rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2019-15-2-244-250rpcardio-1921Research ArticlePOINT OF VIEWТОЧКА ЗРЕНИЯMammographic Screening as a Tool for Cardiovascular Risk Assessing. Part 1. Breast Arterial Calcification: Pathomorphology, Prevalence and Risk FactorsМаммографический скрининг как инструмент оценки сердечно-сосудистого риска. Часть 1. Кальциноз артерий молочной железы: патоморфология, распространенность, факторы рискаБочкареваЕ. В.BochkarevaE. V.

Бочкарева Елена Викторовна - доктор медицинских наук, руководитель лаборатории медикаментозной профилактики в первичном звене здравоохранения, отдел первичной профилактики хронических неинфекционных заболеваний в системе здравоохранения, НМИЦ ПМ.

101990, Москва, Петроверигский пер., 10

Elena V. Bochkareva - MD, PhD, Head of Laboratory of Drug Prevention in Primary Care, Department of Primary Prevention of Chronic Non-Communicable Diseases in the Healthcare System.

Petroverigsky per. 10, Moscow, 101990

ebochkareva@gnicpm.ruКимИ. В.KimI. V.

Ким Ирина Витальевна - кандидат медицинских наук, научный сотрудник, лаборатория медикаментозной профилактики в первичном звене здравоохранения, отдел первичной профилактики хронических неинфекционных заболеваний в системе здравоохранения, НМИЦ ПМ.

101990, Москва, Петроверигский пер., 10

Irina V Kim - MD, PhD, Researcher, Laboratory of Drug Prevention in Primary Care, Department of Primary Prevention of Chronic Non-Communicable Diseases in the Healthcare System.

Petroverigsky per. 10, Moscow, 101990

БутинаЕ. К.ButinaE. K.

Бутина Екатерина Кронидовна – кандидат медицинских наук, старший научный сотрудник, лаборатория медикаментозной профилактики в первичном звене здравоохранения, отдел первичной профилактики хронических неинфекционных заболеваний в системе здравоохранения, НМИЦ ПМ.

101990, Москва, Петроверигский пер., 10

Ekaterina K. Butina - MD, PhD, Senior Researcher, Laboratory of Drug Prevention in Primary Care, Department of Primary Prevention of Chronic Non-Communicable Diseases in the Healthcare System.

Petroverigsky per. 10, Moscow, 101990

СтулинИ. Д.StulinI. D.

Стулин Игорь Дмитриевич - доктор медицинских наук, профессор, заведующий кафедрой нервных болезней, лечебный факультет, МГМСУ им. А.И. Евдокимова.

127473, Москва, ул. Делегатская, 20/1

Igor D. Stulin - MD, PhD, Professor, Head of Chair of Diseases of Nervous System.

Delegatskaya ul. 20/1, Moscow, 127423

ТрухановС. А.TrukhanovS. A.

Труханов Сергей Александрович - кандидат медицинских наук, ассистент, кафедра нервных болезней, лечебный факультет, МГМСУ им. А.И. Евдокимова.

127473, Москва, ул. Делегатская, 20/1

Sergey A. Trukhanov - MD, PhD, Assistant, Chair of Diseases of Nervous System.

Delegatskaya ul. 20/1, Moscow, 127423

РуденкоБ. А.RudenkoB. A.

Руденко Борис Александрович - доктор медицинских наук, руководитель отдела инновационных методов профилактики, диагностики и лечения сердечно-сосудистых и других хронических неинфекционных заболеваний, НМИЦ ПМ.

101990, Москва, Петроверигский пер., 10

Boris A. Rudenko - MD, PhD, Head of Department of Innovative Methods of Cardiovascular and Other Non-Communicable Diseases Prevention, Diagnostics and Treatment.

Petroverigsky per. 10, Moscow, 101990

БойцовС. А.BoytsovS. A.

Бойцов Сергей Анатольевич - доктор медицинских наук, профессор, член-корр. РАН, генеральный директор НМИЦ кардиологии.

121552, Москва, 3-я Черепковская, 15А

Sergey A. Boytsov - MD, PhD, Professor, Corresponding Member of the Russian Academy of Sciences, General Director.

Tretya Cherepkovskaya ul. 15А, Moscow, 121552

ДрапкинаО. М.DrapkinaO. M.

Драпкина Оксана Михайловна - доктор медицинских наук, профессор, член-корр. РАН, директор НМИЦ ПМ.

101990, Москва, Петроверигский пер., 10

Oxana M. Drapkina - MD, PhD, Professor, Corresponding Member of the Russian Academy of Sciences, Director.

Petroverigsky per. 10, Moscow, 101990

Национальный медицинский исследовательский центр профилактической медициныРоссияNational Medical Research Center for Preventive MedicineRussian FederationМосковский государственный медико-стоматологический университет им. А.И. ЕвдокимоваРоссияA.I. Yevdokimov Moscow State University of Medicine and DentistryRussian FederationНациональный медицинский исследовательский центр кардиологииРоссияNational Medical Research Centre of CardiologyRussian Federation201905052019152244250Copyright © Bochkareva E.V., Kim I.V., Butina E.K., Stulin I.D., Trukhanov S.A., Rudenko B.A., Boytsov S.A., Drapkina O.M., 20192019Бочкарева Е.В., Ким И.В., Бутина Е.К., Стулин И.Д., Труханов С.А., Руденко Б.А., Бойцов С.А., Драпкина О.М.Bochkareva E.V., Kim I.V., Butina E.K., Stulin I.D., Trukhanov S.A., Rudenko B.A., Boytsov S.A., Drapkina O.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/1921

Breast arterial calcification (BAC) is a type of calcification of the media of the middle and small arteries (Menkeberg's calcification). This distinguishes it from calcification associated with the atherosclerotic process and localized in the intima of the vessel. There are data on the association of BAC with cardiovascular diseases (CVD). This allows it to be considered as a new marker of cardiovascular risk in women. The purpose of the first part of the review is to analyze the current literature on the prevalence of BAC, factors related to its occurrence and the association of BAC with traditional CVD risk factors. The prevalence of BAC (data from cancer screening programs) is about 12.7%, and it increases with age to 50% in 80-year-old women. It is not an attribute of "healthy aging", but depends on race and ethnicity. There is a connection with reproductive function. The frequency of BAC increases with the number of children born, with breastfeeding, in menopause, and decreases during hormone replacement therapy. Smoking women have a BAC frequency 2 times less than non-smokers. Detection of BAC on mammograms is associated with conditions pathogenetically associated with CVD: an increase in the frequency of hyperlipidemia, diabetes, chronic kidney disease, a decrease in bone mass. There is a strong correlation of BAC with coronary calcium (indicator of coronary atherosclerosis). A statistically significant association of BAC with overweight, obesity, and smoking was not found, but there is a weak association with arterial hypertension. This may indicate an independent pathophysiological role of BAC in the development of vascular disorders and allows us to consider BAC as an independent marker for improving cardiovascular risk stratification in women. BAC is believed to be a marker of a more generalized trend towards the development of medial calcification in other vascular areas. This leads to a systemic increase in arterial stiffness and contributes to the development of CVD.

Кальциноз артерий молочной железы (КМА) является формой кальциноза медиальной оболочки средних и мелких артерий (кальциноза Менкеберга), что отличает его от кальциноза, связанного с атеросклеротическим процессом и локализованного в интиме сосуда. Имеются данные о связи КМА с сердечно-сосудистыми заболеваниями (ССЗ), что позволяет рассматривать его в качестве нового маркера сердечнососудистого риска у женщин. Целью 1 -й части обзора является анализ современной литературы, посвященной распространенности КМА, факторам, связанным с его возникновением, и ассоциации КМА с традиционными факторами риска ССЗ. По данным программ онкологического скрининга распространенность КМА составляет в среднем 12,7%, увеличивается с возрастом, достигая 50% у 80-летних женщин, не являясь при этом атрибутом «здорового старения», зависит от расовой и этнической принадлежности. Имеется связь с репродуктивной функцией, частота КМА возрастает в зависимости от количества рожденных детей, при грудном кормлении, в менопаузе, снижается на фоне гормонозаместительной терапии. Среди курящих женщин частота КМА парадоксальным образом в 2 раза меньше, чем у некурящих. Обнаружение КМА на маммограммах ассоциируется с состояниями, патогенетически связанными с ССЗ: увеличением частоты гиперлипидемии, диабета, хронической болезни почек, снижением костной массы. Имеется сильная корреляция КМА с коронарным кальцием - индикатором коронарного атеросклероза. В то же время отсутствует статистически значимая связь КМА с избыточной массой тела и ожирением, курением, имеется слабая связь с артериальной гипертонией, что может свидетельствовать о самостоятельной патофизиологической роли КМА в развитии сосудистой патологии, и позволяет рассматривать КМА в качестве независимого маркера для улучшения стратификации сердечно-сосудистого риска у женщин. Полагают, что КМА является маркером более генерализованной тенденции к развитию медиального кальциноза в других сосудистых областях, приводящей к системному увеличению артериальной жесткости, что способствует развитию ССЗ.

 

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