Tropismul cardiac negativ în pneumologie: aspecte clinice, farmacologice și patofiziologice.
DOI:
https://doi.org/10.52692/1857-0011.2025.3-83.30Cuvinte cheie:
pneumologie, tuberculoză, BPOC, cardiotoxicitate, hipoxie, inflamație sistemică, îngrijire cardiopulmonarăRezumat
Rezumat. Tropismul cardiac negativ în pneumologie: aspecte clinice, farmacologice și patofiziologice.Pneumologia include afecțiuni pulmonare severe, în special tuberculoza (TB) și boala pulmonară obstructivă cronică (BPOC), cu impact semnificativ asupra sistemului cardiovascular. Această sinteză sistematizează dovezile actuale privind efectele cardiotropice negative ale acestor boli și tratamentelor specifice. Factorii farmacologici, precum medicamentele anti-TB (Bedaquilina, Delamanidul), prezintă riscuri de prelungire a intervalului QT și aritmii, necesitând monitorizare cardiacă atentă. Hipoxia cronică, rezultată din implicarea pulmonară extinsă, induce hipertensiune pulmonară și cor pulmonale, ducând progresiv la insuficiență cardiacă dreaptă. Intoxicația endogenă produsă de inflamație și necroză, împreună cu factori exogeni ca fumatul și alcoolul, agravează suplimentar funcția cardiovasculară. Inflamația sistemică persistentă în TB și bpoc favorizează ateroscleroza și evenimentele cardiace, independent de factorii tradiționali de risc. în practica clinică, scenariile cu mecanisme patogenetice suprapuse complică managementul pacienților. rezultatele subliniază necesitatea îngrijirii integrate și evaluării cardiovasculare sistematice pentru reducerea morbidității cardiovasculare în pneumologie.
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