非阻塞性冠状动脉疾病的谱及其与心房颤动的关系。

Spectrum of Non-Obstructive Coronary Artery Disease and Its Relationship with Atrial Fibrillation.

作者信息

Oancea Alexandru-Florinel, Morariu Paula Cristina, Buburuz Ana Maria, Miftode Ionela-Larisa, Miftode Radu Stefan, Mitu Ovidiu, Jigoranu Alexandru, Floria Diana-Elena, Timpau Amalia, Vata Andrei, Plesca Claudia, Botnariu Gina, Burlacu Alexandru, Scripcariu Dragos-Viorel, Raluca Mitea, Cuciureanu Magdalena, Tanase Daniela Maria, Costache-Enache Irina Iuliana, Floria Mariana

机构信息

Department of Internal Medicine I, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.

Saint Spiridon Emergency Hospital, 700115 Iasi, Romania.

出版信息

J Clin Med. 2024 Aug 21;13(16):4921. doi: 10.3390/jcm13164921.

DOI:10.3390/jcm13164921

PMID:39201063

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11355151/

Abstract

This article aims to analyze the relationship between non-obstructive coronary artery disease (NOCAD) and atrial fibrillation (AF), exploring the underlying pathophysiological mechanisms and implications for clinical management. NOCAD and AF are prevalent cardiovascular conditions that often coexist, yet their interrelation is not well understood. NOCAD can lead to ischemic necrosis of cardiomyocytes and their replacement with fibrous tissue, sustaining focal ectopic activity in atrial myocardium. Atrial fibrillation, on the other hand, the most common sustained cardiac arrhythmia, is able to accelerate atherosclerosis and increase oxygen consumption in the myocardium, creating a mismatch between supply and demand, and thus promoting the development or worsening of coronary ischemia. Therefore, NOCAD and AF seem to be a complex interplay with one begets another.

摘要

本文旨在分析非阻塞性冠状动脉疾病（NOCAD）与心房颤动（AF）之间的关系，探讨其潜在的病理生理机制及其对临床管理的意义。NOCAD和AF是常见的心血管疾病，常并存，但它们之间的相互关系尚未完全明确。NOCAD可导致心肌细胞缺血坏死并被纤维组织替代，维持心房肌的局灶性异位活动。另一方面，心房颤动是最常见的持续性心律失常，能够加速动脉粥样硬化并增加心肌耗氧量，导致供需失衡，从而促进冠状动脉缺血的发展或恶化。因此，NOCAD和AF似乎存在着相互影响、互为因果的复杂关系。