The Cardiovascular Institute, Mount Sinai Medical Center, New York, New York.
The Cardiovascular Institute, Mount Sinai Medical Center, New York, New York.
Am J Cardiol. 2019 Jul 15;124(2):303-311. doi: 10.1016/j.amjcard.2019.04.027. Epub 2019 Apr 25.
Atrial fibrillation (AF) is associated with thrombus formation in the left atrial appendage and systemic embolic events including ischemic stroke. Cardiogenic thromboembolism can also occur in the absence of clinical AF as a result of various pathological conditions affecting the endocardium. The inconsistent temporal relation between AF and ischemic events has stimulated exploration for factors other than clinical AF that contribute to thromboembolism. These include subclinical AF, a thrombogenic atrial cardiomyopathy, and left atrial appendage dysfunction and embolism from other sources. In conclusion, thromboembolism during normal sinus rhythm is likely multifactorial, involving intertwined pathologic processes. Patients at risk, if accurately identified, could theoretically benefit from anticoagulation.
心房颤动（AF）与左心耳血栓形成和全身性栓塞事件相关，包括缺血性脑卒中。尽管没有临床 AF 的存在，但是由于影响心内膜的各种病理状况，也可能发生心源性血栓栓塞。AF 和缺血性事件之间的不一致时间关系促使人们探索除临床 AF 以外的其他因素对血栓栓塞的影响。这些因素包括亚临床 AF、血栓形成性心房心肌病以及左心耳功能障碍和来自其他来源的栓塞。总之，窦性心律期间的血栓栓塞可能是多因素的，涉及交织的病理过程。如果能够准确识别出处于危险中的患者，理论上可以从抗凝治疗中受益。
