radiologyРадиология — практикаRadiology - Practice2713-0118Центральный научно-исследовательский институт лучевой диагностики10.52560/2713-0118-2024-2-27-53radiology-501Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL RESEARCHЭхокардиографическая оценка кардиомиопатии в педиатрической онкологии, связанной с повышенным сердечным выбросом вследствие влияния опухолевого процесса: феохромоцитома/параганглиома, нейробластома (обзор литературы с клиническими наблюдениями)Echocardiographic Assessment of Cardiomyopathy in Pediatric Oncology Associated with Increased Cardiac Output Due to the Influence of the Tumor Process: Pheochromocytoma/Paraganglioma, Neuroblastoma (Literature Review with Clinical Observations)https://orcid.org/0009-0004-4931-8842СажаевЕ. А.SazhaevE. A.

Сажаев Егор Александрович, врач ультразвуковой диагностики рентгенологического отделения, группа ультразвуковой диагностики

117997, Москва, ул. Саморы Машела, д. 1

+7 (495) 287-65-70 (доб. 4815)

Sazhaev Egor Aleksandrovich, Ultrasound Diagnostic Doctor at the Department of Diagnostic Radiology 

1, st. Samory Mashela, Moscow, 117997

+7 (495) 287-65-70 (доб. 4815)

cardio_es@mail.ruhttps://orcid.org/0009-0000-7075-3698БугаеваВ. Ю.BugaevaV. Yu.

Бугаева Вероника Юрьевна, врач ультразвуковой диагностики рентгенологического отделения, группа ультразвуковой диагностики

117997, Москва, ул. Саморы Машела, д. 1

+7 (495) 287-65-70 (доб. 4815)

Bugaeva Veronika Yur’evna,  Ultrasound Diagnostic Doctor at the Department of Diagnostic Radiology

1, st. Samory Mashela, Moscow, 117997

+7 (495) 287-65-70 (доб. 4815)

veronika.bugaeva@fccho-moscow.ruhttps://orcid.org/0009-0002-3582-8783ЩелкановаЕ. С.ShchelkanovaE. S.

Щелканова Екатерина Сергеевна, лаборант-исследователь отдела лучевой диагностики, врач-ординатор рентгенологического отделения

117997, Москва, ул. Саморы Машела, д. 1

+7 (495) 287-65-70 (доб. 4501)

Shchelkanova Ekaterina Sergeevna,  Research Laboratory Assistan, Resident Doctor of Department Radiation Diagnosis

1, st. Samory Mashela, Moscow, 117997

+7 (495) 287 65 70 (add. 4501)

ekaterina.shelkanova@fccho-moscow.ruhttps://orcid.org/0000-0001-7317-7104ТерещенкоГ. В.TereshchenkoG. V.

Терещенко Галина Викторовна,  кандидат медицинских наук, заведующая рентгенологическим отделением

117997, Москва, ул. Саморы Машела, д. 1

+7 (495) 287-65-70 (доб. 1220)

Tereshchenko Galina Viktorovna,  Ph. D., Head of Department Radiation Diagnosis

1, st. Samory Mashela, Moscow, 117997

+7 (495) 287-65 -70 (add. 1220)

Galina.Tereshenko@fccho-moscow.ruФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава РоссииРоссияThe Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of RussiaRussian Federation202414122023022753Copyright © Сажаев Е.А., Бугаева В.Ю., Щелканова Е.С., Терещенко Г.В., 20242024Сажаев Е.А., Бугаева В.Ю., Щелканова Е.С., Терещенко Г.В.Sazhaev E.A., Bugaeva V.Y., Shchelkanova E.S., Tereshchenko G.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.radp.ru/jour/article/view/501

Состояние повышенного сердечного выброса — это состояние, при котором в ответ на разные патологические причины происходит патологическая активация ренин-ангиотензин-альдостероновой и симпатоадреналовой систем, что в целом создает разностороннюю повышенную нагрузку на сердце, приводя в итоге к сердечной недостаточности. Причиной данного состояния могут быть артериовенозные патологические шунты, среди которых отдельное место занимают артериовенозные дуральные фистулы при гломусных опухолях (внутричерепные параганглиомы). Артериовенозная фистула — прямое соединение между артерией и веной в обход капиллярного русла, создающее массивный сброс из системы высокого давления в систему низкого давления, что запускает патофизиологическую цепь. Кроме этого, активация ренин-ангиотензин-альдостероновой и симпатоадреналовой систем и прямое повреждение миокарда может быть вызвано повышенным уровнем катехоламинов в крови при надпочечниковой параганглиоме (феохромоцитома) и нейробластоме. Состояние повышенного сердечного выброса в литературе чаще освещается на примерах клинических случаев у взрослых, при этом в педиатрической практике литературных данных значительно меньше.

The condition of increased cardiac output is a state in which, in response to various pathological causes, there is a pathological activation of the renin-angiotensin-aldosterone and sympathetic-adrenal systems, which overall creates a multifaceted, increased load on the heart, ultimately leading to heart failure. The cause of this condition may be arteriovenous pathological shunts, among which arteriovenous dural fistulas in glomus tumors (intracranial paragangliomas) occupy a special place. An arteriovenous fistula is a direct connection between an artery and a vein bypassing the capillary bed, creating a massive shunt from the high-pressure system to the low-pressure system, triggering a pathophysiological chain. In addition, activation of the renin-angiotensin-aldosterone and sympathetic-adrenal systems and direct myocardial damage can be caused by elevated levels of catecholamines in the blood in cases of adrenal paraganglioma (pheochromocytoma) and neuroblastoma. The condition of increased cardiac output is more often described in the literature using examples of clinical cases in adults, with significantly less literature data available in pediatric practice.

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