Prognostic models in acute pulmonary embolism: a systematic review and meta-analysis / A. Elias, S. Mallett, M. Daoud-Elias [et al.] // BMJ Open. – 2016. – Vol. 6 (4). – e010324. doi: 10.1136/ bmjopen-2015-010324
19. Gutte, H. ANP, BNP, and D-dimer predict right ventricular dysfunction in patients with acute pulmonary embolism / H. Gutte, J. Mortesen, C. V. Jensen [et al.] // Clin. Physiol. Funct. Imaging. – 2010. – Vol. 30. – P. 466–472.
doi: 10.1111/j.1475-097X.2010.00967.x
20. Jaff, M. R. Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension. A scientific statement from the American Heart Association / M. R. Jaff, M. S. McMurtry, S. L. Archer [et al.] // Circulation. – 2011. – Vol. 123. – P. 1788–1830. doi: http://dx.doi.org/10.1161/CIR.0b013e318214914f
21. Jimenez, D. Prognostic significance of deep vein thrombosis in patients presenting with acute symptomatic pulmonary embolism / D. Jimenez, D. Aujesky, G. Dıaz [et al.] // Am. J. Respir. Crit. Care Med. – 2010. – Vol. 181 (9). – P. 983–991. doi: 10.1164/rccm.200908- 1204OC
22. Jimenez, D. Combinations of prognostic tools for identification of high-risk normotensive patients with acute symptomatic pulmonary embolism / D. Jimenez, D. Aujesky, L. Moores [et al.] // Thorax. – 2011. – Vol. 66 (1). – P. 75–78. doi: 10.1136/thx.2010.150656
23. Jiménez, D. Risk stratification of patients with acute symptomatic pulmonary embolism / D. Jiménez, J. L. Lobo, D. Barrios [et al.] // Intern. Emerg. Med. – 2016. – Vol. 11 (1). – P. 11–18. doi: 10.1007/s11739-015-1388-0
24. Jiménez, D. Prognostic significance of multidetector CT in normotensive patients with pulmonary embolism: results of the protect study / D. Jiménez, J. L. Lobo, M. Monreal [et al.] // Thorax. – 2014. – Vol. 69 (2). – P. 109–115. doi: 10.1136/thoraxjnl-2012-202900
25. Jiménez, D. Troponin-based risk stratification of patients with acute non-massive pulmonary embolism: systematic review and meta-analysis / D. Jiménez, F. Uresandi, R. Otero [et al.] // Chest. – 2009. – Vol. 136 (4). – P. 974–982. doi: 10.1378/chest.09-0608
26. Jo, J. Y. Leukocytes and systemic inflammatory response syndrome as prognostic factors in pulmonary embolism patients / J. Y. Jo, M. Y. Lee, J. W. Lee [et al.] // BMC Pulm. Med. – 2013. – Vol. 13. – P. 74. doi: 10.1186/1471-2466-13-74
27. Kayrak, M. Prognostic value of neutrophil to lymphocyte ratio in patients with acute pulmonary embolism: a retrospective study / M. Kayrak, H. I. Erdoğan, Y. Solak [et al.] // Heart Lung Circ. – 2014. – Vol. 23 (1). – P. 56– 62. doi: 10.1016/j.hlc.2013.06.004
28. Klok, F. A. High D-dimer level is associated with increased 15-d and 3 months mortality through a more central localization of pulmonary emboli and serious comorbidity / F. A. Klok, R. K. Djurabi, M. Nijkeuter [et al.] // Br. J. Haematol. – 2008. – Vol. 140. – P. 218–222. doi: 10.1111/j.1365-2141.2007.06888.x
29. Koć, M. Outcome of patients with right heart thrombi: the Right Heart Thrombi European Registry / M. Koć, M. Kostrubiec, W. Elikowski [et al.] // Eur. Respir. J. – 2016. – Vol. 47. – P. 869–875. doi: 10.1183/13993003.00819- 2015
30. Kohn, C. G. Prognostic accuracy of clinical prediction rules for early post-pulmonary embolism all-cause mortality: a bivariate meta-analysis / C. G. Kohn, E. S. Mearns, M. W. Parker [et al.] // Chest. – 2015. – Vol. 147. – P. 1043–1062. doi: 10.1378/chest.14-1888
31. Konstantinides, S. V. Guidelines on the diagnosis and management of acute pulmonary embolism / S. V. Konstantinides, A. Torbicki, G. Agnelli [et al.] // Eur. Heart J. – 2014. – Vol. 35. – P. 3033–3080. doi: 10.1093/ eurheartj/ehu283
32. Kopecna, D. Interobserver reliability of echocardiography for prognostication of normotensive patients with pulmonary embolism / D. Kopecna, S. Briongos, H. Castillo [et al.] // Cardiovasc. Ultrasound. – 2014. – Vol. 12. – P. 29. doi: 10.1186/1476-7120-12-29
33. Kostrubiec, M. Neutrophil gelatinase-associated lipocalin, cystatin C and eGFR indicate acute kidney injury and predict prognosis of patients with acute pulmonary embolism / M. Kostrubiec, A. Łabyk, L. Pedowska- Włoszek [et al.] // Heart. – 2012. – Vol. 98 (16). – P. 1221–1228. doi: 10.1136/heartjnl-2012-301884
34. Kucher, N. Prognostic role of echocardiography among patients with acute pulmonary embolism and a systolic arterial pressure of 90 mm Hg or higher / N. Kucher, E. Rossi, M. De Rosa [et al.] // Arch. Intern. Med. – 2005. – Vol. 165 (15). – P. 1777–1781. doi: 10.1001/ archinte.165.15.1777
35. Liu, M. Prognostic role of heart-type fatty acid binding protein in pulmonary embolism: a meta-analysis / M. Liu, X. Yuan, X. Qiu [et al.] // Thromb. Res. – 2015. – Vol. 135 (1). – P. 20–25. doi: 10.1016/j. thromres.2014.10.007
36. López-Candales, A. Right ventricular apical contractility in acute pulmonary embolism: the McConnell sign revisited / A. López-Candales, K. Edelman, M. D. Candales // Echocardiography. – 2010. – Vol. 27 (6). – P. 614–620. doi: 10.1111/j.1540-8175.2009.01103.x
37. Moores, L. Pulmonary Embolism Severity Index and troponin testing for the selection of low-risk patients with acute symptomatic pulmonary embolism / L. Moores, D. Aujesky, D. Jimenez [et al.] // J. Thromb. Haemost. – 2010. – Vol. 8. – P. 517–522. doi: 10.1111/j.1538- 7836.2009.03725.x
38. Nakada, K. Relation between pulmonary embolus volume quantified by multi detector computed tomography and clinical status and outcome for patients with acute pulmonary embolism / K. Nakada, T. Okada, H. Osada [et al.] // Jpn. J. Radiol. – 2010. – Vol. 28 (1). – P. 34–42. doi: 10.1007/s11604-009-0380-x
39. Ouatu, A. Chronic kidney disease: Prognostic marker of nonfatal pulmonary thromboembolism / A. Ouatu, D. M. Tãnase, M. Floria [et al.] // Anatol. J. Cardiol. – 2015. – Vol. 15 (11). – P. 938–943. doi: 10.5152/ akd.2014.5739
40. Ruan, L. B. Prognostic value of plasma heart-type fatty acid-binding protein in patients with acute pulmonary embolism: a meta-analysis / L. B. Ruan, L. He, S. Zhao [et al.] // Chest. – 2014. – Vol. 146 (6). – P. 1462–1467. doi: 10.1378/chest.13-1008
41. Rudski, L. G. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography / L. G. Rudski, W. W. Lai, J. Afilalo [et al.] // J. Am. Soc. Echocardiogr.– 2010. – Vol. 23 (7). – P. 685–713. doi: 10.1016/j. echo.2010.05.010
42. Sanchez, O. Echocardiography and pulmonary embolism severity index have independent prognostic roles in pulmonary embolism / O. Sanchez, L. Trinquart, B. Planquette [et al.] // Eur. Respir. J. – 2013. – Vol. 42. – P. 681–688. doi: 10.1183/09031936.00097512
43. Squizzato, A. Prognostic clinical prediction rules to identify a low-risk pulmonary embolism: a systematic review and meta-analysis / A. Squizzato, M. P. Donadini, L. Galli [et al.] // J. Thromb. Haemost. – 2012. – Vol. 10. – P. 1276–1290. doi: 10.1111/j.1538-7836.2012.04739.x
44. Turedi, S. Investigation of the relationship between D-dimer and ischemia-modified albumin levels with the radiological imaging-based pulmonary embolism severity score in acute pulmonary embolism / S. Turedi, S. C. Karahan, A. Mentese [et al.] // Anadolu Kardiyol. Derg. – 2010. – Vol. 10 (4). – P. 346–352. doi: 10.5152/ akd.2010.094
45. Zhou, X. Y. The prognostic value of pulmonary embolism severity index in acute pulmonary embolism: a meta-analysis / X. Y. Zhou, S. Q. Ben, H. L. Chen [et al.] // Respir. Res. – 2012. – Vol. 13. – P. 111. doi: 10.1186/1465-9921-13-111
46. Zondag, W. Hestia criteria can safely select patients with pulmonary embolism for outpatient treatment irrespective of right ventricular function / W. Zondag, L. M. A. Vingerhoets, M. F. Durian [et al.] // J. Thromb. Haemost. – 2013. – Vol. 11. – P. 686–692. doi: 10.1111/jth.12146

Ключевые слова: тромбоэмболия легочной артерии, стратификация риска, предикторные модели, сердечные тропонины, мозговой натрийуретический пептид, сердечный белок, связывающий жирные кислоты,Д-димер


Учредители:
Ставропольская государственная медицинская академия
Государственный научно-исследовательский институт курортологии
Пятигорская государственная фармацевтическая академия