心血管

订阅

MedSci主页 / 所有栏目 / 心血管

Heart：阵发性房颤HCM患者易出现运动障碍

2013-12-16 高晓方 译 医学论坛网

阵发性房颤HCM肥厚型心肌病运动障碍
关注

美国一项研究表明，在肥厚型心肌病（HCM）患者中，阵发性房颤与运动障碍具有相关性。论文12月10日在线发表于《心脏》（Heart）。 房颤是HCM最常见的心律失常。此项研究共纳入265例HCM患者，并对其实施了心肺试验和呼出气分析。采集基线人口统计数据、病史和静息超声心动图。通过病历和基线心电图确认房颤诊断。阵发性房颤患者在接受心肺试验时为窦性心律。以峰值VO2<20 mL/kg/mi

美国一项研究表明，在肥厚型心肌病（HCM）患者中，阵发性房颤与运动障碍具有相关性。论文12月10日在线发表于《心脏》（Heart）。

房颤是HCM最常见的心律失常。此项研究共纳入265例HCM患者，并对其实施了心肺试验和呼出气分析。采集基线人口统计数据、病史和静息超声心动图。通过病历和基线心电图确认房颤诊断。阵发性房颤患者在接受心肺试验时为窦性心律。以峰值VO2<20 mL/kg/min定义运动障碍。利用多变量Logistic回归评估运动障碍与阵发性房颤的相关性。

结果显示，55例患者伴有房颤，其中阵发性和永久性房颤分别为28和27例。与无房颤者相比，阵发性房颤患者年龄较大，更有可能性应用抗心律失常和抗凝药物，并且左心房更大。阵发性房颤患者的峰值VO2较低（P=0.02），并且更有可能出现运动障碍（<0.001）。对年龄、性别和体质指数（BMI）进行校正之后，运动障碍仍与阵发性房颤显著相关（OR 4.65；P=0.001）。

原文出处：

Azarbal F, Singh M, Finocchiaro G, Le VV, Schnittger I, Wang P, Myers J, Ashley E, Perez M.Exercise capacity and paroxysmal atrial fibrillation in patients with hypertrophic cardiomyopathy.Heart. 2013 Dec 10. doi: 10.1136/heartjnl-2013-304908. 

版权声明：
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料，版权均属于梅斯医学所有。非经授权，任何媒体、网站或个人不得转载，授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章，或“梅斯号”自媒体发布的文章，仅系出于传递更多信息之目的，本站仅负责审核内容合规，其内容不代表本站立场，本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系，我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1355813, encodeId=0b0313558139c, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1368773, encodeId=aead1368e7337, content=<a href='/topic/show?id=b40b9423884' target=_blank style='color:#2F92EE;'>#运动障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94238, encryptionId=b40b9423884, topicName=运动障碍)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a7b6284, createdName=FukaiBao, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423524, encodeId=0ea71423524db, content=<a href='/topic/show?id=a1a69e630b5' target=_blank style='color:#2F92EE;'>#阵发性房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97630, encryptionId=a1a69e630b5, topicName=阵发性房颤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=36783798280, createdName=lqrandywkz, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1478110, encodeId=948514e811040, content=<a href='/topic/show?id=f51a8556cc' target=_blank style='color:#2F92EE;'>#HCM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8556, encryptionId=f51a8556cc, topicName=HCM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562199, encodeId=00d9156219971, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=)]
    2013-12-18 zhaojie88

    #ART#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1355813, encodeId=0b0313558139c, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1368773, encodeId=aead1368e7337, content=<a href='/topic/show?id=b40b9423884' target=_blank style='color:#2F92EE;'>#运动障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94238, encryptionId=b40b9423884, topicName=运动障碍)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a7b6284, createdName=FukaiBao, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423524, encodeId=0ea71423524db, content=<a href='/topic/show?id=a1a69e630b5' target=_blank style='color:#2F92EE;'>#阵发性房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97630, encryptionId=a1a69e630b5, topicName=阵发性房颤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=36783798280, createdName=lqrandywkz, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1478110, encodeId=948514e811040, content=<a href='/topic/show?id=f51a8556cc' target=_blank style='color:#2F92EE;'>#HCM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8556, encryptionId=f51a8556cc, topicName=HCM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562199, encodeId=00d9156219971, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=)]
    2013-12-18 FukaiBao

    #运动障碍#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1355813, encodeId=0b0313558139c, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1368773, encodeId=aead1368e7337, content=<a href='/topic/show?id=b40b9423884' target=_blank style='color:#2F92EE;'>#运动障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94238, encryptionId=b40b9423884, topicName=运动障碍)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a7b6284, createdName=FukaiBao, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423524, encodeId=0ea71423524db, content=<a href='/topic/show?id=a1a69e630b5' target=_blank style='color:#2F92EE;'>#阵发性房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97630, encryptionId=a1a69e630b5, topicName=阵发性房颤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=36783798280, createdName=lqrandywkz, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1478110, encodeId=948514e811040, content=<a href='/topic/show?id=f51a8556cc' target=_blank style='color:#2F92EE;'>#HCM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8556, encryptionId=f51a8556cc, topicName=HCM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562199, encodeId=00d9156219971, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=)]
    2013-12-18 lqrandywkz

    #阵发性房颤#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1355813, encodeId=0b0313558139c, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1368773, encodeId=aead1368e7337, content=<a href='/topic/show?id=b40b9423884' target=_blank style='color:#2F92EE;'>#运动障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94238, encryptionId=b40b9423884, topicName=运动障碍)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a7b6284, createdName=FukaiBao, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423524, encodeId=0ea71423524db, content=<a href='/topic/show?id=a1a69e630b5' target=_blank style='color:#2F92EE;'>#阵发性房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97630, encryptionId=a1a69e630b5, topicName=阵发性房颤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=36783798280, createdName=lqrandywkz, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1478110, encodeId=948514e811040, content=<a href='/topic/show?id=f51a8556cc' target=_blank style='color:#2F92EE;'>#HCM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8556, encryptionId=f51a8556cc, topicName=HCM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562199, encodeId=00d9156219971, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=)]
    2013-12-18 仁者大医

    #HCM#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1355813, encodeId=0b0313558139c, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1368773, encodeId=aead1368e7337, content=<a href='/topic/show?id=b40b9423884' target=_blank style='color:#2F92EE;'>#运动障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94238, encryptionId=b40b9423884, topicName=运动障碍)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a7b6284, createdName=FukaiBao, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423524, encodeId=0ea71423524db, content=<a href='/topic/show?id=a1a69e630b5' target=_blank style='color:#2F92EE;'>#阵发性房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97630, encryptionId=a1a69e630b5, topicName=阵发性房颤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=36783798280, createdName=lqrandywkz, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1478110, encodeId=948514e811040, content=<a href='/topic/show?id=f51a8556cc' target=_blank style='color:#2F92EE;'>#HCM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8556, encryptionId=f51a8556cc, topicName=HCM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562199, encodeId=00d9156219971, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=)]
    2013-12-18 slcumt

    #HEART#

    0

相关资讯

JCE ：导管消融可用于长期透析伴阵发性房颤患者

　　房颤在长期透析患者中十分常见，有报道显示13%-27%的长期透析患者合并房颤，而且合并房颤者的死亡率显着高于不合并房颤者。在临床实践中，一旦在透析过程中发作快心室率房颤，往往需要调整血透模式，甚至因为血流动力学异常和严重的心悸症状而停止血透。另外由于多数抗心律失常药物需要经过肾脏排泄，抗心律失常药物对慢性透析合并房颤患者的安全性和有效性都明显降低，因此这些患者需要一种新的治疗方法。 　　导管

NEJM述评：导管消融是治疗阵发性房颤的合理策略

房颤是一种最常见的心律不齐形式，患者80岁时的发生风险超过20%。房颤与心脏衰竭，中风，以及死亡率增加相关，随机试验显示旨在维持窦性心律（sinus rhythm）的抗心律失常药物治疗不能改善患者转归。近来，研究者将注意力转移到导管消融方向。一项小型，随机试验选择经抗心律失常药物治疗无效的患者入组，发现导管消融疗法维持窦性心律的效果优于抗心律失常药物。虽然有关生存率和死亡率的受益尚需证实

HRS 2013:治疗阵发性房颤复发 重复环肺静脉电隔离或优于药物

　　第34届美国心律学会年会（HRS 2013） 公布的一项随机试验显示，重复环肺静脉电隔离（PVI）治疗阵发性心房颤动复发优于抗心律失常药物（AAD）治疗；研究进一步表明，AAD治疗阵发性房颤复发作用微乎其微，并可能延误而使房颤病情恶化。 　　指南并不支持任何一种治疗策略用于阵发性房颤复发。有的患者选择重复PVI，有的选择AAD治疗，因此临床上以患者的选择优先。 　　该研

HRS 2013：医生对阵发性房颤患者口服抗凝治疗处方不足

　　第34届美国心律学会年会（HRS 2013） 公布的一项报告表明，尽管具有相似的血栓栓塞风险，但心内科医生为阵发性房颤患者开具口服抗凝治疗的可能性显著低于持续性房颤患者。而指南推荐，无论房颤为阵发性或持续性均应给予口服抗凝治疗。 　　此项研究共纳入62018例CHADS2评分>2的房颤患者，其中阵发性和持续性房颤患者分别占75%和25%。结果显示，与持续性房颤患者相

阵发性房颤非肺静脉触发灶常见部位为上腔静脉

陈红武、陈明龙和杨兵等回顾性分析了阵发性心房颤动（房颤）非肺静脉触发灶的临床特征及消融的长期随访结果。结果表明，非肺静脉触发灶可以发生于任何年龄段，其常见部位为上腔静脉，是肺静脉前庭隔离后复发的主要原因之一。相关论文在线发表于2013年第11期《中华心血管病杂志》。 86例患者入选本研究，男性48例。年龄27~73（52.3±10.2）岁，阵发性房颤的病史为（64.4±58.1）月。26