КЛИНИЧЕСКОЙ ПРИМЕНЕНИЕ ФОТОПЛЕТИЗМОГРАФИИ ДЛЯ ВЫЯВЛЕНИЯ РИСКА РАЗВИТИЯ СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЙ

Введение. Настоящий литературный обзор посвящён современным методам оценки сердечно-сосудистого риска с использованием фотоплетизмографии и вариабельности сердечного ритма. Рассмотрены неинвазивные подходы к анализу состояния сосудистой стенки, артериальной жесткости, сердечного ритма и микроциркуляции, а также их связь с факторами риска сердечно-сосудистых заболеваний.

Цель. Проанализировать возможности фотоплетизмографии как неинвазивного метода раннего выявления риска сердечно-сосудистых заболеваний и обосновать необходимость её более активного применения в клинической практике.

Материалы и методы. Проведен поиск зарубежных и отечественных источников в базах данных PubMed, Google Scholar, Cochrane Library, Scopus Preview и eLibrary, CyberLeninka. посвященных методам оценки показателей вариабельности сердечного ритма и фотоплетизмографии. Глубина поиска составила 10 лет.

Результаты и обсуждение. Обзор выявил перспективность фотоплетизмографии и вариабельности сердечного ритма как информативных цифровых маркеров, способных отражать субклинические сосудистые изменения и предсказывать кардиоваскулярные события, при этом подчеркнуты существующие ограничения: необходимость стандартизации протоколов записи сигналов, вариабельность качества данных, отсутствие долгосрочных клинических исходов и ограниченная внешняя валидация моделей. Представленные данные подтверждают необходимость дальнейших проспективных исследований, улучшения качества сигналов, разработки интерпретируемых AI-моделей и интеграции фотоплетизмографии/вариабельности сердечного ритма с другими биомаркерами для комплексной оценки сердечно-сосудистого здоровья.

Выводы. Литературный обзор показывает, что фотоплетизмография является перспективным и доступным неинвазивным методом ранней оценки сердечно-сосудистого состояния. Анализ Фотоплетизмографии-сигналов позволяет выявлять артериальную жёсткость, сосудистый тонус и другие ранние субклинические изменения, связанные с риском сердечно-сосудистых заболеваний. Однако, несмотря на высокий потенциал, клиническое применение метода ограничено отсутствием стандартизированных протоколов, разнородностью устройств, вариабельностью качества данных и недостаточной клинической валидацией, а также преобладанием кросс-секционных исследований без долгосрочных исходов.

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