sibmedСибирский научный медицинский журналСибирский научный медицинский журнал2410-25122410-2520ИЦиГ СО РАН10.18699/SSMJ20250405sibmed-2335Research ArticleОБЗОРЫREVIEWSСовременное состояние проблемы диагностики кардиоваскулярной автономной нейропатии в клинической практике (обзор литературы)Current state of the problem of diagnosing cardiovascular autonomic neuropathy in the clinical practice (literature review)https://orcid.org/0009-0003-8741-0722ПыхтуноваЕ. А.PykhtunovaE. A.

Пыхтунова Екатерина Александровна

634028, г. Томск, пр. Ленина, 3

Ekaterina A. Pykhtunova

634028, Tomsk, Lenina ave., 3

p.ekaterina92@mail.ruhttps://orcid.org/0009-0004-8878-9524ЗолотаревА. А.ZolotarevA. A.

Золотарев Алексей Александрович

634028, г. Томск, пр. Ленина, 3

Aleksey A. Zolotarev

634028, Tomsk, Lenina ave., 3

zolotarevf_aleksey@inbox.ruhttps://orcid.org/0000-0002-5448-3752КсеневаС. И.KsenevaS. I.

Ксенева Светлана Игоревна, д.м.н.

634028, г. Томск, пр. Ленина, 3

Svetlana I. Kseneva, doctor of medical sciences

634028, Tomsk, Lenina ave., 3

viksbest@mail.ruhttps://orcid.org/0000-0001-9425-5765ТрифоноваО. Ю.TrifonovaO. Yu.

Трифонова Ольга Юрьевна, д.м.н.

634028, г. Томск, пр. Ленина, 3

Olga Yu. Trifonova, doctor of medical sciences

634028, Tomsk, Lenina ave., 3

trifonova61@mail.ruhttps://orcid.org/0000-0002-3829-7132УдутВ. В.UdutV. V.

Удут Владимир Васильевич, д.м.н., проф., чл.-корр. РАН

634028, г. Томск, пр. Ленина, 3

Vladimir V. Udut, doctor of medical sciences, professor, corresponding member of RAS

634028, Tomsk, Lenina ave., 3

udutv@mail.ruНИИ фармакологии и регенеративной медицины им. Е.Д. Гольдберга Томского национального исследовательского медицинского центра РАНРоссияResearch Institute of Pharmacology and Regenerative Medicine named after E.D. Goldberg Tomsk National Research Medical Center of the RASRussian Federation2025050920254544757Copyright © Пыхтунова Е.А., Золотарев А.А., Ксенева С.И., Трифонова О.Ю., Удут В.В., 20252025Пыхтунова Е.А., Золотарев А.А., Ксенева С.И., Трифонова О.Ю., Удут В.В.Pykhtunova E.A., Zolotarev A.A., Kseneva S.I., Trifonova O.Y., Udut V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://sibmed.elpub.ru/jour/article/view/2335

Целью настоящего обзора является представление современного состояния проблемы диагностики кардиоваскулярной автономной нейропатии (КАН), определение преимуществ и недостатков используемых методик, демонстрация возможности внедрения легко воспроизводимого метода, основанного на определении вариабельности ритма сердца.

Материал и методы

Материал и методы. Для анализа отобраны зарубежные статьи 2020–2024 гг. с использованием ключевых слов «cardiac autonomic neuropathy», «diagnosis» и «study» в поисковых системах Google Scholar, PubMed, Springer. Среди найденных материалов зоной интереса представлялись работы, описывающие клинические исследования по изучаемой патологии.

Результаты и их обсуждение. В настоящее время КАН редко диагностируется в клинической практике, несмотря на ее важное прогностическое значение. В проанализированных работах диагностика КАН проводилась в связи с научным, а не клиническим интересом, а методы диагностики разнообразны. Признанные «золотым стандартом» кардиоваскулярные тесты являются трудно воспроизводимыми в крупных масштабах и у пациентов с множественной патологией.

Заключение

Заключение. Проблеме КАН в практической медицине не уделяется должного внимания в связи с отсутствием единого легко воспроизводимого диагностического стандарта. Спектральный анализ вариабельности сердечного ритма с ортостатическим тестом представляется перспективным методом диагностики этого патологического состояния с возможностью определения тяжести состояния и ответа на лечение.

This literature review demonstrates the current state of the problem of diagnosing cardiovascular autonomic neuropathy (CAN), the advantages and disadvantages of the techniques used, and the possibility of introducing an easily reproducible method.

Material and methods

Material and methods. English-language articles from 2020–2024 using the keywords “cardiac autonomic neuropathy”, “diagnosis” and “study” in Google Scholar, PubMed, Springer search engines were selected for analysis. Among the materials found, the area of interest was the works describing clinical studies on the pathology under study.

Results and discussion

Results and discussion. Currently, CAN is rarely diagnosed in clinical practice, despite its prognostic significance. In the analyzed works, CAN diagnosis was performed due to scientific rather than clinical interest, and the diagnostic methods themselves are heterogeneous. Recognized “gold standard” cardiovascular tests are difficult to reproduce on a large scale and in patients with multiple pathologies.

Conclusions

Conclusions. The problem of CAN is not given due attention in practical medicine connectedly the lack of a single easily reproducible diagnostic standard. Spectral analysis of heart rate variability with orthostatic test seems to be a promising method of CAN diagnosis with the possibility to determine the severity of the condition and response to treatment.

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