МОРФОЛОГИЧЕСКИЕ ПРЕДПОСЫЛКИ ТРОМБОЗА УШКА ЛЕВОГО ПРЕДСЕРДИЯ (ОБЗОР)

Клиническое значение фибрилляции предсердий в значительной мере связано с риском развития тромбоэмболических осложнений причиной которых, чаще всего, служит образование тромба в ушке левого предсердия. Цель исследования — систематизировать представленные в литературе данные о роли морфологических особенностей ушка левого предсердия в развитии предсердного тромбоза и тромбоэмболических осложнений у пациентов с фибрилляцией предсердий. Материалы и методы исследования заключались в поиске статей проводился в базах данных РИНЦ и PubMed (MEDLINE), по следующим ключевым словам: «ушко левого предсердия», «тромбоз левого предсердия», «эпикардиальный жир», «фибрилляция предсердий». В результате проведенного мета-анализа литературы установлено, что в ряде исследований показано, что вероятность образования тромба в ушке левого предсердия существенно взаимосвязана с его анатомическими особенностями, в частности, вероятность тромбоза при анатомическом типе ушка левого предсердия в форме «куриного крыла» (Chicken Wing) значительно ниже, чем при других вариантах его строения. Однако вопрос о причинах преимущественного образования тромбов в ушке левого, а не правого предсердия остается не выясненным. Одной из возможных причин может служить присущая ушку левого предсердия эндокринная функция, выражающаяся в секреции ряда биологически активных веществ, в частности натрийуретического пептида. Другой возможной причиной преимущественного образования тромбов в ушке левого предсердия может служить его тесный контакт с предсердным депо эпикардиального жира, избыток которого играет важную роль в развитии целого ряда сердечно-сосудистых заболеваний. Вопрос о морфологических предпосылках развития тромбоза преимущественно в ушке левого предсердия представляется недостаточно изученным. Изучение этого вопроса может способствовать повышению эффективности профилактики тромбоэмболических осложнений при фибрилляции предсердий.

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