medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-419medsovet-9576Research ArticleПРИКЛАДНЫЕ АСПЕКТЫ ЭНДОКРИНОЛОГИИ И КАРДИОЛОГИИAPPLIED ASPECTS OF ENDOCRINOLOGY AND CARDIOLOGYПатофизиология сосудистых когнитивных расстройств, ассоциированных с инфарктом миокардаPathophysiology of vascular cognitive disorders associated with myocardial infarctionhttps://orcid.org/0000-0003-1575-633XЕвсюковА. А.EvsyukovA. A.

Евсюков Александр Александрович, к.м.н., доцент кафедры поликлинической терапии и семейной медицины с курсом последипломного образования

660022, Россия, Красноярск, ул. Партизана Железняка, д. 1 

Aleksandr A. Evsyukov, Cand. Sci. (Med.), Associate Professor of the Department of Outpatient Therapy and Family Medicine with a Course in Postgraduate Education

1, Partizan Zheleznyak St., Krasnoyarsk, 660022, Russia 

evsukovsasha@mail.ruhttps://orcid.org/0000-0002-8493-0058ПетроваМ. М.PetrovaM. M.

Петрова Марина Михайловна, д.м.н., профессор, заведующая кафедрой поликлинической терапии и семейной медицины с курсом последипломного  образования

660022, Россия, Красноярск, ул. Партизана Железняка, д. 1 

Marina M. Petrova, Dr. Sci. (Med.), Professor, Head of the Department of Outpatient Therapy and Family Medicine with a Course in Postgraduate Education

1, Partizan Zheleznyak St., Krasnoyarsk, 660022, Russia

stk99@yandex.ruhttps://orcid.org/0000-0002-2840-837XШнайдерН. А.ShnayderN. A.

Шнайдер Наталья Алексеевна, д.м.н., профессор, главный научный сотрудник Центра коллективного пользования «Молекулярные и клеточные технологии»; главный научный сотрудник Института персонализированной психиатрии и неврологии

660022, Россия, Красноярск, ул. Партизана Железняка, д. 1 

192019, Россия, Санкт-Петербург, ул. Бехтерева, д. 3

Natalia A. Shnayder, Dr. Sci. (Med.), Professor, Chief Researcher of the Center for Collective Use “Molecular and Cellular Technologies”; Chief Researcher of the Institute of Personalized Psychiatry and Neurology

1, Partizan Zheleznyak St., Krasnoyarsk, 660022, Russia

3, Bekhterev St., St Petersburg, 192019, Russia

NASchnaider@yandex.ruhttps://orcid.org/0000-0002-0091-5265ШимохинаН. Ю.ShimokhinaN. Yu.

Шимохина Наталья Юрьевна, д.м.н., профессор кафедры поликлинической терапии и семейной медицины с курсом последипломного образования

660022, Россия, Красноярск, ул. Партизана Железняка, д. 1 

Natalya Yu. Shimokhina, Dr. Sci. (Med.), Professor of the Department of Outpatient Therapy and Family Medicine with a Course in Postgraduate Education 

1, Partizan Zheleznyak St., Krasnoyarsk, 660022, Russia

doctorkardiolog99@rambler.ruhttps://orcid.org/0000-0002-0794-2530КаскаеваД. С.KaskaevaD. S.

Каскаева Дарья Сергеевна, к.м.н., доцент кафедры поликлинической терапии и семейной медицины с курсом последипломного образования

660022, Россия, Красноярск, ул. Партизана Железняка, д. 1 

Darya S. Kaskaeva, Cand. Sci. (Med.), Associate Professor of the Department of Outpatient Therapy and Family Medicine with a Course in Postgraduate Education

1, Partizan Zheleznyak St., Krasnoyarsk, 660022, Russia

dashakas.ru@mail.ruhttps://orcid.org/0000-0001-9528-762XЛейманА. Р.LeymanA. R.

Лейман Алена Руслановна, аспирант кафедры поликлинической терапии и семейной медицины с курсом последипломного образования

660022, Россия, Красноярск, ул. Партизана Железняка, д. 1 

Alena R. Leyman, Postgraduate Student of the Department of Outpatient Therapy and Family Medicine with a Course in Postgraduate Education

1, Partizan Zheleznyak St., Krasnoyarsk, 660022, Russia

alena.anohina.rus@yandex.ruhttps://orcid.org/0009-0002-5261-1463АзимоваС. Н.AzimovaS. N.

Азимова Севинч Нураддин кызы, студент лечебного факультета

660022, Россия, Красноярск, ул. Партизана Железняка, д. 1 

Sevinch N. Azimova, Student of the Faculty of Medicine

1, Partizan Zheleznyak St., Krasnoyarsk, 660022, Russia

sevinch.azimova.2002@mail.ruhttps://orcid.org/0009-0004-3795-7532БекузароваА. М.BekuzarovaA. M.

Бекузарова Амага Майрамовна, студент лечебного факультета

660022, Россия, Красноярск, ул. Партизана Железняка, д. 1 

 Amaga M. Bekuzarova, Student of the Faculty of Medicine 

1, Partizan Zheleznyak St., Krasnoyarsk, 660022, Russia

amaga-maga@mail.ruhttps://orcid.org/0009-0006-2456-9498СтепаненкоС. С.StepanenkoS. S.

Степаненко Софья Сергеевна, студент лечебного факультета

660022, Россия, Красноярск, ул. Партизана Железняка, д. 1 

Sofya S. Stepanenko, Student of the Faculty of Medicine

1, Partizan Zheleznyak St., Krasnoyarsk, 660022, Russia

sonia.02@mail.ruКрасноярский государственный медицинский университет имени профессора В.Ф. Войно-ЯсенецкогоРоссияKrasnoyarsk State Medical University named after Professor V.F. Voino-YasenetskyRussian FederationКрасноярский государственный медицинский университет имени профессора В.Ф. Войно-Ясенецкого; Национальный медицинский исследовательский центр психиатрии и неврологии имени В.М. БехтереваРоссияKrasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky; Bekhterev National Medical Research Centre for Psychiatry and NeurologyRussian Federation202520112025016305–313Copyright © Евсюков А.А., Петрова М.М., Шнайдер Н.А., Шимохина Н.Ю., Каскаева Д.С., Лейман А.Р., Азимова С.Н., Бекузарова А.М., Степаненко С.С., 20252025Евсюков А.А., Петрова М.М., Шнайдер Н.А., Шимохина Н.Ю., Каскаева Д.С., Лейман А.Р., Азимова С.Н., Бекузарова А.М., Степаненко С.С.Evsyukov A.A., Petrova M.M., Shnayder N.A., Shimokhina N.Y., Kaskaeva D.S., Leyman A.R., Azimova S.N., Bekuzarova A.M., Stepanenko S.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9576

По данным Всемирной организации здравоохранения, к 2030 г. ожидается увеличение числа пациентов, страдающих деменцией. К сожалению, первые симптомы, заметные для пациента и его окружения, проявляются спустя относительно продолжительное время после начала заболевания, что является прогностически неблагоприятным фактором. Существует множество этиологических причин, которые способствуют развитию нарушения когнитивных способностей. В структуре заболеваемости второе место принадлежит сосудистой деменции, которая будет рассмотрена в данной статье. Стоит помнить, что нарушения липидного обмена среди населения РФ составляют в среднем 58,4%, что является одним из главных факторов риска инфаркта миокарда, который непосредственно связан с развитием сосудистых когнитивных расстройств (СКР). Согласно анализу исследований, приведенных в данном обзоре, у пациентов, перенесших инфаркт миокарда, отмечается повышенный риск развития когнитивных расстройств, связанных с патоморфологическими изменениями, такими как нейровоспаление и уменьшение плотности дендритных клеток. Также было продемонстрировано, что апоптоз и изменения «Альцгеймер-ассоциированных» белков в различных зонах мозга при СН способствуют развитию СКР. Патофизиологическая связь между инфарктом миокарда и СКР реализуется через сосудистую дисрегуляцию, нарушение церебральной перфузии, а также такие факторы, как окислительный стресс, воспаление, дисфункция нейроваскулярной единицы, атеросклероз и реперфузионное повреждение, приводящие к микроинфарктам, гипоперфузии и когнитивным нарушениям. Повышенный риск развития СКР отмечается у пациентов после коронарной реваскуляризации, что требует особого внимания к их когнитивному статусу в постпервичный период.

According to the World Health Organization, there is an anticipated increase in the number of patients suffering from dementia by 2030. Unfortunately, the initial symptoms noticeable to patients and their surroundings tend to appear relatively late after the onset of the disease, which is a poor prognostic factor. There are numerous etiological factors contributing to the development of cognitive impairments. Vascular dementia accounts for the second most common type of dementia among disease cases and will be discussed in this article. It is important to note that lipid metabolism disorders affect approximately 58.4% of the Russian population, representing one of the main risk factors for myocardial infarction, which is directly associated with the development of vascular cognitive disorders (VCD). According to the studies referenced in this review, it was found that patients who have experienced a myocardial infarction show an increased risk of developing cognitive disorders related to pathological changes such as neuroinflammation and reduced density of dendritic cells. Additionally, it was determined that apoptosis and alterations in “Alzheimer’s-associated” proteins across different brain regions during myocardial conditions contribute to the development of vascular cognitive impairment. The pathophysiological link between myocardial infarction and VCD is mediated by vascular dysregulation, impaired cerebral perfusion, and factors such as oxidative stress, inflammation, neurovascular dysfunction, atherosclerosis, and reperfusion injury, leading to microinfarctions, hypoperfusion, and cognitive impairment. An increased risk of developing VCD is observed in patients following coronary revascularization, necessitating special attention to their cognitive status in the post-primary period.

сосудистые когнитивные расстройствакогнитивные функциицеребральная гипоперфузияпровоспалительные цитокинымикроглияамилоидная ангиопатияmyocardial infarctionvascular cognitive disorderscognitive functionscerebral hypoperfusionpro-inflammatory cytokinesmicrogliaamyloid angiopathyРабота выполнена в рамках государственного задания ФГБОУ ВО «Красноярский государственный медицинский университет имени профессора В.Ф. Войно-Ясенецкого» Министерства здравоохранения РФ (2023–2025 гг.): «Разработка персонализированного алгоритма диагностики сосудистой умеренной когнитивной дисфункции на фоне перенесенного острого инфаркта миокарда на основе новых генетических и биохимических биомаркеров», №123022800057-6. Научное исследование профинансировано ФГБОУ ВО «Красноярский государственный медицинский университет имени профессора В.Ф. 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The authors declare that there are no conflicts of interest present.