Abe Yukio, Takahashi Yosuke, Shibata Toshihiko
Department of Cardiology, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka 534-0021, Japan.
Department of Cardiovascular Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.
Cardiol Clin. 2021 May;39(2):281-288. doi: 10.1016/j.ccl.2021.01.010. Epub 2021 Mar 23.
Atrial functional mitral regurgitation (AFMR) can occur in patients with atrial fibrillation despite a preserved left ventricular systolic function. AFMR has received attention as a cause of heart failure; it is a therapeutic target in patients with heart failure with atrial fibrillation. Mitral annular dilatation from atrial fibrillation-induced left atrial dilatation is necessary for the generation of AFMR. Posterior mitral leaflet hamstringing also relates to the generation of AFMR. Further mitral annular dilatation owing to progressive left atrial and left ventricular dilatations, with mitral regurgitation-induced volume overload, worsens AFMR.
尽管左心室收缩功能保留,但心房颤动患者仍可发生心房功能性二尖瓣反流(AFMR)。AFMR作为心力衰竭的一个病因已受到关注;它是心房颤动所致心力衰竭患者的治疗靶点。心房颤动引起的左心房扩张导致二尖瓣环扩张是AFMR产生的必要条件。二尖瓣后叶受限也与AFMR的产生有关。由于左心房和左心室逐渐扩张以及二尖瓣反流引起的容量超负荷导致二尖瓣环进一步扩张,会使AFMR恶化。