Left Atrial Size and Atrial Fibrillation in Mitral Stenosis: Factors Influencing Their Relationship
Left Atrial Size and Atrial Fibrillation in Mitral Stenosis: Factors Influencing Their Relationship
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二尖瓣狭窄时的左心房大小和心房颤动：影响其关系的因素
DOI：
10.1161/01.cir.48.6.1282
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发表时间：
1973
期刊：
影响因子：
37.8
通讯作者：
A. Selzer
中科院分区：
文献类型：
--
作者：
P. Probst;N. Goldschlager;A. Selzer
在135例二尖瓣狭窄患者中，分为三组：窦性心律患者、间歇性房颤患者和长期房颤患者。研究二尖瓣狭窄患者心房颤动、血流动力学表现和放射学资料之间的关系。对三组患者的临床和血流动力学因素分析表明：1）年龄是房颤发生的一个病因，这一点从三组患者的年龄分布中可以看出; 2）左房扩大可能是房颤的结果，而不是原因; 3）二尖瓣狭窄的严重程度与房颤的发生率并不总是相关的。三组之间的血流动力学测量结果无显著差异，唯一例外是在已确诊房颤的患者中发现心输出量较低。由于二尖瓣狭窄的单一后果并不总是导致房颤，因此建议不同组合的几个因素可以启动房颤的自我持续过程，并且心律失常的经典形式可能继发于左心房扩大。
In a series of 135 patients with mitral valvular stenosis, three groups were identified: those in sinus rhythm, those with intermittent atrial fibrillation, and those with longstanding, established atrial fibrillation. Examination of the relationships between atrial fibrillation, hemodynamic findings and radiologic data in mitral stenosis was undertaken. Analysis of clinical and hemodynamic factors in the three groups revealed that: 1) age is an etiological factor in the production of atrial fibrillation, as suggested by the age distribution among the three groups; 2) left atrial enlargement may be the result, rather than the cause, of atrial fibrillation; and 3) severity of mitral stenosis is not invariably related to the incidence of atrial fibrillation. Hemodynamic measurements were not significantly different among the three groups, with the single exception of lower cardiac outputs found in patients with established atrial fibrillation. Since no single consequence of mitral stenosis always produces atrial fibrillation, it is suggested that several factors in different combinations can initiate the self-perpetuating process of atrial fibrillation and that the classic form of the arrhythmia may lead secondarily to left atrial enlargement.