Gustafsson C, Britton M, Brolund F, Eriksson S V, Lindvall K
Department of Medicine, Mariestad Hospital, Sweden.
Cardiology. 1992;81(4-5):189-95. doi: 10.1159/000175804.
We studied whether cardiac abnormalities contribute to the increased risk of stroke in patients with nonvalvular atrial fibrillation (NVAF). M-mode and 2D echocardiography were performed in four age- and gender-matched groups: 20 stroke patients with NVAF, 20 patients with NVAF who had not suffered a previous stroke, 20 stroke patients with sinus rhythm, and 40 healthy controls. Their mean age was 77 years. The two groups with atrial fibrillation differed from healthy controls in that they had more 2D-echocardiographic findings of severe left-ventricular-wall-motion abnormalities (p < 0.05) and tended more often to have enlarged left ventricles, and hypertrophic and congestive cardiomyopathy. Left atrial diameter was 47 mm compared to 41 and 39 mm in the two groups with sinus rhythm (p < 0.001). Intracardiac thrombi were only found in the two atrial-fibrillation groups (with stroke: 15% without stroke: 5%). Aortic sclerosis was common in all groups (30-60%), as was mitral annulus calcification (10-20%). The only significant difference between the two atrial-fibrillation groups was a higher frequency of earlier ischemic heart disease in the stroke group. Both atrial-fibrillation groups had cardiac abnormalities predisposing for embolic as well as thrombotic stroke.
我们研究了心脏异常是否会增加非瓣膜性心房颤动（NVAF）患者的中风风险。对四个年龄和性别匹配的组进行了M型和二维超声心动图检查：20名患有NVAF的中风患者、20名既往未发生过中风的NVAF患者、20名窦性心律的中风患者以及40名健康对照者。他们的平均年龄为77岁。两组心房颤动患者与健康对照者的不同之处在于，他们二维超声心动图显示严重左心室壁运动异常的结果更多（p < 0.05），左心室扩大、肥厚性和充血性心肌病的情况更常见。左心房直径在房颤组为47mm，而窦性心律的两组分别为41mm和39mm（p < 0.001）。心内血栓仅在两个心房颤动组中发现（有中风的组：15%；无中风的组：5%）。主动脉硬化在所有组中都很常见（30 - 60%），二尖瓣环钙化也是如此（10 - 20%）。两个心房颤动组之间唯一显著的差异是中风组早期缺血性心脏病的发生率更高。两个心房颤动组都有易导致栓塞性和血栓性中风的心脏异常。
