Is ventricular arrhythmia a possible mediator of the association between aortic stenosis-related midwall fibrosis and mortality?
Is ventricular arrhythmia a possible mediator of the association between aortic stenosis-related midwall fibrosis and mortality?
复制标题
室性心律失常是否是主动脉瓣狭窄相关的中壁纤维化与死亡率之间关联的可能中介因素？
DOI：
10.1016/j.jacc.2011.04.045
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发表时间：
2011
影响因子：
24
通讯作者：
Nazarian,Saman
中科院分区：
文献类型：
--
作者：
Nazarian,Saman
1954年，Mitchell等人(1)报告了在马萨诸塞州波士顿的Peter Bent Brigham医院治疗的533例主动脉狭窄患者的40年临床特征。这些患者系列涉及汞类利尿剂、主动脉狭窄的外科治疗和青霉素的发展，这些进展改变了主动脉狭窄的流行病学和预后。这项研究的几个引人注目的观察结果仍然是本期《华尔街日报》报道的发现的核心。Mitchell等人(1)注意到症状出现后预期生存期显著缩短。平均寿命为心绞痛发作后4年，充血性心力衰竭发作后3.5年，晕厥后3年。在目击死亡的患者中，35%死于充血性衰竭，20.1%死于亚急性细菌性心内膜炎，2.3%死于心肌梗死，18.7%死于猝死，其余死因均为非心源性。猝死多发生在疾病的晚期，且与心绞痛史有关。然而，尸检显示，在没有死亡的情况下，猝死经常发生。
In 1954, Mitchell et al.(1) reported on 40 years of experience with clinical features of 533 cases of aortic stenosis managed at the Peter Bent Brigham Hospital of Boston, Massachusetts. This patient series spanned the development of mercurial diuretics, surgical cure for aortic stenosis, and penicillin, advances that have transformed the epidemiology and prognosis of aortic stenosis. Several remarkable observations of this study remain central to the findings reported in this issue of the Journal. Mitchell et al.(1) noted significantly shorter expected survival after the onset of symptoms. The average lifespan was 4 years after the onset of angina, 3.5 years after the onset of congestive heart failure, and 3 years after syncope. Among patients with witnessed deaths, 35% died of congestive failure, 20.1% of subacute bacterial endocarditis, 2.3% of myocardial infarction, and 18.7% of sudden death; the remaining causes of death were noncardiac. Sudden death tended to occur in the later stages of disease and was associated with history of angina. However, autopsy examinations revealed that sudden death frequently occurred in the absence of