clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2026-104-3-176-183clinmed-1420Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESОсобенности поражения сердечных структур при употреблении наркотических средств: от патофизиологии к алгоритмам леченияFeatures of cardiac damage in illicit drugs users: from pathophysiology to treatment algorithmshttps://orcid.org/0000-0002-2706-3496КрыловВ. В.KrylovV. V.

Крылов Владислав Викторович — канд. мед. наук, врач сердечнососудистый хирург кардиохирургического отделения для взрослых и отделения экстренной и плановой консультативной медицинской помощи 

Москва

Vladislav V. Krylov — Candidate of Medical Sciences, cardiovascular surgeon of the adult’s cardiovascular surgery department and emergency and routine counseling department 

Moscow

malus5@yandex.ruКлименкоТ. В.KlimenkoT. V.

Клименко Татьяна Валентиновна — д-р мед. наук, профессор, директор 

Москва

Tatyana V. Klimenko — Doctor of Medical Sciences, professor, director 

Moscow

https://orcid.org/0000-0002-3130-3149ШагиахметовФ. Ш.ShagiakhmetovF. S.

Шагиахметов Фарид Шамилевич — канд. мед. наук, врач-нарколог, научный сотрудник 

Москва

Farid Sh. Shagiakhmetov — Candidate of Medical Sciences, narcologist, researcher 

Moscow

ГБУЗ Московской области «Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского»РоссияM.F. Vladimirsky Moscow Regional Research and Clinical Institute «MONIKI»Russian FederationНациональный научный центр наркологии — филиал ФГБУ «Национальный медицинский исследовательский центр психиатрии и наркологии им. В.П. Сербского» Минздрава РоссииРоссияNational Scientific Center for Narcology, branch of V.P. Serbsky National Medical Research Center for Psychiatry and Narcology of the Ministry of Health of Russian FederationRussian Federation2026170520261043176183Copyright © Крылов В.В., Клименко Т.В., Шагиахметов Ф.Ш., 20262026Крылов В.В., Клименко Т.В., Шагиахметов Ф.Ш.Krylov V.V., Klimenko T.V., Shagiakhmetov F.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.clinmedjournal.com/jour/article/view/1420Актуальность

Актуальность. В современных условиях спектр кардиохирургической патологии, развивающейся и протекающей на фоне систематического употребления наркотических средств существенно расширился и не ограничивается только инфекционными поражениями клапанов сердца. Это диктует необходимость углубленного изучения патофизиологических механизмов воздействия различных наркотических средств на сердечные структуры с целью разработки дифференцированного подхода к лечению данной категории пациентов. В статье приведены современные данные о патофизиологических механизмах влияния различных наркотических средств на сердечные структуры с обоснованием необходимости разработки дифференцированного подхода к лечению кардиохирургических пациентов на фоне систематической наркотизации в зависимости от типа наркотического средства.

Заключение

Заключение. Разработка дифференцированного подхода, учитывающего патофизиологические механизмы воздействия различных наркотических средств на сердечные структуры, позволит разработать алгоритмы снижения патологических эффектов систематической наркотизации и приведет к существенному улучшению результатов лечения данной категории кардиохирургических пациентов.

Relevance

Relevance. In modern society, the spectrum of cardiac surgical pathology that develops in chronic drug users has expanded significantly and is not limited only to infectious lesions of the heart valves. This dictates the need for an in-depth study of the pathophysiological mechanisms of the effects of various narcotic substances on cardiac structures in order to develop a differentiated approach to the treatment of these patients. The literature review concerns the need of development of approach to the treatment of cardiac surgical patients with comorbid past or current drug abuse, depending on the type of narcotic substance used.

Conclusion

Conclusion. The development of a differentiated approach that considers the mechanisms of cardiovascular toxicity of various narcotic substances might help elaborate the ways to reduce the pathological changes yielding in significant improvement in treatment of these patients.

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