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[炎症过程在心房颤动发病机制及自然病程中的作用]

[The contribution of inflammatory process in pathogenesis and natural history of atrial fibrillation].

作者信息

Zyśko Dorota, Gajek Jacek, Mazurek Walentyna

机构信息

Katedra i Klinika Kardiologii AM we Wrocławiu.

出版信息

Pol Merkur Lekarski. 2005 Feb;18(104):227-8.

Abstract

The inflammatory process plays important role in pathogenesis of some cardiovascular diseases. Atrial fibrillation is atrial arrhythmia with rapid, asynchronous activation of atrial myocytes. The inflammatory process can be responsible for atrial electrical and anatomical remodeling and therefore shifts towards arrhythmia persistence. The presence of systemic inflammation may be assessed by means of C-reactive protein (CRP) measurement. Maximal concentration of CRP coincidences with the peak of paroxysmal atrial fibrillation occurrence in patients after cardiac surgery. In patients with sinus rhythm the concentration of CRP is a risk factor for this arrhythmia in long-term follow-up. In patients with atrial fibrillation mean CRP concentration is 2-fold higher comparing to control group. CRP concentration is higher in patients with chronic than paroxysmal form of this arrhythmia. High CRP level predicts worse results of direct current cardioversion and more frequent paroxysms of atrial fibrillation during follow-up. Besides of, the patients with echocardiographic signs of thromboembolic risk have higher CRP levels than control subjects. There is no data about the influence of anti-inflammatory therapy on atrial fibrillation or its recurrences.

摘要

炎症过程在某些心血管疾病的发病机制中起重要作用。心房颤动是一种心房心律失常,伴有心房肌细胞快速、不同步的激活。炎症过程可能导致心房电重构和解剖重构,从而促使心律失常持续存在。全身性炎症的存在可通过检测C反应蛋白(CRP)来评估。心脏手术后患者CRP的最大浓度与阵发性心房颤动发作的峰值一致。在窦性心律患者中,CRP浓度是长期随访中发生这种心律失常的一个危险因素。心房颤动患者的平均CRP浓度比对照组高2倍。慢性心房颤动患者的CRP浓度高于阵发性心房颤动患者。高CRP水平预示着直流电复律效果较差,且随访期间心房颤动发作更频繁。此外,有超声心动图血栓栓塞风险迹象的患者CRP水平高于对照组。关于抗炎治疗对心房颤动或其复发的影响尚无相关数据。

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