The autonomic nervous system and ventricular arrhythmias in myocardial infarction and heart failure.

The autonomic nervous system and ventricular arrhythmias in myocardial infarction and heart failure.
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DOI:
10.1111/pace.13856
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发表时间:
2020-02
期刊:
Pacing and clinical electrophysiology : PACE
影响因子:
--
通讯作者:
Vaseghi M
Vaseghi M
中科院分区:
其他
文献类型:
--
作者:
Wu P;Vaseghi M

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室性心律失常(VA)的表现可以从无症状到心脏骤停和心源性猝死(SCD)。持续性室性心动过速/室颤(VT/VF)是SCD的常见原因,在最近的一项院外心脏骤停前瞻性研究中占病例的48%。与心肌梗死(MI)相关的VT发生率在3.2%至5.7%之间,并与左心室功能障碍相关。这些研究强调了在冠状动脉综合征和心力衰竭的背景下特别致血栓的心脏合胞体。在这篇综述中,我们概述了心脏自主神经系统(ANS)的组成部分,在正常的心脏电生理和功能中发挥重要作用。此外,发生在心脏病的设置,包括不利的神经重塑和神经激素激活,这显着有助于VT/VF的倾向的变化进行了讨论。
Ventricular arrhythmias (VA) can range in presentation from asymptomatic to cardiac arrest and sudden cardiac death (SCD). Sustained ventricular tachycardia/ventricular fibrillation (VT/VF) are a common cause of SCD, accounting for up to 48% of cases in a recent prospective study of out-of-hospital sudden cardiac arrests. The incidence of VT associated with myocardial infarction (MI) ranges between 3.2% and 5.7%, and in association with left ventricular dysfunction. These studies highlight a particularly arrhythmogenic cardiac syncytia in the setting of coronary syndromes and heart failure. In this review, we outline the components of the cardiac autonomic nervous system (ANS) that play an important role in normal cardiac electrophysiology and function. In addition, changes that occur in the setting of cardiac disease including adverse neural remodeling and neurohormonal activation, which significantly contribute to propensity for VT/VF are discussed.
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