抗凝与应激性心肌病。

Anticoagulation and stress-induced cardiomyopathy.

机构信息

Department of Internal Medicine, University of Cincinnati College of Medicine, 231 Albert B. Sabin Way, ML 0542, Cincinnati, OH, 45267-0542, USA.

Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

出版信息

J Thromb Thrombolysis. 2019 Jan;47(1):1-7. doi: 10.1007/s11239-018-1729-8.

DOI:10.1007/s11239-018-1729-8

PMID:30328054

Abstract

Stress-induced cardiomyopathy (SCM), is a reversible cardiomyopathy characterized by transient systolic dysfunction following an acute physiologic stress. Thromboembolism occurs at a high frequency in patients with intracardiac thrombus secondary to SCM, with one systematic review reporting a rate of 33.3%. The risk of thrombus formation following SCM has been associated with left-ventricular (LV) contraction abnormalities, catecholaminergic surge, and other associated comorbidities. However, established guidelines for screening and management of intracardiac thrombus in the setting of SCM do not exist at present due to a lack of sufficient clinical trial data. The purpose of this article is to discuss the pathophysiological theory and previously documented evidence from cases of LV thrombus secondary to SCM, and to present our recommendations for management of intracardiac thrombus secondary to SCM.

摘要

应激性心肌病（SCM）是一种可逆性心肌病，其特征是在急性生理应激后出现短暂的收缩功能障碍。继发于 SCM 的心腔内血栓患者血栓栓塞的发生率较高，一项系统评价报道其发生率为 33.3%。SCM 后血栓形成的风险与左心室（LV）收缩功能异常、儿茶酚胺激增和其他相关合并症有关。然而，由于缺乏足够的临床试验数据，目前尚不存在 SCM 患者心腔内血栓筛查和管理的既定指南。本文旨在讨论继发于 SCM 的 LV 血栓形成的病理生理学理论和之前病例中记录的证据，并提出我们对继发于 SCM 的心腔内血栓形成的管理建议。