在心房动中扩张性功能障碍的患病率和发病率:临床影响
Jwan A Naser1, Eunjung Lee1, Christopher G Scott2
1Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55902, USA.
European heart journal
|August 28, 2023
概括
新发动的心房 (AF) 与扩张性功能障碍 (DD) 的更高的患病率和更快的进展有关,这是心力衰竭的关键特征,具有保存的射出分数 (HFpEF). 在AF患者中早期评估HFpEF至关重要.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 心脏衰竭研究研究
背景情况:
- 心房动 (AF) 和心力衰竭与保存的喷射分数 (HFpEF) 密切相关.
- 在AF患者中,HFpEF可能会被忽视,症状仅归因于心律失常.
- 新发病的AF可能表明患有扩张性功能障碍 (DD) 的风险增加.
研究的目的:
- 为了确定新发性AF患者中DD的患病率,与鼻腔节律 (SR) 患者相比.
- 评估新发性AF患者中DD的发病率和进展率与SR相比.
- 确定新发性AF与HFpEF风险因素之间的关联.
主要方法:
- 分析了没有结构性心脏病的新发性AF (n=1747) 或SR (n=29,623) 的成年人.
- 倾向性得分匹配 (1:3比) 用于在关键的人口统计和并发症方面平衡AF和SR组.
- 严重的DD被定义为4个异常心声学参数中的≥3个;中度或更大的DD (≥MDD) 定义为4个中的≥2个.
主要成果:
- 新发性AF与较高的严重DD (8%与3%) 和≥MDD (25%与16%) 相关.
- 在3.2年内,DD在新发性AF患者中进展速度快2至4倍.
- 新发性AF中发生DD的风险显著增加 (SDD的HR为2.69,MDD≥的HR为1.73).
结论:
- 新发性AF患者在诊断时表现出高风险HFpEF特征.
- 评估具有症状的AF患者的HFpEF是必不可少的.
- 新发性AF中的加速DD进展可能会识别临床前的HFpEF,为预防性治疗提供一个窗口.
相关概念视频
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
23
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
23
Mitral Stenosis II: Clinical features and Diagnostic Tests
22
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
22
Aortic Regurgitation III: Medical Management
25
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
25
Cardiomyopathy II: Dilated Cardiomyopathy
11
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
11
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
38
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
38
Mitral Regurgitation II: Clinical Features and Diagnostic Tests
22
Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...
22


