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心脏淀粉样变性患者窦性心律时出现的心房血栓：心房电机械分离的证据。

Atrial thrombi occurring during sinus rhythm in cardiac amyloidosis: evidence for atrial electromechanical dissociation.

作者信息

Dubrey S, Pollak A, Skinner M, Falk R H

机构信息

Boston University School of Medicine, Section of Cardiology, Massachusetts 02118, USA.

出版信息

Br Heart J. 1995 Nov;74(5):541-4. doi: 10.1136/hrt.74.5.541.

DOI:10.1136/hrt.74.5.541
PMID:8562243
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC484078/
Abstract

Thrombus formation in the left atrium is rare in patients in sinus rhythm. In three patients with extensive cardiac amyloidosis transthoracic echocardiography showed large atrial thrombi in or protruding into the body of the left atrium during sinus rhythm. Doppler studies showed no A wave on mitral inflow. Severe atrial and ventricular infiltration by amyloid may have resulted in mechanical atrial standstill with resultant thrombus formation. These findings suggest that patients with severe cardiac amyloidosis may require anticoagulation when atrial function is impaired.

摘要

窦性心律的患者左心房形成血栓较为罕见。在3例广泛性心脏淀粉样变性患者中，经胸超声心动图显示在窦性心律时左心房内或突出至左心房腔内有巨大心房血栓。多普勒研究显示二尖瓣血流无A波。淀粉样物质严重浸润心房和心室可能导致心房机械性静止，进而形成血栓。这些发现提示，严重心脏淀粉样变性患者在心房功能受损时可能需要抗凝治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6180/484078/16f848671c33/brheartj00168-0066-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6180/484078/9e319459bc38/brheartj00168-0064-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6180/484078/16f848671c33/brheartj00168-0066-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6180/484078/9e319459bc38/brheartj00168-0064-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6180/484078/16f848671c33/brheartj00168-0066-a.jpg

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本文引用的文献

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Mitral regurgitation associated with reduced thromboembolic events in high-risk patients with nonrheumatic atrial fibrillation. Stroke Prevention in Atrial Fibrillation Investigators.二尖瓣反流与非风湿性心房颤动高危患者血栓栓塞事件减少相关。心房颤动卒中预防研究人员。
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