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Stroke:缺血性卒中在非持续性房颤患者中的表型

2015-02-02 李志行译 MedSci原创

动态心脏检测的广泛应用不仅提高了对高风险心律失常,例如持久或阵发性房颤的检测水平,而且还使准确检测其他失常例如室上性心动过速的短暂(<30 秒) 不规则心率成为可能。缺血性卒中的表型可能会帮助我们理解这些非持续性片段在卒中病理生理学上所起到的作用,正如与其相应的持久或阵发的部分。研究方法:在一组连续的卒中患者中,我们回顾性地明确了与非持续性房颤有关的临床和影像学特征(n=126),定义为持续

动态心脏检测的广泛应用不仅提高了对高风险心律失常,例如持久或阵发性房颤的检测水平,而且还使准确检测其他失常例如室上性心动过速的短暂(<30 秒) 不规则心率成为可能。缺血性卒中的表型可能会帮助我们理解这些非持续性片段在卒中病理生理学上所起到的作用,正如与其相应的持久或阵发的部分。

研究方法:


在一组连续的卒中患者中,我们回顾性地明确了与非持续性房颤有关的临床和影像学特征(n=126),定义为持续小于30秒的阵发性心动过速并通过24小时Holter检测伴有不规则的RR间期,进而将研究对象与持续性或阵发性房颤的患者(n=239)以及没有房颤的患者进行比较。



研究结果:

持续性或阵发性房颤患者与非持续性房颤患者之间有显著的不同,其女性患者有更高的患病率 (OR [95% CI], 1.8 [1.1–2.9]),冠心病发病率(1.9 [1.1–3.0])与栓塞影像学特性(2.7 [1.1–6.5])也更加显著,但在吸烟频率(0.4 [0.2–0.8])和高血脂(0.5 [0.3–0.8])方面有较低的水平。与非持续性房颤患者相比,无房颤的患者更加年轻 (0.5 [0.4–0.6] per decade)而且以男性患者(1.7 [1.0–2.8])居多,非持续性房颤的发病率在隐源性和非隐源性卒中患者中是相似的(32% versus 29%)。对于损伤概率地图进行基于Voxel水平的比较发现,在患有或不患有非持续性房颤的隐源性卒中患者之间没有显著的差别。




研究结论:

非持续性房颤患者的临床特点表现出在持续性或阵发性房颤患者和无房颤患者之间存在一种中间表型。除此之外,影像学特征在长期房颤患者中也不完全一样。

原始出处:

Ethem M. Arsava, Demet F. Bas, Enver Atalar, Arzu C. Has, Kader K. Oguz, and Mehmet A. Topcuoglu
Ischemic Stroke Phenotype in Patients With Nonsustained Atrial Fibrillation
Stroke 2015; first published on January 29 2015 as doi:10.1161/STROKEAHA.114.006396

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    2015-02-04 tastas
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    2015-02-03 MedSci客户端网友

    持续性或阵发性房颤患者与非持续性房颤患者之间有显著的不同

    0

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