PLos One:心脏血流动力学对阵发性和非阵发性房颤患者血栓栓塞事件的影响

2019-03-30 xiangting MedSci原创

阵发性和非阵发性房颤具有不同的机制,导致血栓形成和随后的栓塞事件。

左心房(LA)或左心耳(LAA)中的血流停滞被认为是房颤(AF)患者血栓形成和全身性栓塞的主要原因。阵发性和非阵发性AF在很多方面有明显的不同。两个不同的AF群体间心脏血流动力学对全身性栓塞的影响也可能不同。这项研究旨在评估心脏血流动力学对阵发性和非阵发性房颤患者全身性栓塞的影响。

对1998年6月至2018年2月在韩国大学医学中心Anam医院接受射频导管消融术(RFCA)的连续性AF患者进行分析。在首次接受RFCA治疗的2,801名患者中,共有231名患者既往有缺血性卒中、短暂性脑缺血发作或动脉栓塞。在阵发性AF患者中,有和无血栓栓塞事件患者间的LA直径、LA容积(用磁共振成像测量)、左心室(LV)射血分数、E/e'、LAA流速、自发性回声对比(SEC)和密集SEC的患病率有显著不同。然而,在非阵发性AF患者中,有和无血栓栓塞事件的患者间只有E/e'不同。LA直径、LA容积、LVEF、LAA流速和密集SEC对血栓栓塞事件的影响受到AF类型的显著影响。

总之,阵发性和非阵发性房颤具有不同的机制,导致血栓形成和随后的栓塞事件。血流动力学参数和其他因素如心房肌病,对阵发性和非阵发性房颤血栓栓塞事件的相对贡献需要进一步的评估。

原始出处:

Yun Gi Kim. Different influence of cardiac hemodynamics on thromboembolic events in patients with paroxysmal and non-paroxysmal atrial fibrillation. PLos One. 29 March 2019.

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    2019-03-30 中医痴

    不错的,学习了,谢谢分享!

    0

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对于二尖瓣狭窄和房颤患者,需要服用抗凝药物以预防卒中的发生,到目前为止,所有研究直接口服抗凝药物(DOACs)的研究均排除了中重度二尖瓣狭窄患者。本研究的目的旨在评估DOACs对二尖瓣狭窄患者的疗效影响。本研究纳入了2230名二尖瓣狭窄和房颤患者(平均年龄为69.7±10.5岁,男性占30.6%),主要终点事件是缺血性卒中或系统性血栓的发生。结果显示,血栓栓塞事件的发生率在DOAC组中为2.22%

JAHA:NT-proBNP与房颤发生风险种族差异相关

黑种人的心血管疾病风险因素要多于白种人,但房颤的发生率却低于白种人,相反,白种人的心衰风险更低。在白人中,N末端前B型钠尿肽(NT-proBNP)水平较高,可预测房颤的发生,并在心室舒张压升高的情况下具有利尿作用,这可能为这些种族差异提供统一的解释。本研究纳入了4731名CHS临床研究中参与者(770名黑种人)和12418名ARIC临床研究的参与者(3091名黑种人),其中分别有1277名和125

JACC:经导管二尖瓣修复患者房颤的患病率以及对1年预后的影响

接受经导管MV修复的患者中AF很常见,并与1年的临床结局较差相关。

JACC:房颤患者认知功能的降低与亚临床脑损伤相关

房颤患者发生认知功能下降的风险更高,可能是由未知的脑血管损伤引起。本研究的目的旨在评估房颤患者的认知功能和脑血管损伤的相关性。本研究纳入了1737名房颤患者,平均年龄为73 ± 8 岁,女性占28%,90%接受有口服抗凝药物治疗。经过头颅磁共振检查,发现387名(22%)患者有大的非皮质或皮质梗塞(LNCCIs),368名(21%)患者有皮质下小梗死(SNCIs),372名(22%)患者有微出血,

JAHA:有心脏植入装置的黑人与白人房颤风险的比较

在拥有能够检测心房节律心脏植入装置的医保受益者中,尽管黑人血管危险因素的负担和卒中风险高,但其AF发病率低。

JAMA:导管消融 vs 抗心律失常药物对房颤患者生活质量的影响

研究认为对于症状性房颤患者,导管消融治疗对患者12个生活质量的改善效果优于抗心律失常药物