emcardioНеотложная кардиология и кардиоваскулярные рискиEmergency Cardiology and Cardiovascular Risks journal2616-633XБелорусский государственный медицинский университетemcardio-243Research ArticleОбзоры и лекцииReviews and lecturesТонзиллогенная кардиомиопатия: нерешенные вопросы диагностики и леченияTonsilogenic cardiomyopathy: unsolved issues in diagnosis and treatmentВойделевичА. С.VaidzelevichA. S.КолядичЖ. В.KolyadichZh. V.МитьковскаяН. П.MitkovskayaN. P.Войсковая часть 20193Military unit number 20193РНПЦ онкологии и мед. радиологии им. Н.Н. АлександроваRepublic Scientific-Practical Center of Oncology and Medical Radiology named after N.N. AleksandrovБелорусский государственный медицинский университетBelarusian State Medical University20191211202531576–581Copyright © Войделевич А.С., Колядич Ж.В., Митьковская Н.П., 20252025Войделевич А.С., Колядич Ж.В., Митьковская Н.П.Vaidzelevich A.S., Kolyadich Z.V., Mitkovskaya N.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://emcardio.bsmu.by/jour/article/view/243

Высокая распространенность хронического тонзиллита (ХТ) среди населения позволяет назвать данное заболевание социально значимым. В связи с полиморфностью данной патологии, а также высоким риском возникновения и развития метатонзиллогенных заболеваний и осложнений, проблемой ХТ занимаются врачи различных специальностей (оториноларингологи, кардиологи, ревматологи, иммунологи, терапевты), что указывает на мультидисциплинарный характер ХТ. В данной статье изложены общие представления о ХТ (классификация, этиология, механизмы патогенеза, тактика лечения, тонзиллогенные осложнения). Акцентировано внимание на изучение тонзиллогенных поражений сердца (тонзиллогенной кардиомиопатии), механизмов их развития и методов диагностики. Из проведенного обзора следует, что тонзиллэктомия является единственным эффективным методом лечения, а также предупреждения развития метатонзиллогенных заболеваний и осложнений ХТ.

High prevalence of chronic tonsillitis among the population makes it possible to call this disease socially significant. Due to the polymorphism of this pathology, as well as a high risk of occurrence and development of metatonsilogenic diseases and complications, doctors of various specialties (otorhinolaryngologists, cardiologists, rheumatologists, immunologists, therapists) deal with the problem of chronic tonsillitis, which indicates a multidisciplinary nature of chronic tonsillitis. This article outlines the general concepts of chronic tonsillitis (classification, etiology, pathogenesis mechanisms, treatment tactics, tonsilogenic disorders). Attention is focused on the study of tonsillogenic lesions of the heart (tonsillogenic cardiomyopathy), the mechanisms of their development and diagnostic methods. From the review it follows that tonsillectomy is the only effective method of treatment, as well as prevention of the development of metatonsilogenic complications of chronic tonsillitis.

хронический тонзиллиттонзиллогенная кардиомиопатиятонзиллэктомияchronic tonsillitistonsillogenic cardiomyopathytonsillectomyReferencesOvchinnikov A.Yu., Gabedava V.A., Svet A.V., Doletskiy A.A. O neobkhodimosti kardiologicheskogo skrininga u bol’nykh khronicheskim tonzillitom [On the need for cardiac screening in patients with chronic tonsillitis]. Effektivnaya farmakoterapiya. Pul’monologiya i otorinolaringologiya, 2010, no. 1, pp. 67–71. (in Russian).Ovchinnikov A.Yu., Gabedava V.A., Svet A.V., Doletskiy A.A. O neobkhodimosti kardiologicheskogo skrininga u bol’nykh khronicheskim tonzillitom [On the need for cardiac screening in patients with chronic tonsillitis]. Effektivnaya farmakoterapiya. Pul’monologiya i otorinolaringologiya, 2010, no. 1, pp. 67–71. (in Russian).Bykova V.P. Sovremennyye predstavleniya o strukture i funktsii mindalin limfadenoidnogo glotochnogo kol’tsa [Modern ideas about the structure and function of the tonsils of the lymphadenoid pharyngeal ring]. Aktual’naya otorinolaringologiya, 2002, no. 4, pp. 2–11. (in Russian).Bykova V.P. Sovremennyye predstavleniya o strukture i funktsii mindalin limfadenoidnogo glotochnogo kol’tsa [Modern ideas about the structure and function of the tonsils of the lymphadenoid pharyngeal ring]. Aktual’naya otorinolaringologiya, 2002, no. 4, pp. 2–11. (in Russian).Mal’ceva G.S., Burova L.A. B-gemoliticheskie streptokokki v jetiologii hronicheskogo tonzillita [B-hemolytic streptococci in the etiology of chronic tonsillitis]. Ros Otorinolaringologija, 2008, suppl. 3, pp. 65–69. (in Russian).Mal’ceva G.S., Burova L.A. B-gemoliticheskie streptokokki v jetiologii hronicheskogo tonzillita [B-hemolytic streptococci in the etiology of chronic tonsillitis]. Ros Otorinolaringologija, 2008, suppl. 3, pp. 65–69. (in Russian).Lopatin A.S., Var v yanskaya A.V., Kaspranskaya G.R. Spravochnik otorinolaringologa [Reference otolar yngologist]. Moscow, GEOTAR-Media, 2018, 336 p. (in Russian).Lopatin A.S., Var v yanskaya A.V., Kaspranskaya G.R. Spravochnik otorinolaringologa [Reference otolar yngologist]. Moscow, GEOTAR-Media, 2018, 336 p. (in Russian).Yalymova D.L., Vishnyakov V.V., Talalayev V.N. Khronicheskiy tonzillit: diagnostika, klassifikatsiya, lecheniye [Chronic tonsillitis: diagnosis, classification, treatment]. Spravochnik poliklinicheskogo vracha, 2014, no. 8, pp. 29–31. (in Russian).Yalymova D.L., Vishnyakov V.V., Talalayev V.N. Khronicheskiy tonzillit: diagnostika, klassifikatsiya, lecheniye [Chronic tonsillitis: diagnosis, classification, treatment]. Spravochnik poliklinicheskogo vracha, 2014, no. 8, pp. 29–31. (in Russian).Burton M.J., Glasziou P.P. Tonsillectomy or adeno-tonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev, 2009, vol. 21, no. 1, pp. CD001802. doi: 10.1002/14651858.CD001802.pub2.Burton M.J., Glasziou P.P. Tonsillectomy or adeno-tonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev, 2009, vol. 21, no. 1, pp. CD001802. doi: 10.1002/14651858.CD001802.pub2.Bykova V.P. Morphofunctional characteristics of the immunoregulatory compartment in human palatine and pharyngeal tonsils in the aspect of the innate immunity. Folia Otorhinolaryngologiae et Pathologiae Respiratoriae, 2009, vol. 15, no. 4, pp. 15–23.Bykova V.P. Morphofunctional characteristics of the immunoregulatory compartment in human palatine and pharyngeal tonsils in the aspect of the innate immunity. Folia Otorhinolaryngologiae et Pathologiae Respiratoriae, 2009, vol. 15, no. 4, pp. 15–23.Melio F., Berge L. Upper respiratory tract infections In Marx J., Walls R., Hockberger R. Rosen’s Emergency Medicine Concepts and Clinical Practice. Elsevier Health Sciences, 2010, pp. 913–926.Melio F., Berge L. Upper respiratory tract infections In Marx J., Walls R., Hockberger R. Rosen’s Emergency Medicine Concepts and Clinical Practice. Elsevier Health Sciences, 2010, pp. 913–926.Khasanov S.A., Asrorov A.A., Vokhidov U.N. Rasprostranennost’ khronicheskogo tonzillita v sem’ye i yego profilaktika [The prevalence of chronic tonsillitis in the family and its prevention]. Vestnik otorinolaringologii, 2006, no. 4, pp. 38–40. (in Russian).Khasanov S.A., Asrorov A.A., Vokhidov U.N. Rasprostranennost’ khronicheskogo tonzillita v sem’ye i yego profilaktika [The prevalence of chronic tonsillitis in the family and its prevention]. Vestnik otorinolaringologii, 2006, no. 4, pp. 38–40. (in Russian).Todorovich M.M., Zvrko E.Z. Immunoregulatory cytokines and chronic tonsillitis. Bosnian J Basic Med Sciences, 2013, vol. 13, no. 4, pp. 230–236.Todorovich M.M., Zvrko E.Z. Immunoregulatory cytokines and chronic tonsillitis. Bosnian J Basic Med Sciences, 2013, vol. 13, no. 4, pp. 230–236.Izvin A.I. Geneticheskie aspekty hronicheskogo tonzillita [Genetic aspects of chronic tonsillitis]. Novosti otorinolaringologii i logopatologii, 2002, no. 2, pp. 90–92. (in Russian)Izvin A.I. Geneticheskie aspekty hronicheskogo tonzillita [Genetic aspects of chronic tonsillitis]. Novosti otorinolaringologii i logopatologii, 2002, no. 2, pp. 90–92. (in Russian)Degtyareva Ye.A., Novikova YU.YU., Kantemirova M.G., Kufa M.A., Pavlova Ye.V., Skoropupov A.A. Etapnyy podkhod k diagnostike khronicheskogo miokardita u rebenkas khronicheskim tonzillitom [A phased approach to the diagnosis of chronic myocarditis in a child with chronic tonsillitis]. Trudnyy patsiyent, 2017, no. 8–9, pp. 43–46. (in Russian).Degtyareva Ye.A., Novikova YU.YU., Kantemirova M.G., Kufa M.A., Pavlova Ye.V., Skoropupov A.A. Etapnyy podkhod k diagnostike khronicheskogo miokardita u rebenkas khronicheskim tonzillitom [A phased approach to the diagnosis of chronic myocarditis in a child with chronic tonsillitis]. Trudnyy patsiyent, 2017, no. 8–9, pp. 43–46. (in Russian).Detsik YU.I., Dutka R.Ya. K diagnostike tonzillogennoy miokardiodistrofii [To the diagosis of tonsillogenic myocardial dystrophy]. Vrach. Delo, 1982, no. 6, pp. 69–72. (in Russian).Detsik YU.I., Dutka R.Ya. K diagnostike tonzillogennoy miokardiodistrofii [To the diagosis of tonsillogenic myocardial dystrophy]. Vrach. Delo, 1982, no. 6, pp. 69–72. (in Russian).Marmolevskaya G.S. Nerevmaticheskiye tonzillogennyye zabolevaniya serdtsa. 2-ye izd [Non-rheumatic tonsillogenic heart disease. 2nd ed.]. Sverdlovsk, Izdatel’stvo Ural’skogo universiteta, 1988, 164 p. (in Russian).Marmolevskaya G.S. Nerevmaticheskiye tonzillogennyye zabolevaniya serdtsa. 2-ye izd [Non-rheumatic tonsillogenic heart disease. 2nd ed.]. Sverdlovsk, Izdatel’stvo Ural’skogo universiteta, 1988, 164 p. (in Russian).Chevretton E.B., Davis J.P. Tonsillitis: its causes, management and possible complications. Int J Clin Pract. 1997, vol. 51, no. 8, pp. 485–486.Chevretton E.B., Davis J.P. Tonsillitis: its causes, management and possible complications. Int J Clin Pract. 1997, vol. 51, no. 8, pp. 485–486.Kirkina N.YU., Pronina D.V., Slyudova A.I. Tonzillokardial’nyy sindrom [Tonsilocardial syndrome]. Klinicheskaya meditsina i farmakologiya, 2010, vol. 4, no. 1, pp. 42–46. (in Russian).Kirkina N.YU., Pronina D.V., Slyudova A.I. Tonzillokardial’nyy sindrom [Tonsilocardial syndrome]. Klinicheskaya meditsina i farmakologiya, 2010, vol. 4, no. 1, pp. 42–46. (in Russian).Ostropolets S.S. Miokard: struktura i funktsii v norme i patologii [Myocardium: structure and function in health and patholog]. Donetsk, Nord-Press, 2007, 208 p. (in Russian).Ostropolets S.S. Miokard: struktura i funktsii v norme i patologii [Myocardium: structure and function in health and patholog]. Donetsk, Nord-Press, 2007, 208 p. (in Russian).Kovalenko V.N., Nesukay Ye.G. Nekoronarogennyye bolezni serdtsa. Prakticheskoye rukovodstvo [Non-coronary heart disease. A practical guide]. Kiev, Morion, 2001, 480 p. (in Russian).Kovalenko V.N., Nesukay Ye.G. Nekoronarogennyye bolezni serdtsa. Prakticheskoye rukovodstvo [Non-coronary heart disease. A practical guide]. Kiev, Morion, 2001, 480 p. (in Russian).Leont’yeva I.V. Lektsii po kardiologii detskogo vozrasta [Lectures on children’s cardiology]. Moscow, ID «Medpraktika-M», 2005, 536 p. (in Russian).Leont’yeva I.V. Lektsii po kardiologii detskogo vozrasta [Lectures on children’s cardiology]. Moscow, ID «Medpraktika-M», 2005, 536 p. (in Russian).Bbattacbaryya N., Kepnes L.J, Sbapiro J. Efficacy and qualitu-of-life impact of adult tonsillectomy. Arcb Otolaryngol Head Neck Surg, 2001, vol. 127, no. 11, pp. 1347–1350.Bbattacbaryya N., Kepnes L.J, Sbapiro J. Efficacy and qualitu-of-life impact of adult tonsillectomy. Arcb Otolaryngol Head Neck Surg, 2001, vol. 127, no. 11, pp. 1347–1350.Mui S., Rasgon B.M., Hilsinger R.L. Efficacy of tonsillectomy for recurrent throat infection in adults. Laryngoscope, 1998, vol. 108, no. 9, pp. 1325–1328.Mui S., Rasgon B.M., Hilsinger R.L. Efficacy of tonsillectomy for recurrent throat infection in adults. Laryngoscope, 1998, vol. 108, no. 9, pp. 1325–1328.

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