孤立性心房淀粉样变模式：100例心脏尸检研究

Patterns of isolated atrial amyloid: a study of 100 hearts on autopsy.

作者信息

Steiner Ivo, Hájková Petra

机构信息

The Fingerland Department of Pathology, Charles University Faculty of Medicine and Faculty Hospital, 500 05 Hradec Králové, Czech Republic.

出版信息

Cardiovasc Pathol. 2006 Sep-Oct;15(5):287-290. doi: 10.1016/j.carpath.2006.01.005.

DOI:10.1016/j.carpath.2006.01.005

PMID:16979036

Abstract

Isolated atrial amyloid (IAA), one of the most common members of the family of age-related ("senile") amyloids, seems to play a role in the pathogenesis of atrial fibrillation. Patterns of IAA deposition were histologically studied in the hearts of 100 elderly patients. The incidence (%) and severity (grade 0-3) of atrial IAA deposits increase with age, from 75% incidence and 0.50 average grade in patients aged 51-60 years, to 86% incidence and 1.49 average grade in those aged 81-90 years. Deposits are more pronounced in females (88% incidence, 1.45 average grade) than in males (68% incidence, 0.79 average grade). Left atrial deposits are more pronounced (78% incidence, 1.25 average grade) than right atrial deposits (67% incidence, 1.09 average grade). The distribution of IAA in the walls of the left atrium is uneven, with deposits being more pronounced in the anterior wall than in both the posterior wall and the left appendage. IAA deposits are heavier (1.34 average grade) in patients with chronic atrial fibrillation than in those with sinus rhythm (1.01 average grade); the difference, however, lacks statistical significance. Hypertension, diabetes mellitus, hypertrophy of the heart, coronary atherosclerosis, and dilatation of the atria show no significant relationship to the incidence or severity of atrial amyloidosis.

摘要

孤立性心房淀粉样变（IAA）是与年龄相关（“老年性”）淀粉样变家族中最常见的成员之一，似乎在房颤的发病机制中起作用。对100例老年患者心脏进行组织学研究，观察IAA沉积模式。心房IAA沉积的发生率（%）和严重程度（0 - 3级）随年龄增长而增加，51 - 60岁患者的发生率为75%，平均分级为0.50级，81 - 90岁患者的发生率为86%，平均分级为1.49级。女性的沉积更明显（发生率88%，平均分级1.45级），高于男性（发生率68%，平均分级0.79级）。左心房沉积比右心房沉积更明显（发生率78%，平均分级1.25级），右心房沉积发生率为67%，平均分级为1.09级。IAA在左心房壁的分布不均匀，前壁的沉积比后壁和左心耳更明显。慢性房颤患者的IAA沉积更严重（平均分级1.34级），高于窦性心律患者（平均分级1.01级）；然而，差异无统计学意义。高血压、糖尿病、心脏肥大、冠状动脉粥样硬化和心房扩张与心房淀粉样变的发生率或严重程度无显著关系。