СОЗЫЛМАЛЫ ЖҮРЕК ЖЕТКІЛІКСІЗДІГІ ЕКІ ҚАРЫНШАЛЫҚ СТИМУЛЯЦИЯНЫҢ ОРЫНЫ: ӘДЕБИЕТТІК ШОЛУ
Кіріспе: Созылмалы жүрек жеткіліксіздігі (СЖЖ) - заманауи кардиологияның аса маңызды мәселелерінің бірі. Оның еміндегі нәтижелі әдіс, жүрекше-қарыншалық стимуляциямен жүзеге асырылатын – жүректік ресинхронды терапия (ЖРТ).
Зерттеу мақсаты: Миокард диссинхрониясының, СЖЖ-мен науқастардың клиникалық жағдайына әсері, оны анықтау әдістері, рефрактерлі ағымды СЖЖ-мен науқастар еміндегі ЖРТ-ң нәтижелілігі және қауіпсіздігі жөніндегі әдеби ақпараттарды талдау.
Зерттеудің материалдары мен әдістері: Іздеу стратегиясы: PubMed, Scopus, Web of Science, Google Scholar жүйелеріндегі, ЕLIBRARY.ru, СyberLeninka электронды ғылыми кітапханаларында жарияланған – ғылыми мақалалар. Іздеу ауқымы 17 жыл (2001 - 2018). Қосу критерийлері: созылмалы жүрек жетіспеушілігі, миокард диссинхрониясы, екі қарыншалы стимуляция, Гисс шоғырының сол аяқшасының блокадасы кілтті сөздерін қолданумен, науқастардың үлкен популяциясында жүргізілген проспективті зерттеулер қорытындысы, мета - анализдер жəне əдеби шолулар нәтижесі. Іздеу барысында, рефрактерлі ағымды СЖЖ-мен науқастар еміндегі ЖРТ-ң нәтижелілігі және қауіпсіздігі, миокард диссинхрониясының туындау механизмі және оның СЖЖ ағымына әсері, оны анықтау әдістері, қарыншаішілік диссинхрония кезіндегі ЖРТ-ң электрофизиологиялық негіздері, сол қарыншалық электродты орналастыру әдістері жөніндегі ақпараттар қарастырылып, талданды.
Зерттеу нәтижесі: ЖРТ-ны қолдану, сол қарыншаның (СҚ) айқын систолалық дисфункциясымен және қарыншааралық немесе қарыншаішілік миокард диссинхрониясы бар СЖЖ-мен науқастарда клиникалық белгілердің, ауруханаға жату жиілігінің және өлімділіктің азаюына, өмір сапасының жақсаруына алып келді. Рефрактерлі СЖЖ-мен науқастар емінде ЖРТ қолданудың айқын артықшылықтарына қарамастан, бұл емдеу әдісінің клиникалық нәтижелілігін бағалауда, әртүрлі клиникалық зерттеулердің қорытындыларында қарама-ұайшылыұтар кездеседі. Әртүрлі ақпараттар көзіне сәйкес нонреспондерлер 20-30% құрайтыны анықталған.
Қорытынды: ЖРТ жүзеге асыру үшін, қарапайым әдістермен науқастарды дұрыс таңдаудың тәжірибелік маңызы зор. Ол, көптеген емдеу мекемелеріне және мамандар үшін қол жетімді әдістер. ЖРТ-дан кейін ЭХоКГ көмегімен, науқастардың көпшілігінде, миокардтың кері модельденуі – аластау фракциясының жоғарылауы және жүрек камераларының кішіреюі байқалады. ЖРТ-ға оң жауаптың болмауының себептері: науқастарды таңдау талаптарының жетілдірілмеуі, миокардтың фиброзды зақымдалуының көлемділілігі, құрылғы бағдарламасының дұрыс таңдалмауы, қарыншалық электродтардың дұрыс орналастырылмауы және нағыз екі қарыншалы стимуляцияның пайыздық көрсеткішінің төмендігі.
Ерсын Т.Сабитов 1, https://orcid.org/0000-0003-0937-5813
Алтай А. Дюсупов 1, http://orcid.org/0000-0003-0875-1020
Аян С. Абдрахманов 2,
Андрей Ю. Орехов 1, https://orcid.org/0000-0001-7201-1399
1 КеАҚ «Семей медицина университеті», Семей қ., Қазақстан Республикасы
2 «Ұлттық ғылыми кардиохирургия орталығы» АҚ, Астана қ., Қазақстан Республикасы
1. Барт Б.Я., Ларина В.Н. Блокада левой ножки пучка Гиса при хронической сердечной недостаточности: клинико-прогностическая значимость // Российский кардиологический журнал. 2009. Т. 80, № 6. С. 56–61.
2. Кузнецов В.А., Чуркевич (Виноградова) Т.О., Колунин Г.В. Отдаленные результаты влияния сердечной ресинхронизирующей терапии на выживаемость пациентов с хронической сердечной недостаточностью и низкой фракцией выброса левого желудочка // Сердечная недостаточность. 2010. Т. 60, № 4. С. 203–205.
3. Курбанов Р.Д., Амиркулов Б.Д., Абдуллаев Т.А., Амиркулов Р.Д. Бивентрикулярная стимуляция: текущие тенденции и будущие стратегии // Международный журнал сердца и сосудистых заболеваний. 2015. №7 Т.3. С. 9-21.
4. Мареев В.Ю., Фомин И.В., Агеев Ф.Т., Арутюнов Г.П., Беграмбекова Ю.Л., Беленков Ю.Н. и др. Клинические рекомендации. Хроническая сердечная недостаточность (ХСН) // Сердечная Недостаточность. 2017. №1. Т.18. С. 3–40
5. Abraham W.T., Fisher W.G., Smith A.L., Delurgio D.B., Leon A.R., Loh E., Kocovic D.Z., Packer M., Clavell A.L., Hayes D.L., Ellestad M., Trupp R.J., Underwood J., Pickering F., Truex C., McAtee P., Messenger J. Cardiac resynchronization in chronic heart failure // The New England Journal of Medicine. 2002. Vol. 46. Р.1845–1853.
6. Abraham W.T., Young J.B., Leon A.R., et al. Effects of cardiac resynchronization on disease progression in patients with left ventricular systolic dysfunction, an indication for an implantable cardioverter-defibrillator, and mildly symptomatic chronic heart failure // Circulation. 2004. Vol. 110. Р.2864–2868.
7. Anand I.S., Carson P., Galle E., et al. Cardiac resynchronization therapy reduces the risk of hospitalizations in patients with advanced heart failure: Results from the Comparison of Medical Therapy, Pacing and Defibrillation in Heart Failure (COMPANION) trial // Circulation. 2009. Vol. 119. Р. 969–977.
8. Auricchio A., Fantoni C., Regoli F., et al. Characterization of left ventricular activation in patients with heart failure and left bundle-branch block // Circulation. 2004. Vol. 109. Р.1133–1139.
9. Bax J.J., Bleeker G.B., Marwick T.H., et al. Left ventricular dyssynchrony predicts response and prognosis after cardiac resynchronization therapy // Journal of the American College of Cardiology. 2004. 44. Р. 1834–1840.
10. Bax J.J., Ansalone G., Breithardt O.A., et al. Echocardiographic evaluation of cardiac resynchronization therapy: ready for routine clinical use? A critical appraisal // Journal of the American College of Cardiology. 2004. 44 Р.1–9.
11. Bilchick K.C., Dimaano V., Wu K.C., et al. Cardiac magnetic resonance assessment of dyssynchrony and myocardial scar predicts function class improvement following cardiac resynchronization therapy // Journal of the American College of Cardiology. 2008. Vol. 1. Р.561–568.
12. Birnie D., Hudnall H., Lemke B., Aonuma K., Lee K.L., Gasparini M., Gorcsan J., Cerkvenik J., Martin D.O. Continuous optimization of cardiac resynchronization therapy reduces atrial fibrillation in heart failure patients: Results of the Adaptive Cardiac Resynchronization Therapy Tria // Heart Rhythm. 2017. Vol. 14(12). Р.1820-1825.
13. Bradley D.J., Bradley E.A., Baughman K.L., Berger R.D., Calkins H., Goodman S.N., Kass D.A., Powe N.R. Cardiac resynchronization and death from progressive heart failure: a meta-analysis of randomized controlled trials // The Journal of the American Medical Association. 2003. Vol. 89. Р. 730–740.
14. Bristow M.R., Saxon L.A., Boehmer J., et al. Comparison of Medical Therapy P, Defibrillation in Heart Failure I. Cardiacresynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure // The New England Journal of Medicine. 2004. Vol. 350. Р. 2140–2150.
15. Brugada J., Delnoy P.P., Brachmann J., Reynolds D., Padeletti L., Noelker G., Kantipudi C., Rubin Lopez J.M., Dichtl W., Borri-Brunetto A., Verhees L., Ritter P., Singh J.P. Contractility sensor-guided optimization of cardiac resynchronization therapy: results from the RESPOND-CRT trial // European Heart Journal. 2017. Vol. 38(10). Р.730-738.
16. Cazeau S., Leclercq C., Lavergne T., et al. Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay // The New England Journal of Medicine. 2001. Vol. 344. Р.873–880.
17. Chung E.S., Leon A.R., Tavazzi L., et al. Results of the Predictors of Response to CRT (PROSPECT) trial // Circulation. 2008. Vol. 117. Р.2608–2616.
18. Cleland J.G., Daubert J.C., Erdmann E., et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure // The New England Journal of Medicine. 2005. Vol. 352 Р.1539–1549.
19. Cleland J.G., Daubert J.C., Erdmann E., et al. Longer-term effects of cardiac resynchronization therapy on mortality in heart failure [the CArdiac REsynchronization-Heart Failure (CARE-HF) trial extension phase] // European Heart Journal. 2006. Vol. 27. Р.1928–1932.
20. Damy T., Ghio S., Rigby A.S., Hittinger L., Jacobs S., Leyva F., Delgado J.F., Daubert J.C., Gras D., Tavazzi L., Cleland J.G. Interplay between right ventricular function and cardiac resynchronization therapy: an analysis of the CARE-HF trial (Cardiac Resynchronization-Heart Failure) // Journal of the American College of Cardiology. 2013. Vol. 61(21). Р. 2153-2160.
21. Dıaz-Infante E., Sitges M., Vidal B., et al. Usefulness of ventricular dyssynchrony measured using M-mode echocardiography to predict response to resynchronization therapy // American Journal of Cardiology. 2007. Vol. 100. Р. 84–89.
22. Duncan A.M., Francis D.P., Gibson D.G., et al. Differentiation of ischemic from nonischemic cardiomyopathy during dobutamine stress by left ventricular long-axis function: Additional effect of left bundle-branch block // Circulation. 2003. Vol. 108 Р.1214–1220.
23. Duncan A.M., O’Sullivan C.A., Carr-White G.S., et al. Long axis electromechanics during dobutamine stress in patients with coronary artery disease and left ventricular dysfunction // Heart. 2001. Vol. 86. Р.397–404.
24. Duncan A.M., Lim E., Clague J., et al. Comparison of segmental and global markers of dyssynchrony in predicting clinical response to cardiac resynchronization // European Heart Journal. 2006. Vol. 27. Р.2426–2432.
25. Duncan A., Francis D., Gibson D., et al. Electromechanical left ventricular resynchronisation by coronary artery bypass surgery // European Journal of Cardio-Thoracic Surgery. 2004. Vol. 26. Р.711–719.
26. Egoavil C.A., Ho R.T., Greenspon A.J., Pavri B.B. Cardiac resynchronization therapy in patients with right bundle branch block: analysis of pooled data from the MIRACLE and Contak CD trials // Heart Rhythm. 2005. Vol. 2. Р. 611–615.
27. Ellims A.H., Pfluger H., Elsik M., et al. Utility of cardiac magnetic resonance imaging, echocardiography and electrocardiography for the prediction of clinical response and long-term survival following cardiac resynchronization therapy // The International Journal of Cardiovascular Imaging. 2013. Vol. 29. Р.1303–1311.
28. Ghio S., Constantin C., Klersy C., et al. Interventricular and intraventricular dyssynchrony are common in heart failure patients, regardless of QRS duration // European Heart Journal. 2004. Vol. 25. Р.571–578.
29. Gold M.R., Birgersdotter-Green U., Singh J.P., et al. The relationship between ventricular electrical delay and left ventricular remodelling with cardiac resynchronization therapy // European Heart Journal. 2011. Vol. 32. Р. 2516–2524.
30. Goldberger J.J., Buxton A.E., Cain M. et al. Risk stratification for arrhythmic sudden cardiac death: identifying the roadblocks // Circulation. 2011. Vol. 123. P. 2423–2430.
31. Götze S., Butter C., Fleck E. Cardiac resynchronization therapy for heart failure - from experimental pacing to evidence-based therapy // Clinical Research in Cardiology. 2006. Vol. 95 Suppl 4. Р.18-33.
32. Henein M.Y., Priestley K., Davarashvili T., et al. Early changes in left ventricular subendocardial function after successful coronary angioplasty // British Heart Journal. 1993. Vol. 69. Р.501–506.
33. Henein M.Y., Gibson D.G. Suppression of left ventricular early diastolic filling by long axis asynchrony // British Heart Journal. 1995. Vol. 73. Р.151–157.
34. Heist E.K., Taub C., Fan D., et al. Usefulness of a novel ‘response score’ to predict hemodynamic and clinical outcome from cardiac resynchronization therapy // American Journal of Cardiology. 2006. Vol. 97. Р.1732–1736.
35. Hsu J.C., Solomon S.D., Bourgoun M., et al. Predictors of super-response to cardiac resynchronization therapy and associated improvement in clinical outcome: The MADITCRT (multicenter automatic defibrillator implantation trial with cardiac resynchronization therapy) study // American Journal of Cardiology. 2012. 59. Р.2366–2373.
36. Issa Z.F., Miller J.M., Zipes D.P. Clinical arrhythmology and electrophysiology: a companion to Braunwald’s heart disease // Elsevier Inc. 2012. 726 p.
37. Jeevanantham V., Daubert J.P., Zareba W. Cardiac resynchronization therapy in heart failure patients: an update // Cardiology Journal. 2009. 1 Vol. 6(3). Р.197-209.
38. Kalscheur M.M., Kipp R.T., Tattersall M.C., Mei C., Buhr K.A., DeMets D.L., Field M.E., Eckhardt L.L., Page C.D. Machine Learning Algorithm Predicts Cardiac Resynchronization Therapy Outcomes: Lessons From the COMPANION Trial // Circulation: Arrhythmia and Electrophysiology. 2018. Vol. 11(1). e005499.
39. Koos R., Neizel M., Schummers G., et al. Feasibility and initial experience of assessment of mechanical dyssynchrony using cardiovascular magnetic resonance and semi-automatic border detection // Journal of Cardiovascular Magnetic Resonance. 2008. Vol. 10. Р.49.
40. Koç M., Kaypakli O., Gözübüyük G., Yıldıray Şahin D. Coronary sinus lead delay index for optimization of coronary sinus lead placement // Annals of Noninvasive Electrocardiology. 2018. Vol. 23(1). P 74-79
41. Kron J., Aranda J.M. Jr., Miles W.M., Burkart T.A., Woo G.W., Saxonhouse S.J., Sears S.F. Jr., Conti J.B. Benefit of cardiac resynchronization in elderly patients: results from the Multicenter InSyncRandomized Clinical Evaluation (MIRACLE) and Multicenter InSync ICD Randomized ClinicalEvaluation (MIRACLE-ICD) trials // Journal of Interventional Cardiac Electrophysiology. 2009. Vol. 25(2). Р.91-96.
42. Lamia B., Tanabe M., Kim H.K., et al. Quantifying the role of regional dyssynchrony on global left ventricular performance // Journal of the American College of Cardiology. 2009. Vol. 2. Р.1350–1356.
43. Lecoq G., Leclercq C., Leray E., et al. Clinical and electrocardiographic predictors of a positive response to cardiac resynchronization therapy in advanced heart failure // European Heart Journal. 2005. Vol. 26. Р.1094–1100.
44. Leclercq C., Gadler F., Kranig W., Ellery S., Gras D., Lazarus A., Clémenty J., Boulogne E., Daubert J.C. TRIP-HF (Triple Resynchronization In Paced Heart Failure Patients) Study Group. A randomized comparison of triple-site versus dual-site ventricular stimulation in patients with congestive heart failure // Journal of the American College of Cardiology. 2008. Vol. 51(15). Р. 1455-1462.
45. Lin J., Buhr K.A., Kipp R. Effect of PR Interval on Outcomes Following Cardiac Resynchronization Therapy: A Secondary Analysis of the COMPANION Trial // J Journal of Cardiovascular Electrophysiology. 2017. Vol. 28(2). Р.185-191.
46. Linde C., Curtis A.B., Fonarow G.C., Lee K., Little W., Tang A., Levya F., Momomura S., Manrodt C., Bergemann T. Cardiac resynchronization therapy in chronic heart failure with moderately reduced left ventricular ejection fraction: Lessons from the Multicenter InSync Randomized ClinicalEvaluation MIRACLE EF study // International Journal of Cardiology. 2016. Vol. 202. Р.349-355.
47. Linde C., Abraham W.T., Gold M.R., Daubert J.C., Tang A.S., Young J.B., Sherfesee L, Hudnall JH., Fagan DH., Cleland J.G. Predictors of short-term clinical response to cardiac resynchronization therapy // European Journal of Heart Failure. 2017. Vol. 19(8). Р.1056-1063.
48. Lozano I., Bocchiardo M., Achtelik M., et al. Impact of biventricular pacing on mortality in a randomized crossover study of patients with heart failure and ventricular arrhythmias // Pacing and Clinical Electrophysiology. 2000. Vol. 23. Р.1711–1722.
49. Lopez-Andrès N., Rossignol P., Iraqi W., Fay R., Nuée J., Ghio S., Cleland J.G., Zannad F., Lacolley P. Association of galectin-3 and fibrosis markers with long-term cardiovascular outcomes in patients with heart failure, left ventricular dysfunction, and dyssynchrony: insights from the CARE-HF (Cardiac Resynchronization in Heart Failure) trial // European Journal of Heart Failure. 2012. 1 Vol. 4(1). Р.74-81.
50. Marcus G.M., Rose E., Viloria E.M., et al. Septal to posterior wall motion delay fails to predict reverse remodeling or clinical improvement in patients undergoing cardiac resynchronization therapy // Journal of the American College of Cardiology. 2005. Vol. 46. Р. 2208–2214.
51. Marsan N.A., Bleeker G.B., Ypenburg C., et al. Real-time three-dimensional echocardiography permits quantification of left ventricular mechanical dyssynchrony and predicts acute response to cardiac resynchronization therapy // Journal of Cardiovascular Electrophysiology. 2008. Vol. 19. Р.392–399.
52. Miyazaki C., Redfield M.M., Powell B.D., et al. Dyssynchrony indices to predict response to cardiac resynchronization therapy: A comprehensive prospective single-center study // Circulation: Heart Failure. 2010. Vol. 3. P. 565–573.
53. Mischi M., Kaklidou F., Houthuizen P., et al. Three-dimensional quantification of regional left ventricular dyssynchrony by magnetic resonance imaging. Conf Proc IEEE // Engineering in Medicine and Biology Society. 2011. Р.2646–2649.
54. Morgan J.M., Biffi M., Gellér L., Leclercq C., Ruffa F., Tung S., Defaye P., Yang Z., Gerritse B., van Ginneken M., Yee R., Jais P. ALternate Site Cardiac ResYNChronization (ALSYNC): a prospective and multicentre study of left ventricular endocardial pacing for cardiac resynchronization therapy // European Heart Journal. 2016. Vol. 37(27). Р.2118-2127.
55. Oddone D., Solari D., Nangah R., Arena G., Mureddu R., Giorgi D., Sitta N., Bottoni N. Optimization of coronary sinus lead placement targeted to the longest right-to-left delay in patients undergoing cardiac resynchronization therapy: The Optimal Pacing SITE 2 (OPSITE 2) acute study and protocol // Pacing and Clinical Electrophysiology. 2017. Vol. 40(12). Р.1350-1357
56. O’Mara J.E., Fruechte E.M., Palac R.T., et al. Regional patterns of dyssynchrony: Lateral wall delay is desirable but not essential for left ventricular remodeling in biventricular pacing // Echocardiography. 2012. Vol. 29. P. 554–559.
57. Petryka J., Misko J., Przybylski A., et al. Magnetic resonance imaging assessment of intraventricular dyssynchrony and delayed enhancement as predictors of response to cardiac resynchronization therapy in patients with heart failure of ischaemic and non-ischaemic etiologies // European Journal of Radiology. 2012. Vol 34. Р. 2639–2647.
58. Pitzalis M.V., Iacoviello M., Romito R. Cardiac resynchronization therapy tailored by echocardiographic evaluation of ventricular asynchrony // Journal of the American College of Cardiology. 2002. Vol. 40. Р.1615–1622.
59. Pitzalis M.V., Iacoviello M., Romito R. Ventricular asynchrony predicts a better outcome in patients with chronic heart failure receiving cardiac resynchronization therapy // Journal of the American College of Cardiology. 2005. Vol. 45. Р.65–69.
60. Prinz C., Lehmann R., Schwarz M. Left ventricular dyssynchrony predicts clinical response to CRT - a longterm follow-up single-center prospective observational cohort study // Echocardiography. 2013. Vol. 30. Р.896–903.
61. Rivero-Ayerza M., Theuns D.A., Garcia-Garcia H.M., Bersma E., Simoons M., Jordaens L.J. Effects of cardiac resynchronization therapy on overall mortality and mode of death: a meta-analysis of randomized controlled trials // European Heart Journal. 2006. Vol. 27. Р.2682–2688
62. Roger V.L. Epidemiology of heart failure. // Circulation Research. 2013. Vol. 113 Р. 646–659.
63. Russo C., Jaubert M.P., Jin Z., et al. Intra- and interobserver reproducibility of left ventricular mechanical dyssynchrony assessment by real time three-dimensional echocardiography // Echocardiography. 2012. Vol. 29. Р.598–607.
64. Santangeli .P, Di Biase L., Pelargonio G., Dello Russo A., Casella M., Bartoletti S, Burkhardt J.D., Mohanty P., Santarelli P., Natale A. Cardiac resynchronization therapy in patients with mild heart failure: a systematic review and meta-analys // Journal of Interventional Cardiac Electrophysiology. Vol. 2011. 32(2). Р.125-135.
65. Smiseth O.A., Russell K., Skulstad H. The role of echocardiography in quantification of left ventricular dyssynchrony: State of the art and future directions // European Heart Journal. 2012. Vol. 13 Р.61–68.
66. Sorrell V.L., Ross W.D., Gregoire J., et al. Color M-mode echocardiography is more reproducible than conventional M-mode echocardiography for septal-to-posterior wall motion delay measurements // Echocardiography. 2008. Vol. 25. Р.821–826.
67. Spencer J.H., Larson A.A., Drake R., Iaizzo P.A. A detailed assessment of the human coronary venous system using contrast computed tomography of perfusion-fixed specimens // Heart Rhythm. 2014. Vol. 11(2). Р. 282-288.
68. Tamborero D., Vidal B., Tolosana J.M., et al. Electrocardiographic versus echocardiographic optimization of the interventricular pacing delay in patients undergoing cardiac resynchronization therapy // Journal of Cardiovascular Electrophysiology. 2011. Vol. 22. Р.1129–1134.
69. Tanabe M., Lamia B., Tanaka H., et al. Echocardiographic speckle tracking radial strain imaging to assess ventricular dyssynchrony in a pacing model of resynchronization therapy // Journal of the American Society of Echocardiography. 2008. Vol. 21. P. 1382–1388.
70. Tang A.S., Wells G.A., Talajic M., et al. Cardiac-resynchronization therapy for mild-to-moderate heart failure // The New England Journal of Medicine. 2010. Vol. 363. Р.2385–2395.
71. Tatsumi K., Tanaka H., Tsuji T., et al. Strain dyssynchrony index determined by three-dimensional speckle area tracking can predict response to cardiac resynchronization therapy // Cardiovascular Ultrasound. 2011. Vol. 1. P. 9-11.
72. Thebault C., Donal E., Bernard A., et al. Real-time threedimensional speckle tracking echocardiography: A novel technique to quantify global left ventricular mechanical dyssynchrony // European Journal of Echocardiography. 2011. Vol. 12. Р. 26–32.
73. Wokhlu A., Rea R.F., Asirvatham S.J., et al. Upgrade and de novo cardiac resynchronization therapy: impact of paced or intrinsic QRS morphology on outcomes and survival // Heart Rhythm. 2009. Vol. 6. Р.1439–1447.
74. Yu C.M., Fung J.W., Zhang Q., et al. Tissue Doppler imaging is superior to strain rate imaging and postsystolic shortening on the prediction of reverse remodeling in both ischemic and nonischemic heart failure after cardiac resynchronization therapy // Circulation. 2004. Vol. 110. Р. 66–73.
75. Yu C.M., Gorcsan J., Bleeker G.B., et al. Usefulness of tissue Doppler velocity and strain dyssynchrony for predicting left ventricular reverse remodeling response after cardiac resynchronization therapy // American Journal of Cardiology. 2007. Vol. 100. Р.1263–1270.
76. Yu C.M., Chan Y.S., Zhang Q., et al. Benefits of cardiac resynchronization therapy for heart failure patients with narrow QRS complexes and coexisting systolic asynchrony by echocardiography // Journal of the American College of Cardiology. 2006. Vol. 48. Р.2251–2257.
77. Zareba W., Klein H., Cygankiewicz I., et al. Effectiveness of cardiac resynchronization therapy by QRS morphology in the Multicenter Automatic Defibrillator Implantation Trial- Cardiac Resynchronization Therapy (MADIT-CRT) // Circulation. 2011. Vol. 123. Р.1061–1072.
78. Reddy V.Y., Miller M.A., Neuzil P., Søgaard P., Butter C., Seifert M., Delnoy P.P., van Erven L., Schalji M., Riahi S. Cardiac Resynchronization Therapy With Wireless Left Ventricular Endocardial Pacing: The SEL ECT-LV Study // J Am Coll Cardiol. 2017. Vol. 69(17). Р.2119-2129.
Rеfеrеncеs:
1. Bart B.Ya., Larina V.N. Blokada levoi nozhki puchka Gisa pri khronicheskoi serdechnoi nedostatochnosti: kliniko-prognosticheskaya znachimost' [Left bundle branch block in chronic heart failure]. Rossiiskii kardiologicheskii zhurnal [Russian Journal of Cardiology]. 2009. Vol. 80, № 6. pp. 56–61. [in Russian]
2. Kuznetsov V.A., Churkevich (Vinogradova) T.O., Kolunin G.V. Otdalennye rezul'taty vliyaniya serdechnoi resinkhroniziruyushchei terapii na vyzhivaemost' patsientov s khronicheskoi serdechnoi nedostatochnost'yu i nizkoi fraktsiei vybrosa levogo zheludochka [Long-term results of the effect of cardiac resynchronization therapy on the survival of patients with chronic heart failure and low left ventricular ejection fraction]. Serdechnaya nedostatochnost' [Russian Heart Failure Journal]. 2010. Vol. 60, №4. pp. 203–205. [in Russian]
3. Kurbanov R.D., Amirkulov B.D., Abdullaev T.A., Amirkulov R.D. Biventrikulyarnaya stimulyatsiya: tekushchie tendentsii i budushchie strategii [Biventricular pacing: current trends and future strategies]. Mezhdunarodnyi zhurnal serdtsa i sosudistykh zabolevanii [International Heart and Vascular Disease Journal]. 2015. Vol. 3, № 7. pp. 9-21. [in Russian]
4. Mareev V.Yu., Fomin I.V., Ageev F.T., Arutyunov G.P., Begrambekova Yu. L., Belenkov Yu.N. i dr. Klinicheskie rekomendatsii. Khronicheskaya serdechnaya nedostatochnost' (KhSN) [Clinical guidelines. Chronic heart failure (CHF)] Zhurnal Serdechnaya Nedostatochnost' [Russian Heart Failure Journal]. 2017. Vol 18. №1. pp. 3–40. [in Russian]
5. Abraham W.T., Fisher W.G., Smith A.L., Delurgio D.B., Leon A.R., Loh E., Kocovic D.Z., Packer M., Clavell A.L., Hayes D.L., Ellestad M., Trupp R.J., Underwood J., Pickering F., Truex C., McAtee P., Messenger J. Cardiac resynchronization in chronic heart failure. The New England Journal of Medicine. 2002. Vol. 46. Р.1845–1853.
6. Abraham W.T., Young J.B., Leon A.R., et al. Effects of cardiac resynchronization on disease progression in patients with left ventricular systolic dysfunction, an indication for an implantable cardioverter-defibrillator, and mildly symptomatic chronic heart failure. Circulation. 2004. Vol. 110. Р.2864–2868.
7. Anand I.S., Carson P., Galle E., et al: Cardiac resynchronization therapy reduces the risk of hospitalizations in patients with advanced heart failure: Results from the Comparison of Medical Therapy, Pacing and Defibrillation in Heart Failure (COMPANION) trial. Circulation. 2009. Vol. 119. Р. 969–977.
8. Auricchio A., Fantoni C., Regoli F., et al. Characterization of left ventricular activation in patients with heart failure and left bundle-branch block. Circulation. 2004. Vol. 109. Р.1133–1139.
9. Bax J.J., Bleeker G.B., Marwick T.H., et al: Left ventricular dyssynchrony predicts response and prognosis after cardiac resynchronization therapy. Journal of the American College of Cardiology. 2004. 44. Р. 1834–1840.
10. Bax J.J., Ansalone G., Breithardt O.A., et al. Echocardiographic evaluation of cardiac resynchronization therapy: ready for routine clinical use? A critical appraisal. Journal of the American College of Cardiology. 2004. 44 Р.1–9.
11. Bilchick K.C., Dimaano V., Wu K.C., et al. Cardiac magnetic resonance assessment of dyssynchrony and myocardial scar predicts function class improvement following cardiac resynchronization therapy. Journal of the American College of Cardiology. 2008. Vol. 1. Р.561–568.
12. Birnie D., Hudnall H., Lemke B., Aonuma K., Lee K.L., Gasparini M., Gorcsan J., Cerkvenik J., Martin D.O. Continuous optimization of cardiac resynchronization therapy reduces atrial fibrillation in heart failure patients: Results of the Adaptive Cardiac Resynchronization Therapy Tria. Heart Rhythm. 2017. Vol. 14(12). Р.1820-1825.
13. Bradley D.J., Bradley E.A., Baughman K.L., Berger R.D., Calkins H., Goodman S.N., Kass D.A., Powe N.R. Cardiac resynchronization and death from progressive heart failure: a meta-analysis of randomized controlled trials. The Journal of the American Medical Association. 2003. Vol. 89. Р. 730–740.
14. Bristow M.R., Saxon L.A., Boehmer J., et al. Comparison of Medical Therapy P, Defibrillation in Heart Failure I. Cardiacresynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. The New England Journal of Medicine. 2004. Vol. 350. Р. 2140–2150.
15. Brugada J., Delnoy P.P., Brachmann J., Reynolds D., Padeletti L., Noelker G., Kantipudi C., Rubin Lopez J.M., Dichtl W., Borri-Brunetto A., Verhees L., Ritter P., Singh J.P. Contractility sensor-guided optimization of cardiac resynchronization therapy: results from the RESPOND-CRT trial. European Heart Journal. 2017. Vol. 38(10). Р.730-738.
16. Cazeau S., Leclercq C., Lavergne T., et al. Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay. The New England Journal of Medicine. 2001. Vol. 344. Р.873–880.
17. Chung E.S., Leon A.R., Tavazzi L., et al: Results of the Predictors of Response to CRT (PROSPECT) trial. Circulation. 2008. Vol. 117. Р.2608–2616.
18. Cleland J.G., Daubert J.C., Erdmann E., et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. The New England Journal of Medicine. 2005. Vol. 352 Р.1539–1549.
19. Cleland J.G., Daubert J.C., Erdmann E., et al: Longer-term effects of cardiac resynchronization therapy on mortality in heart failure [the CArdiac REsynchronization-Heart Failure (CARE-HF) trial extension phase]. European Heart Journal. 2006. Vol. 27. Р.1928–1932.
20. Damy T., Ghio S., Rigby A.S., Hittinger L., Jacobs S., Leyva F., Delgado J.F., Daubert J.C., Gras D., Tavazzi L., Cleland J.G. Interplay between right ventricular function and cardiac resynchronization therapy: an analysis of the CARE-HF trial (Cardiac Resynchronization-Heart Failure). Journal of the American College of Cardiology. 2013. Vol. 61(21). Р. 2153-2160.
21. Dıaz-Infante E., Sitges M., Vidal B., et al: Usefulness of ventricular dyssynchrony measured using M-mode echocardiography to predict response to resynchronization therapy. American Journal of Cardiology. 2007. Vol. 100. Р. 84–89.
22. Duncan A.M., Francis D.P., Gibson D.G., et al: Differentiation of ischemic from nonischemic cardiomyopathy during dobutamine stress by left ventricular long-axis function: Additional effect of left bundle-branch block. Circulation. 2003. Vol. 108 Р.1214–1220.
23. Duncan A.M., O’Sullivan C.A., Carr-White G.S., et al: Long axis electromechanics during dobutamine stress in patients with coronary artery disease and left ventricular dysfunction. Heart. 2001. Vol. 86. Р.397–404.
24. Duncan A.M., Lim E., Clague J., et al: Comparison of segmental and global markers of dyssynchrony in predicting clinical response to cardiac resynchronization. European Heart Journal. 2006. Vol. 27. Р.2426–2432.
25. Duncan A., Francis D., Gibson D., et al: Electromechanical left ventricular resynchronisation by coronary artery bypass surgery. European Journal of Cardio-Thoracic Surgery. 2004. Vol. 26. Р.711–719.
26. Egoavil C.A., Ho R.T., Greenspon A.J., Pavri B.B. Cardiac resynchronization therapy in patients with right bundle branch block: analysis of pooled data from the MIRACLE and Contak CD trials. Heart Rhythm. 2005. Vol. 2. Р. 611–615.
27. Ellims A.H., Pfluger H., Elsik M., et al: Utility of cardiac magnetic resonance imaging, echocardiography and electrocardiography for the prediction of clinical response and long-term survival following cardiac resynchronization therapy. The International Journal of Cardiovascular Imaging. 2013. Vol. 29. Р.1303–1311.
28. Ghio S., Constantin C., Klersy C., et al: Interventricular and intraventricular dyssynchrony are common in heart failure patients, regardless of QRS duration. European Heart Journal. 2004. Vol. 25. Р.571–578.
29. Gold M.R., Birgersdotter-Green U., Singh J.P., et al: The relationship between ventricular electrical delay and left ventricular remodelling with cardiac resynchronization therapy. European Heart Journal. 2011. Vol. 32. Р. 2516–2524.
30. Goldberger J.J., Buxton A.E., Cain M. et al. Risk stratification for arrhythmic sudden cardiac death: identifying the roadblocks. Circulation. 2011. Vol. 123. P. 2423–2430.
31. Götze S., Butter C., Fleck E. Cardiac resynchronization therapy for heart failure - from experimental pacing to evidence-based therapy. Clinical Research in Cardiology. 2006. Vol. 95 Suppl 4. Р.18-33.
32. Henein M.Y., Priestley K., Davarashvili T., et al: Early changes in left ventricular subendocardial function after successful coronary angioplasty. British Heart Journal. 1993. Vol. 69. Р.501–506.
33. Henein M.Y., Gibson D.G.: Suppression of left ventricular early diastolic filling by long axis asynchrony. British Heart Journal. 1995. Vol. 73. Р.151–157.
34. Heist E.K., Taub C., Fan D., et al. Usefulness of a novel ‘response score’ to predict hemodynamic and clinical outcome from cardiac resynchronization therapy. American Journal of Cardiology. 2006. Vol. 97. Р.1732–1736.
35. Hsu J.C., Solomon S.D., Bourgoun M., et al: Predictors of super-response to cardiac resynchronization therapy and associated improvement in clinical outcome: The MADITCRT (multicenter automatic defibrillator implantation trial with cardiac resynchronization therapy) study. American Journal of Cardiology. 2012. 59. Р.2366–2373.
36. Issa Z.F., Miller J.M., Zipes D.P. Clinical arrhythmology and electrophysiology: a companion to Braunwald’s heart disease. Elsevier Inc. 2012. 726 p.
37. Jeevanantham V., Daubert J.P., Zareba W. Cardiac resynchronization therapy in heart failure patients: an update. Cardiology Journal. 2009. 1 Vol. 6(3). Р.197-209.
38. Kalscheur M.M., Kipp R.T., Tattersall M.C., Mei C., Buhr K.A., DeMets D.L., Field M.E., Eckhardt L.L., Page C.D. Machine Learning Algorithm Predicts Cardiac Resynchronization Therapy Outcomes: Lessons From the COMPANION Trial. Circulation: Arrhythmia and Electrophysiology. 2018. Vol. 11(1). e005499.
39. Koos R., Neizel M., Schummers G., et al: Feasibility and initial experience of assessment of mechanical dyssynchrony using cardiovascular magnetic resonance and semi-automatic border detection. Journal of Cardiovascular Magnetic Resonance. 2008. Vol. 10. Р.49.
40. Koç M., Kaypakli O., Gözübüyük G., Yıldıray Şahin D. Coronary sinus lead delay index for optimization of coronary sinus lead placement. Annals of Noninvasive Electrocardiology. 2018. Vol. 23(1). P 74-79
41. Kron J., Aranda J.M. Jr., Miles W.M., Burkart T.A., Woo G.W., Saxonhouse S.J., Sears S.F. Jr., Conti J.B. Benefit of cardiac resynchronization in elderly patients: results from the Multicenter InSyncRandomized Clinical Evaluation (MIRACLE) and Multicenter InSync ICD Randomized ClinicalEvaluation (MIRACLE-ICD) trials. Journal of Interventional Cardiac Electrophysiology. 2009. Vol. 25(2). Р.91-96.
42. Lamia B., Tanabe M., Kim H.K., et al: Quantifying the role of regional dyssynchrony on global left ventricular performance. Journal of the American College of Cardiology. 2009. Vol. 2. Р.1350–1356.
43. Lecoq G., Leclercq C., Leray E., et al. Clinical and electrocardiographic predictors of a positive response to cardiac resynchronization therapy in advanced heart failure. European Heart Journal. 2005. Vol. 26. Р.1094–1100.
44. Leclercq C., Gadler F., Kranig W., Ellery S., Gras D., Lazarus A., Clémenty J., Boulogne E., Daubert J.C.; TRIP-HF (Triple Resynchronization In Paced Heart Failure Patients) Study Group. A randomized comparison of triple-site versus dual-site ventricular stimulation in patients with congestive heart failure. Journal of the American College of Cardiology. 2008. Vol. 51(15). Р. 1455-1462.
45. Lin J., Buhr K.A., Kipp R. Effect of PR Interval on Outcomes Following Cardiac Resynchronization Therapy: A Secondary Analysis of the COMPANION Trial. J Journal of Cardiovascular Electrophysiology. 2017. Vol. 28(2). Р.185-191.
46. Linde C., Curtis A.B., Fonarow G.C., Lee K., Little W., Tang A., Levya F., Momomura S., Manrodt C., Bergemann T. Cardiac resynchronization therapy in chronic heart failure with moderately reduced left ventricular ejection fraction: Lessons from the Multicenter InSync Randomized ClinicalEvaluation MIRACLE EF study. International Journal of Cardiology. 2016. Vol. 202. Р.349-355.
47. Linde C., Abraham W.T., Gold M.R., Daubert J.C., Tang A.S., Young J.B., Sherfesee L, Hudnall JH., Fagan DH., Cleland J.G. Predictors of short-term clinical response to cardiac resynchronization therapy. European Journal of Heart Failure. 2017. Vol. 19(8). Р.1056-1063.
48. Lozano I., Bocchiardo M., Achtelik M., et al. Impact of biventricular pacing on mortality in a randomized crossover study of patients with heart failure and ventricular arrhythmias. Pacing and Clinical Electrophysiology. 2000. Vol. 23. Р.1711–1722.
49. Lopez-Andrès N., Rossignol P., Iraqi W., Fay R., Nuée J., Ghio S., Cleland J.G., Zannad F., Lacolley P. Association of galectin-3 and fibrosis markers with long-term cardiovascular outcomes in patients with heart failure, left ventricular dysfunction, and dyssynchrony: insights fr om the CARE-HF (Cardiac Resynchronization in Heart Failure) trial. European Journal of Heart Failure. 2012. 1 Vol. 4(1). Р.74-81.
50. Marcus G.M., Rose E., Viloria E.M., et al: Septal to posterior wall motion delay fails to predict reverse remodeling or clinical improvement in patients undergoing cardiac resynchronization therapy. Journal of the American College of Cardiology. 2005. Vol. 46. Р. 2208–2214.
51. Marsan N.A., Bleeker G.B., Ypenburg C., et al: Real-time three-dimensional echocardiography permits quantification of left ventricular mechanical dyssynchrony and predicts acute response to cardiac resynchronization therapy. Journal of Cardiovascular Electrophysiology. 2008. Vol. 19. Р.392–399.
52. Miyazaki C., Redfield M.M., Powell B.D., et al: Dyssynchrony indices to predict response to cardiac resynchronization therapy: A comprehensive prospective single-center study. Circulation: Heart Failure. 2010. Vol. 3. P. 565–573.
53. Mischi M., Kaklidou F., Houthuizen P., et al: Three-dimensional quantification of regional left ventricular dyssynchrony by magnetic resonance imaging. Conf Proc IEEE. Engineering in Medicine and Biology Society. 2011. Р.2646–2649.
54. Morgan J.M., Biffi M., Gellér L., Leclercq C., Ruffa F., Tung S., Defaye P., Yang Z., Gerritse B., van Ginneken M., Yee R., Jais P.. ALternate Site Cardiac ResYNChronization (ALSYNC): a prospective and multicentre study of left ventricular endocardial pacing for cardiac resynchronization therapy. European Heart Journal. 2016. Vol. 37(27). Р.2118-2127.
55. Oddone D., Solari D., Nangah R., Arena G., Mureddu R., Giorgi D., Sitta N., Bottoni N. Optimization of coronary sinus lead placement targeted to the longest right-to-left delay in patients undergoing cardiac resynchronization therapy: The Optimal Pacing SITE 2 (OPSITE 2) acute study and protocol. Pacing and Clinical Electrophysiology. 2017. Vol. 40(12). Р.1350-1357
56. O’Mara J.E., Fruechte E.M., Palac R.T., et al: Regional patterns of dyssynchrony: Lateral wall delay is desirable but not essential for left ventricular remodeling in biventricular pacing. Echocardiography. 2012. Vol. 29. P. 554–559.
57. Petryka J., Misko J., Przybylski A., et al: Magnetic resonance imaging assessment of intraventricular dyssynchrony and delayed enhancement as predictors of response to cardiac resynchronization therapy in patients with heart failure of ischaemic and non-ischaemic etiologies. European Journal of Radiology. 2012. Vol 34. Р. 2639–2647.
58. Pitzalis M.V., Iacoviello M., Romito R. Cardiac resynchronization therapy tailored by echocardiographic evaluation of ventricular asynchrony. Journal of the American College of Cardiology. 2002. Vol. 40. Р.1615–1622.
59. Pitzalis M.V., Iacoviello M., Romito R. Ventricular asynchrony predicts a better outcome in patients with chronic heart failure receiving cardiac resynchronization therapy. Journal of the American College of Cardiology. 2005. Vol. 45. Р.65–69.
60. Prinz C., Lehmann R., Schwarz M. Left ventricular dyssynchrony predicts clinical response to CRT - a longterm follow-up single-center prospective observational cohort study. Echocardiography. 2013. Vol. 30. Р.896–903.
61. Rivero-Ayerza M., Theuns D.A., Garcia-Garcia H.M., Bersma E., Simoons M., Jordaens L.J. Effects of cardiac resynchronization therapy on overall mortality and mode of death: a meta-analysis of randomized controlled trials. European Heart Journal. 2006. Vol. 27. Р.2682–2688
62. Roger V.L. Epidemiology of heart failure Circulation Research. 2013. Vol. 113 Р. 646–659.
63. Russo C., Jaubert M.P., Jin Z., et al: Intra- and interobserver reproducibility of left ventricular mechanical dyssynchrony assessment by real time three-dimensional echocardiography. Echocardiography. 2012. Vol. 29. Р.598–607.
64. Santangeli .P, Di Biase L., Pelargonio G., Dello Russo A., Casella M., Bartoletti S, Burkhardt J.D., Mohanty P., Santarelli P., Natale A. Cardiac resynchronization therapy in patients with mild heart failure: a systematic review and meta-analys. Journal of Interventional Cardiac Electrophysiology. Vol. 2011. 32(2). Р.125-135.
65. Smiseth O.A., Russell K., Skulstad H. The role of echocardiography in quantification of left ventricular dyssynchrony: State of the art and future directions. European Heart Journal. 2012. Vol. 13 Р.61–68.
66. Sorrell V.L., Ross W.D., Gregoire J., et al: Color M-mode echocardiography is more reproducible than conventional M-mode echocardiography for septal-to-posterior wall motion delay measurements. Echocardiography. 2008. Vol. 25. Р.821–826.
67. Spencer J.H., Larson A.A., Drake R., Iaizzo P.A. A detailed assessment of the human coronary venous system using contrast computed tomography of perfusion-fixed specimens. Heart Rhythm. 2014. Vol. 11(2). Р. 282-288.
68. Tamborero D., Vidal B., Tolosana J.M., et al: Electrocardiographic versus echocardiographic optimization of the interventricular pacing delay in patients undergoing cardiac resynchronization therapy. Journal of Cardiovascular Electrophysiology. 2011. Vol. 22. Р.1129–1134.
69. Tanabe M., Lamia B., Tanaka H., et al: Echocardiographic speckle tracking radial strain imaging to assess ventricular dyssynchrony in a pacing model of resynchronization therapy. Journal of the American Society of Echocardiography. 2008. Vol. 21. P. 1382–1388.
70. Tang A.S., Wells G.A., Talajic M., et al. Cardiac-resynchronization therapy for mild-to-moderate heart failure. The New England Journal of Medicine. 2010. Vol. 363. Р.2385–2395.
71. Tatsumi K., Tanaka H., Tsuji T., et al: Strain dyssynchrony index determined by three-dimensional speckle area tracking can predict response to cardiac resynchronization therapy. Cardiovascular Ultrasound. 2011. Vol. 1. P. 9-11.
72. Thebault C., Donal E., Bernard A., et al: Real-time threedimensional speckle tracking echocardiography: A novel technique to quantify global left ventricular mechanical dyssynchrony. European Journal of Echocardiography. 2011. Vol. 12. Р. 26–32.
73. Wokhlu A., Rea R.F., Asirvatham S.J., et al. Upgrade and de novo cardiac resynchronization therapy: impact of paced or intrinsic QRS morphology on outcomes and survival. Heart Rhythm. 2009. Vol. 6. Р.1439–1447.
74. Yu C.M., Fung J.W., Zhang Q., et al: Tissue Doppler imaging is superior to strain rate imaging and postsystolic shortening on the prediction of reverse remodeling in both ischemic and nonischemic heart failure after cardiac resynchronization therapy. Circulation. 2004. Vol. 110. Р. 66–73.
75. Yu C.M., Gorcsan J., Bleeker G.B., et al: Usefulness of tissue Doppler velocity and strain dyssynchrony for predicting left ventricular reverse remodeling response after cardiac resynchronization therapy. American Journal of Cardiology. 2007. Vol. 100. Р.1263–1270.
76. Yu C.M., Chan Y.S., Zhang Q., et al. Benefits of cardiac resynchronization therapy for heart failure patients with narrow QRS complexes and coexisting systolic asynchrony by echocardiography. Journal of the American College of Cardiology. 2006. Vol. 48. Р.2251–2257.
77. Zareba W., Klein H., Cygankiewicz I., et al. Effectiveness of cardiac resynchronization therapy by QRS morphology in the Multicenter Automatic Defibrillator Implantation Trial- Cardiac Resynchronization Therapy (MADIT-CRT). Circulation. 2011. Vol. 123. Р.1061–1072.
78. Reddy V.Y., Miller M.A., Neuzil P., Søgaard P., Butter C., Seifert M., Delnoy P.P., van Erven L., Schalji M., Riahi S. Cardiac Resynchronization Therapy With Wireless Left Ventricular Endocardial Pacing: The Select-LV Study. J Am Coll Cardiol. 2017. Vol. 69(17). Р. 2119-2129.
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Сабитов Е.Т., Дюсупов А.А., Абдрахманов А.С., Орехов А.Ю. Созылмалы жүрек жеткіліксіздігі екі қарыншалық стимуляцияның орыны: әдебиеттік шолу // Ғылым және Денсаулық сақтау. 2019. 3 (Т.21). Б. 5-19.Ұқсас жариялымдар:
ІШ АСУЫНЫҢ ЗАРАҚАТЫНДАҒЫ ДИАГНОСТИКАЛЫҚ ЖӘНЕ ЕМДЕУ ЛАПАРОСКОПИЯСЫ. ӘДЕБИЕТТЕРДІ ШОЛУ.
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БАУЫРДЫҢ ДӘРІЛІК-ИНДУКЦИЯЛАНҒАН ЗАҚЫМДАНУЫ ЖӘНЕ ГЕНДЕРЛІК АЙЫРМАШЫЛЫҚТАР
КӨП АҒЗАЛЫ ДИСФУНКЦИЯСЫ БАР НАУҚАСТАРДАҒЫ ИНТРААБДОМИНАЛЬДЫ ГИПЕРТЕНЗИЯ МЕН АСҚАЗАН-ІШЕК ЖОЛДАРЫНЫҢ ЗАҚЫМДАНУ МАРКЕРЛЕРІНІҢ ӨЗАРА БАЙЛАНЫСЫ
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