[1]刘磊 杨震.心肌梗死后左心室壁瘤相关室性心律失常的形成机制与治疗进展[J].心血管病学进展,2020,(1):46-50.[doi:10.16806/j.cnki.issn.1004-3934.2020.01.013]
 LIU Lei,YANG Zhen.Mechanism and Progress in Treatment of Post-infarction Left Ventricular Aneurysm with Ventricular Arrhythmias[J].Advances in Cardiovascular Diseases,2020,(1):46-50.[doi:10.16806/j.cnki.issn.1004-3934.2020.01.013]
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心肌梗死后左心室壁瘤相关室性心律失常的形成机制与治疗进展()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2020年1期
页码:
46-50
栏目:
综述
出版日期:
2020-02-04

文章信息/Info

Title:
Mechanism and Progress in Treatment of Post-infarction Left Ventricular Aneurysm with Ventricular Arrhythmias
作者:
刘磊 杨震
(宁夏医科大学总医院心内科,宁夏 银川 750000)
Author(s):
LIU Lei;YANG Zhen
(Department of Cardiology,General Hospital of Ningxia Medical University,Yinchuan 75000 0,Ningxia,China)
关键词:
左心室壁瘤室性心律失常机制治疗
Keywords:
Left ventricular aneurysm Ventricular arrhythmias Mechanism Treatment
DOI:
10.16806/j.cnki.issn.1004-3934.2020.01.013
摘要:
左心室壁瘤是大面积急性透壁心肌梗死后的机械并发症,常因改变左心室正常解剖结构而促进折返环通路的形成,诱发反复性、难治性的室性心律失常导致心源性猝死。但近年来研究提示参与心肌梗死后左心室壁瘤相关室性心律失常的形成机制众多,左心室壁瘤除导致机械性心室壁和心脏传导系统的改变外,还涉及离子通道、细胞外基质、缝隙连接通道、交感神经重构等多种因素,故而单纯内科药物保守治疗和传统手术的效果欠佳。非体外循环下冠状动脉旁路移植术加室壁瘤成形术并联合双极射频消融是近年来针对该类患者的新治疗方法,较以往的治疗方式具有明显的优势。现对心肌梗死后左心室壁瘤相关室性心律失常的形成机制与治疗进展做简要综述。
Abstract:
Left ventricular aneurysm is one of the mechanical complications secondary to massive acute myocardial infarction.Left ventricular aneurysm can lead to the changes of the anatomic structure of left ventricle,facilitating the formation of reentrant?circuit,which provide the substrate for recurrent and intractable ventricular arrhythmias and consequently lead to suddencardiacdeath. But recent researches demonstrated that the mechanism s of ventricular arrhythmias related to p ost-infarction left ventricular aneurysm are complicated and multifactorial. I n addition to the changes of both ventricular structure and cardiac conduction system ,many other factors are involved,such as ion channels,extracellular matrix,gap junction and sympathetic nerve system.Therefore, the effects of medicine s and conventional?surgery are not ideal. In recent years,off-pump coronary artery bypass grafting in combination with ventricular aneurysm plasty and bipolar radiofrequency ablation is a new treatment strategy for these patients which provide obvious advantages over the previous methods. This paper briefly reviewed the developmental mechanisms and therapeutic progresses of post-infarction ventricular aneurysm-related ventricular arrhythmias.

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备注/Memo

备注/Memo:
通讯作者:杨震,E-mail:yangzhen888@163.com
收稿日期:2019-05-23
更新日期/Last Update: 2020-03-23