孤独的心房与左心室能量的损伤有关,尽管管切除成功,但仍然存在
Rohan S Wijesurendra1, Alexander Liu1, Christian Eichhorn1
1From Division of Cardiovascular Medicine, University of Oxford, Oxford, UK (R.S.W., A.L., C.E., R.A., E.L., W.T.C., C.T.R., T.D.K., V.M.F., S.N., B.C.); University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, UK (R.S.W., A.L., C.E., R.A., E.L., W.T.C., C.T.R., T.D.K., V.M.F., S.N.); and Oxford Heart Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK (Y.B., M.G., K.R., T.B.).
孤独心房动 (AF) 患者表现出持续的左心室功能障碍和能量损失,即使经过切除恢复了鼻节律 (SR). 这些发现表明心肌梗塞可能源于潜在的心肌病, 而不是仅仅是心肌病的原因.
科学领域:
- 心脏病学
- 电生理学
- 心血管成像
背景情况:
- 孤独心房动 (AF) 可能表明潜在的亚临床心肌病.
- 这种心肌病甚至在成功恢复鼻节律 (SR) 后也可能持续存在.
研究的目的:
- 在单独的AF患者中,通过导管切除恢复SR对左心室 (LV) 功能和能量的影响进行调查.
- 确定AF切除后LV功能障碍和能量损失是否恢复正常.
主要方法:
- 磁共振成像 (MRI) 评估了 LV 喷射分数 (LVEF),最大静脉周围应变 (PSCS) 和左心房体积/功能.
- -31磁共振光谱评估了心室能量 (蛋白与ATP的比率).
- 使用霍尔特和前后的事件监测来量化AF负担.
主要成果:
- 单独的AF患者与对照患者相比,表现出LV功能和能量受损.
- 在切除后的早期, LV 功能呈现过渡性改善,但没有长期正常化.
- 无论是SR恢复还是AF复发,心房功能和心室能量仍然受到损害.
结论:
- 孤独的AF患者具有内在的心肌能量损伤和微妙的LV功能障碍.
- 这些异常在导管切除后仍然存在, 表明AF是隐性心肌病的结果.
- 尽管AF负担显著降低,但潜在心肌病并没有消失.
相关概念视频
Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Heart Failure II: Pathophysiology
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
Cardiac Cycle
During the cardiac cycle, blood flow through the heart is regulated entirely by changing pressure gradients. This sequence of events begins with the heart in a state of total relaxation, known as mid-to-late diastole, during which blood passively flows from...
Pathophysiology of Cardiac Performance


