RELATION BETWEEN ECHOCARDIOGRAPHICALLY DETERMINED LEFT ATRIAL SIZE AND ATRIAL-FIBRILLATION
RELATION BETWEEN ECHOCARDIOGRAPHICALLY DETERMINED LEFT ATRIAL SIZE AND ATRIAL-FIBRILLATION
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DOI：
10.1161/01.cir.53.2.273
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发表时间：
1976-01-01
期刊：
影响因子：
37.8
通讯作者：
EPSTEIN, SE
中科院分区：
文献类型：
--
作者：
HENRY, WL;MORGANROTH, J;EPSTEIN, SE
为了定量确定左房大小与房颤的关系，我们采用超声心动图对85例孤立性二尖瓣疾病患者、50例孤立性主动脉瓣疾病患者和130例不对称间隔肥厚患者进行了研究。在所有三组患者中，左房径小于44 mm的房颤少见（117例中有3例，占3%），但左房径大于40 mm的房颤很常见（148例中有80例，占54%）。此外，当左房面积超过45mm时，复律虽然最初成功，但不太可能产生维持至少6个月的窦性心律。这些数据表明，左心房大小是心房颤动发展的一个重要因素，并决定了心脏复律的长期结果。病理生理机制与此最一致的是，慢性血流动力学负担最初产生左心房扩大，这反过来又易发生心房颤动。只有前瞻性研究才能明确地确定这些观察结果是否有助于预防性抗凝和选择性心律转复的决策。
In an attempt to define quantitatively the relation between left atrial size and atrial fibrillation, echocardiography was used to study 85 patients with isolated mitral valve disease, 50 patients with isolated aortic valve disease, and 130 patients with asymmetric septal hypertrophy. In all three groups of patients, atrial fibrillation was rare when left atrial dimension was below 44 mm (3 of 117 or 3%) but common when this dimension exceeded 40 mm (80 of 148 or 54%). In addition, when left atrial dimension exceeds 45 mm, cardioversion, while initially successful, is unlikely to produce sinus rhythm that can be maintained at least six months. These data suggest that left atrial size is an important factor in the development of atrial fibrillation and in determining the long term result of cardioversion. The pathophysiologic mechansim most consistent with this is that a chronic hemodynamic burden initially produces left atrial enlargement which in turn predisposes to atrial fibrillation. Only prospective studies will determine definitively whether these observations will be useful in decisions concerning prophylactic anticoagulation and elective cardioversion.