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[生物标志物与心房颤动:节律控制管理后复发及血栓栓塞事件的预测]

[Biomarkers and atrial fibrillation : Prediction of recurrences and thromboembolic events after rhythm control management].

作者信息

Kornej Jelena, Schumacher Katja, Husser Daniela, Hindricks Gerhard

机构信息

Abteilung für Rhythmologie, Herzzentrum Leipzig, HELIOS Kliniken GmbH, Strümpellstraße 39, 04289, Leipzig, Deutschland.

出版信息

Herzschrittmacherther Elektrophysiol. 2018 Jun;29(2):219-227. doi: 10.1007/s00399-018-0558-y. Epub 2018 May 14.

Abstract

Atrial fibrillation (AF) is the most common arrhythmia in clinical praxis and is associated with an increased risk for cardio- and cerebrovascular complications leading to an increased mortality. Catheter ablation represents one of the most important and efficient therapy strategies in AF patients. Nevertheless, the high incidence of arrhythmia recurrences after catheter ablation leads to repeated procedures and higher treatment costs. Recently, several scores had been developed to predict rhythm outcomes after catheter ablation. Biomarker research is also of enormous interest. There are many clinical and blood biomarkers pathophysiologically associated with AF occurrence, progression and recurrences. These biomarkers-including different markers in blood (e. g. von Willebrand factor, D‑dimer, natriuretic peptides) or urine (proteins, epidermal grown factor receptor) but also cardiac imaging (echocardiography, computed tomography, magnetic resonance imaging)-could help to improve clinical scores and be useful for individualized AF management and optimized patients' selection for different AF treatment strategies. In this review, the role of diverse biomarkers and their predictive value related to AF-associated complications are discussed.

摘要

心房颤动(AF)是临床实践中最常见的心律失常,与心血管和脑血管并发症风险增加相关,进而导致死亡率上升。导管消融是房颤患者最重要且有效的治疗策略之一。然而,导管消融术后心律失常复发率高,导致需要重复手术且治疗成本增加。最近,已经开发了几种评分系统来预测导管消融后的节律结果。生物标志物研究也备受关注。有许多临床和血液生物标志物在病理生理上与房颤的发生、进展和复发相关。这些生物标志物——包括血液中的不同标志物(如血管性血友病因子、D-二聚体、利钠肽)或尿液中的标志物(蛋白质、表皮生长因子受体),还有心脏成像(超声心动图、计算机断层扫描、磁共振成像)——有助于改进临床评分,对房颤的个体化管理以及为不同房颤治疗策略优化患者选择有用。在本综述中,将讨论多种生物标志物的作用及其与房颤相关并发症的预测价值。

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