動脈動における左心房付属体の動脈動と動脈動の役割
Luigi Di Biase1, Andrea Natale1, Jorge Romero1
1Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
Circulation
|October 30, 2018
まとめ
左心房付属体 (LAA) は心房細動において重要な役割を果たし,血栓形成と心律不整に寄与する. LAAを標的とした治療法,例えば電気隔離や結合は,これらの状態の管理に希望を示しています.
科学分野:
- 心臓病科
- 電気生理学
- 血管生物学
背景:
- 左心房付属体 (LAA) は,心房細動 (AF) の病理生理学,特に血栓形成および動脈動乱に決定的に関与しています.
- LAAの解剖学と生理学を理解することは AFの効果的な治療法の開発に不可欠です
- LAAは非弁性AFにおける主要な血栓源であり,その形態は血栓栓塞栓のリスクを左右する.
研究 の 目的:
- 心房細動におけるLAAの解剖学的,生理学的,および臨床的重要性を検討する.
- 電気隔離と結合を含むLAAの介入がAFと関連するリスクの管理に果たす役割を議論する.
- LAAの電気隔離の安全性と有効性と,抗凝固戦略への影響を強調する.
主な方法:
- LAAの解剖学,生理学,AFにおける役割に関する研究の文献レビュー.
- LAAの電気隔離と結合に関する臨床データの分析.
- LAAの介入に関連する手続き上のリスクと利益の評価
主要な成果:
- LAAの形状は,血栓形成に影響を与え,血栓栓症のリスクの階層化に役立ちます.
- LAAの電気隔離はAFのカテーテル除去で達成可能ですが,遅い再接続は一般的です.
- LAA結合はレニン・アニオテンシン・アルドステロン系を調節し,血圧制御に影響を与える.
結論:
- LAAの電気隔離は,患者さんが終身の抗凝固療法に従っている限り,AF管理のための安全な手順です.
- 筋動脈の穿孔や神経/動脈の損傷などの合併症を避けるために,LAAの手続きでは特別な注意が必要です.
- LAAを標的とした治療は,心房細動患者の治療結果を改善する有望な治療戦略です.
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