Sitges Marta, Teijeira Victor A, Scalise Andrea, Vidal Bàrbara, Tamborero David, Collvinent Blanca, Rivera Socorro, Molina Irma, Azqueta Manel, Paré Carles, Brugada Josep, Mont Lluis
Department of Cardiology, Thorax Institute, Hospital Clínic, IDIBAPS, University of Barcelona, Villarroel 136, 08036 Barcelona, Spain.
Europace. 2007 May;9(5):294-8. doi: 10.1093/europace/eum045. Epub 2007 Apr 7.
Idiopathic paroxysmal atrial fibrillation (AF) occurs in patients with apparently normal heart. Its mechanisms may be complex and are poorly understood. The aim of the study was to evaluate whether patients with idiopathic AF have any structural abnormality that may explain the occurrence of AF.
A case-control study was undertaken including 60 consecutive patients (mean age 48 +/- 12 years; 75% men) with idiopathic AF admitted to the emergency department. Sixty sex- and age-matched healthy volunteers made up the control group. An echocardiogram was performed in all patients and volunteers to assess the left atrial (LA) and ventricular (LV) dimensions and valvular function. LV diastolic function was also evaluated by analysis of the LV inflow and pulmonary vein flow velocity patterns and tissue Doppler imaging of the mitral annulus. All AF patients showed normal echocardiographic studies with similar LV dimensions, ejection fraction, and diastolic function when compared with normal controls. However, patients with AF had larger LA dimensions (27 +/- 3 vs. 24 +/- 3 mm/m(2)), LA area (10 +/- 2 vs. 8 +/- 2 mm(2)/m(2)), and LA volume (27 +/- 9 vs. 19 +/- 6 mL/m(2)) (P < 0.05 for all). Among patients with AF, there were no differences in LA size between patients with a first episode or recurrent paroxysmal episodes.
Patients with idiopathic AF showed larger left atria when compared with controls, there being no differences between patients with a first episode or a recurrence. This suggests the presence of an enhanced substrate to develop idiopathic lone AF.
特发性阵发性心房颤动（房颤）发生于心脏看似正常的患者。其机制可能很复杂，目前了解甚少。本研究的目的是评估特发性房颤患者是否存在任何可能解释房颤发生的结构异常。
进行了一项病例对照研究，纳入了60例连续入住急诊科的特发性房颤患者（平均年龄48±12岁；75%为男性）。60名年龄和性别匹配的健康志愿者组成对照组。对所有患者和志愿者进行超声心动图检查，以评估左心房（LA）和心室（LV）大小及瓣膜功能。还通过分析LV流入和肺静脉血流速度模式以及二尖瓣环组织多普勒成像来评估LV舒张功能。与正常对照组相比，所有房颤患者的超声心动图检查均显示正常，LV大小、射血分数和舒张功能相似。然而，房颤患者的LA尺寸更大（27±3 vs. 24±3 mm/m²）、LA面积更大（10±2 vs. 8±2 mm²/m²）、LA容积更大（27±9 vs. 19±6 mL/m²）（所有P<0.05）。在房颤患者中，首次发作或复发性阵发性发作患者的LA大小无差异。
与对照组相比，特发性房颤患者的左心房更大，首次发作或复发患者之间无差异。这表明存在发展为特发性孤立性房颤的增强底物。
