spbmedicalrecordsНовые Санкт-Петербургские врачебные ведомостиNew St. Petersburg Medical Records1609-2201Первый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова10.24884/1609-2201-2025-104-1-32-43spbmedicalrecords-62Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSДислипидемия как причина развития аортального стеноза. Обзор литературы и собственный опыт наблюдения пациентов с семейной гиперхолестеринемиейDyslipidemia as a cause of aortic stenosis. Review of literature and own experience of monitoring patients with familial hypercholesterolemiahttps://orcid.org/0000-0003-2231-4695КорневаВ. А.KornevaV. A.

Корнева Виктория Алексеевна, кандидат медицинских наук, доцент, доцент кафедры факультетской терапии, фтизиатрии, инфекционных болезней и эпидемиологии медицинского института им. А. П. Зильбера

185035, Респ. Карелия, Петрозаводск, пр. Ленина, д. 33

Victoria A. Korneva, Cand. of Sci. (Med.), assistant professor, assistant professor of the Department of Faculty Therapy, Phthisiology, Infectious Diseases and Epidemiology, Institute of Medicine named after prof. Anatoly P. Zilber

33, Lenin str., Petrozavodsk, 185035

vikkorneva@mail.ruhttps://orcid.org/0000-0002-6654-1382КузнецоваТ. Ю.KuznetsovaT. Yu.

Кузнецова Татьяна Юрьевна, доктор медицинских наук, заведующая кафедрой факультетской терапии, фтизиатрии, инфекционных болезней и эпидемиологии медицинского института им. А. П. Зильбера

185035, Респ. Карелия, Петрозаводск, пр. Ленина, д. 33

Tatiana Yu. Kuznetsova, Dr. of Sci. (Med.), head of the Department of Faculty Therapy, Phthisiology, Infectious Diseases and Epidemiology, Institute of Medicine named after prof. Anatoly P. Zilber

33, Lenin str., Petrozavodsk, 185035

eme@karelia.ruПетрозаводский государственный университетРоссияPetrozavodsk State UniversityRussian Federation202523072025013243Copyright © Корнева В.А., Кузнецова Т.Ю., 20252025Корнева В.А., Кузнецова Т.Ю.Korneva V.A., Kuznetsova T.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.docved.ru/jour/article/view/62

Введение. Аортальный стеноз (АС) – третья по частоте причина смерти от сердечно-сосудистых заболеваний. АС является мультифакторным заболеванием, при этом дислипидемия – один из возможных этиопатогенеических механизмов его развития. Семейная гиперхолестеринемия (СГХС) представляет собой генетическое заболевание с повышением уровня общего холестерина (ОХС) и холестерина липопротеинов низкой плотности (ХС ЛНП) с рождения.Цель: проанализировать вклад дислипидемии и повышенного уровня Лп(а) в формирование АС у пациентов с СГХС.Материалы и методы. Обследовано 134 пациента с гетерозиготной СГХС (средний возраст 52,9±3,2 лет, мужчин 85 (63,4%)), из них у 10 (7,46%) пациентов выявлен АС. СГХС диагностировалась по критериям Dutch Lipid Clinic Network. Концентрацию липопротеида(а) (Лп(а)) измеряли с помощью турбометрического метода.Результаты. У пациентов с СГХС и АС выявлены более высокие уровни ОХС (11,88±1,83 ммоль/л по сравнению с 9,85±1,47 ммоль/л без АС, р<0,01); ХС ЛНП (9,24±1,2 ммоль/л по сравнению с 7,23±1,34 ммоль/л без АС, р< 0,001). Уровень ТГ повышает ОШ АС в 2 раза (ОШ 1,97 [1,33; 2,87], р=0,0007). Увеличение Лп(а) на 1 единицу измерения (1 г/л) приводит к повышению ОШ АС в 10,6 раз (ОШАС = 10,5 [5,0; 21,9] p=0,0017).Выводы: Повышение уровня ОХС и ХС ЛНП, ТГ, Лп(а) ассоциируется с развитием АС у пациентов с СГХС.

Introduction. Aortic stenosis (AS) is the third leading cause of death from cardiovascular disease. AS is a multifactorial disease, and dyslipidemia is one of the possible etiopathogenetic mechanisms of its development. Familial hypercholesterolemia (FH) is a genetic disorder characterized by elevated total cholesterol and low-density lipoprotein cholesterol levels from birth.Aim: to analyze the contribution of dyslipidemia and elevated Lp(a) levels to the formation of AS in patients with FH.Materials and methods: 134 patients with heterozygous FH were examined (mean age 52.9±3.2 years, 85 (63.4%) men), of which 10 (7.46%) patients were diagnosed with AS. FH was diagnosed according to the Dutch Lipid Clinic Network criteria. Lipoprotein(a) (Lp(a)) concentration was measured using the turbometric method.Results. In patients with FH and AS, higher levels of total cholesterol were detected (11.88±1.83 mmol/l compared with 9.85±1.47 mmol/l without AS, p<0.01); higher levels of LDL cholesterol (9.24±1.2 mmol/l compared with 7.23±1.34 mmol/l without AS, p<0.001). An increase in Lp(a) by 1 unit of measurement (1 g/l) leads to a 10.6-fold increase in the OR for AS (OR = 10.5 [5.0; 21.9] p=0.0017).Conclusions: Increased levels of total cholesterol and LDL cholesterol, Lp(a) are associated with the development of AS in patients with FH.. The role of extraoral TAS2Rs and mechanisms of its regulation remain uncertain, that requires further research, including the field of respiratory pathology.

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The authors declare that there are no conflicts of interest present.