動脈動における血栓形成のメカニズム:Virchowのトライアードは再検討されました
Timothy Watson1, Eduard Shantsila, Gregory Y H Lip
1University Department of Medicine, City Hospital, Birmingham, UK.
Lancet (London, England)
|January 13, 2009
まとめ
常見の心臓リズム障害である心房細動は,複雑な血栓形成メカニズムによる脳卒中リスクを高めます. このレビューは,血流,血管壁,および血液成分が,心房細動患者の血栓形成にどのように寄与するかを詳細に説明します.
科学分野:
- 心臓病学 心臓病学
- 病理生理学 病理生理学とは
- トロンボシス (Thrombosis) とは
背景:
- 心房細動は,最も一般的な持続心律不整です.
- 脳卒中や血栓塞栓症のリスクが高い.
- 心房細動における血栓形成には,複数の病理生理学的メカニズムが関与します.
研究 の 目的:
- 動脈動における血栓形成の確立されたおよび推定されたメカニズムをレビューする.
- この心拍不良における血栓形成に寄与する要因の概要を述べる.
主な方法:
- 動脈動と血栓形成に関する既存の証拠の文献レビュー.
- 流動力学,血管壁の変化,血液成分を含む病理生理学的メカニズムの分析.
主要な成果:
- 異常な左心房の流れ (静止,自発的なエコーコントラスト) は,血栓形成に寄与する.
- 血管壁の異常 (心房の膨張,心臓内臓の変化,マトリックス浸透) が関与しています.
- 血液成分の変化 (血静性/血小板活性化,炎症,成長因子) は,前血栓状態を促進する.
結論:
- 心房細動における血栓形成のメカニズムは,Virchowのトライアードと一致しています.
- これらの要因は,集団的に高凝固状態を生み出し,脳卒中のリスクを高めます.
- これらのメカニズムを理解することは,心房細動における血栓塞栓性イベントの管理に不可欠です.
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