流行病学,预后和与甲状腺功能障碍相关的心房动的管理中的挑战
Georgios Kostopoulos1, Grigoris Effraimidis2
1Department of Endocrinology and Metabolism, Ippokratio General Hospital of Thessaloniki, Greece.
European thyroid journal
|February 20, 2024
概括
与甲状腺功能障碍相关的心房动 (AF) 是可逆的. 恢复甲状腺功能和使用基于CHA2DS2-VASc评分的抗凝剂是这种常见心脏并发症的关键管理策略.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 内部医学 内部医学
背景情况:
- 心房动 (AF) 影响全球6000万,是甲状腺功能障碍症的常见心脏并发症 (患者中有5-15%).
- 亚临床甲状腺功能障碍和自由T4水平升高增加了AF风险.
- 甲状腺功能障碍与甲状腺功能障碍相关的AF通常在实现甲状腺功能改善后是可逆的.
研究的目的:
- 审查与甲状腺功能障碍相关的AF的流行病学,预后和诊断.
- 讨论与甲状腺功能障碍相关的AF当前的管理策略和争议.
- 评估抗凝剂和新型口服抗凝剂在治疗这种疾病中的作用.
主要方法:
- 文献综述,重点关注甲状腺功能障碍和心房动.
- 对流行病学数据和临床结果的分析.
- 讨论治疗指南和新兴治疗方法.
主要成果:
- 恢复类甲状腺症对于AF管理至关重要,大多数患者在4-6个月内恢复到鼻节律.
- β抑制剂是控制速率的第一线;节律控制是保留给持久病例的.
- 抗凝血决定应遵循CHA2DS2-VASc评分,直接口服抗凝血剂显示出有前途.
结论:
- 与甲状腺功能过高相关的AF需要迅速诊断和管理,重点是恢复甲状腺功能.
- 控制速率和适当的抗凝剂是必不可少的,以既定的风险评分为指导.
- 需要进一步的研究来澄清甲状腺功能障碍在中风风险中的独立作用,并优化治疗方案.
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