[1]秦可隽?姜述斌.左心耳封堵术对非瓣膜性心房颤动患者左心功能影响的研究进展[J].心血管病学进展,2024,(5):425.[doi:10.16806/j.cnki.issn.1004-3934.2024.05.010]
 QIN KejuanJIANG Shubin.Effects of Left Atrial Appendage Closure on Left Heart Function in Patients with Nonvalvular Atrial Fibrillation[J].Advances in Cardiovascular Diseases,2024,(5):425.[doi:10.16806/j.cnki.issn.1004-3934.2024.05.010]
点击复制

左心耳封堵术对非瓣膜性心房颤动患者左心功能影响的研究进展()
分享到:

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2024年5期
页码:
425
栏目:
综述
出版日期:
2024-05-25

文章信息/Info

Title:
Effects of Left Atrial Appendage Closure on Left Heart Function in Patients with Nonvalvular Atrial Fibrillation
作者:
秦可隽1?姜述斌 2
(1.新疆医科大学第四临床医学院,新疆 乌鲁木齐 830000;2.新疆医科大学第四附属医院心内科,新疆 乌鲁木齐 830000)
Author(s):
QIN Kejuan1JIANG Shubin2
?1.The Fourth Clinical Medical College of Xinjiang Medical University,Urumqi 830000,Xinjiang,China; 2.Department of Cardiology,The Fourth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang,China)
关键词:
左心耳封堵术非瓣膜性心房颤动心脏功能复发心肌纤维化
Keywords:
Left atrial appendage closureNonvalvular atrial fibrillationHeart functionRecurrenceMyocardial fibrosis
DOI:
10.16806/j.cnki.issn.1004-3934.2024.05.010
摘要:
近年来左心耳封堵术(LAAC)作为一项预防卒中发生的有效措施逐渐被大众接受。流行病学调查显示,近5年来在中国部分地区,LAAC的比例已从0.16%上升至1.23%。作为一项发展时间较短的术式,LAAC预防卒中发生的有效性已得到临床检验,但术后是否存在对患者左心功能的影响仍存在争论。现归纳总结LAAC对左心功能影响的研究,并对LAAC是否会通过对左心功能的影响增加一站式手术的术后心房颤动复发率而进行展望。
Abstract:
In recent years,left atrial appendage closure(LAAC) has gradually been accepted by the public as an effective measure to prevent stroke. Epidemiological survey shows that the proportion of LAAC in some areas in China has increased from 0.16% to 1.23% in recent 5 years. As an operation with a relatively short development time,its effectiveness in preventing stroke has been clinically tested,but whether there is any effect on the left heart function of patients after surgery is still controversial. This paper summarizes the research on the impact of LAAC on left cardiac function,and looks forward to whether LAAC will increase the postoperative atrial fibrillation recurrence rate of one-stop surgery by affecting left heart function

参考文献/References:

[1] 中华医学会心血管病学分会,中国生物医学工程学会心律分会. 心房颤动诊断和治疗中国指南[J]. 中华心血管病杂志,2023,51(6):572-618.

[2] Hindricks G,Potpara T,Dagres N,et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS):The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC[J]. Eur Heart J,2021,42(5):373-498.

[3] Boersma LV,Ince H,Kische S,et al. Evaluating real-world clinical outcomes in atrial fibrillation patients receiving the WATCHMAN left atrial appendage closure technology:final 2-year outcome data of the EWOLUTION trial focusing on history of stroke and hemorrhage[J]. Circ Arrhythmia Electrophysiol,2019,12(4):e006841.

[4] Block PC,Burstein S,Casale PN,et al. Percutaneous left atrial appendage occlusion for patients in atrial fibrillation suboptimal for warfarin therapy:5-year results of the PLAATO (Percutaneous Left Atrial Appendage Transcatheter Occlusion) study[J]. JACC Cardiovasc interv,2009,2(7):594-600.

[5] 霍家敏,李学文. 非瓣膜性心房颤动患者左心耳结构与血栓形成的相关性[J]. 中华老年多器官疾病杂志,2022, 21(8):561-566.

[6] Al-Saady NM,Obel OA,Camm AJ. Left atrial appendage:structure,function,and role in thromboembolism[J]. Heart,1999,82(5):547-554.

[7] Regazzoli D,Ancona F,Trevisi N,et al. Left atrial appendage:physiology,pathology,and role as a therapeutic target[J]. BioMed Res Int,2015,2015:205013.

[8] 谢海宝,沈建平. 常见老年病的防治与管理[M]. 杭州: 浙江大学出版社,201806:441.

[9] Boucebci S,Pambrun T,Velasco S,et al. Assessment of normal left atrial appendage anatomy and function over gender and ages by dynamic cardiac CT[J]. Eur Radiol,2016,26(5): 1512-1520.

[10] Asmarats L,Bernier M,O’Hara G,et al. Hemodynamic impact of percutaneous left atrial appendage closure in patients with paroxysmal atrial fibrillation[J]. J Interv Card Electrophysiol,2018,53(2):151-157.

[11] Budge LP,Shaffer KM,Moorman JR,et al. Analysis of in vivo left atrial appendage morphology in patients with atrial fibrillation:a direct comparison of transesophageal echocardiography,planar cardiac CT,and segmented three-dimensional cardiac CT[J]. J Interv Card Electrophysiol,2008,23(2):87-93.

[12] Hoit BD,Shao Y,Tsai LM,et al. Altered left atrial compliance after atrial appendectomy. Influence on left atrial and ventricular filling[J]. Circ Res,1993,72(1):167-175.

[13] Davis CA 3rd,Rembert JC,Greenfield JC Jr. Compliance of left atrium with and without left atrium appendage[J]. Am J Physiol,1990,259(4 Pt 2):H1006-H1008.

[14] Luani B,Groscheck T,Genz C,et al. Left atrial enlargement and clinical considerations in patients with or without a residual interatrial shunt after closure of the left atrial appendage with the WATCHMAN-device[J]. BMC Cardiovasc Disord,2017,17(1):294.

[15] Coisne A,Pilato R,Brigadeau F,et al. Percutaneous left atrial appendage closure improves left atrial mechanical function through Frank-Starling mechanism[J]. Heart Rhythm,2017,14(5):710-716.

[16] Phan QT,Shin SY,Cho IS,et al. Impact of left atrial appendage closure on cardiac functional and structural remodeling:a difference-in-difference analysis of propensity score matched samples[J]. Cardiol J, 2019,26(5):519-528.

[17] ?abano?lu C,Okutucu S,Halil ?nan? I,et al. The impact of percutaneous left atrial appendage closure on left ventricular diastolic function and natriuretic peptide levels[J]. Eur Rev Med Pharmacol Sci,2021,25(23):7418-7424.

[18] 张艳,李晓云,姬冬辉. 房颤患者行左心耳封堵术后左心房结构和功能的随访研究[J]. 河北医药,2020,42(11):1629-1632.

[19] 林菁菁. 左心耳封堵对心房颤动患者左心结构及功能影响的临床观察[D]. 福州:福建医科大学,2021.

[20] 朱世杰. 左心耳封堵术对毗邻结构、左心房容积及房颤患者预后的影响[D]. 广州:南方医科大学,2020.

[21] 李华康. 左心耳封堵术在非瓣膜性心房颤动患者中的临床应用研究[D]. 重庆:第三军医大学,2017.

[22] Fastner C,Brachmann J,Lewalter T,et al. Left atrial appendage closure in patients with a reduced left ventricular ejection fraction: results from the multicenter German LAARGE registry[J]. Clin Res Cardiol,2020,109(11):1333-1341.

[23] 张帅超. 非瓣膜性心房颤动患者行左心耳封堵术对左心功能的影响[D]. 南昌:南昌大学,2022.

[24] Hanna IR,Kolm P,Martin R,et al. Left atrial structure and function after percutaneous left atrial appendage transcatheter occlusion (PLAATO):six-month echocardiographic follow-up[J]. J Am Coll of Cardiol ,2004,43(10):1868-1872.

[25] Wan SH,Vogel MW,Chen HH. Pre-clinical diastolic dysfunction[J]. J Am Coll Cardiol,2014,63(5):407-416.

[26] Whitlock RP,Belley-Cote EP,Paparella D,et al. Left atrial appendage occlusion during cardiac surgery to prevent stroke[J]. N Engl J Med,2021,384(22):2081-2091.

[27] Eqbal A,Tong W,Lamy A,et al. Cost implications of left atrial appendage occlusion during cardiac surgery:a cost analysis of the LAAOS Ⅲ trial[J]. J Am Heart Assoc,2023,12(10):e028716.

[28] Belcher JR,Somerville W. Systemic embolism and left auricular thrombosis in relation to mitral valvotomy[J]. Br Med J,1955,2(4946):1000-1003.

[29] Crystal E,Lamy A,Connolly SJ,et al. Left atrial appendage occlusion study (LAAOS):a randomized clinical trial of left atrial appendage occlusion during routine coronary artery bypass graft surgery for long-term stroke prevention[J]. Am Heart J,2003,145(1):174-178.

[30] 徐海霞,陆齐,黄荫浩,等. 阵发性心房颤动患者射频消融术后复发的预测因素分析[J]. 中国循环杂志,2017,32(12):1203-1207.

[31] Beyer C,Tokarska L,Stühlinger M,et al. Structural cardiac remodeling in atrial?fibrillation[J]. JACC Cardiovasc Imaging,2021,14(11):2199-2208.

[32] Nattel S,Harada M. Atrial remodeling and atrial fibrillation:recent advances and translational perspectives[J]. J Am Coll Cardiol,2014,63(22):2335-2345.

[33] 李向东,单兆亮. 心房钠尿肽对心房重构的影响[J]. 中华老年心脑血管病杂志,2022,24(4):442-443.

[34] Siebermair J,Kholmovski EG,Marrouche N. Assessment of left atrial fibrosis by late?gadolinium enhancement magnetic resonance imaging:methodology and clinical implications[J]. JACC Clin electrophysiol,2017,3(8):791-802.

[35] Hoit BD,Walsh RA. Regional atrial distensibility[J]. Am J Physiol,1992,262(5 Pt 2): H1356-H1360.

相似文献/References:

[1]安硕研,郑金刚.左心耳封堵术预防心源性卒中的进展[J].心血管病学进展,2019,(6):869.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.008]
 AN Shuoyan,ZHENG Jingang.Left Atrial Appendage Closure for Prevention of Cardiogenic Stroke[J].Advances in Cardiovascular Diseases,2019,(5):869.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.008]
[2]朱世杰,郑慕晗,张建武,等.心脏CT在左心耳封堵术中的应用价值[J].心血管病学进展,2020,(1):11.[doi:10.16806/j.cnki.issn.1004-3934.2020.01.004]
 ZHU Shijie,ZHENG Muhan,ZHANG Jianwu,et al.Application of Cardiac CT in Left Atrial Appendage Closure[J].Advances in Cardiovascular Diseases,2020,(5):11.[doi:10.16806/j.cnki.issn.1004-3934.2020.01.004]
[3]李亚会 黄从新.左心耳封堵术常见并发症及其防治[J].心血管病学进展,2021,(5):408.[doi:10.16806/j.cnki.issn.1004-3934.2021.05.006]
 LI YahuiHUANG Congxin.Common Complications of Left Atrial Appendage Occlusion and Its Prevention and Treatment[J].Advances in Cardiovascular Diseases,2021,(5):408.[doi:10.16806/j.cnki.issn.1004-3934.2021.05.006]
[4]吴阳 杨桂荣 张波 陈各才.双源CT在左心耳封堵术前评估及指导选择WatchmanTM封堵器型号的应用[J].心血管病学进展,2021,(4):374.[doi:10.16806/j.cnki.issn.1004-3934.2020.04.020]
 WU Yang,YANG Guirong,ZHANG Bo,et al.The Application of Dual Source CT in Preoperative Evaluation of Left Atrial Appendage Occlusion and Size Selection of Watchman TM Occluder.com[J].Advances in Cardiovascular Diseases,2021,(5):374.[doi:10.16806/j.cnki.issn.1004-3934.2020.04.020]
[5]柏懿璇 崔凯军.左心耳封堵术后装置相关血栓[J].心血管病学进展,2022,(5):407.[doi:10.16806/j.cnki.issn.1004-3934.2022.05.006]
 BAI Yixuan,CUI Kaijun.Device-Related Thrombus After Left Atrial Appendage Occlusion[J].Advances in Cardiovascular Diseases,2022,(5):407.[doi:10.16806/j.cnki.issn.1004-3934.2022.05.006]
[6]王璐 李耀东.TAVR合并心房颤动抗凝策略的研究进展[J].心血管病学进展,2022,(8):695.[doi:10.16806/j.cnki.issn.1004-3934.2022.08.007]
 WANG Lu,LI Yaodong.Anticoagulation Strategy in Patients After TAVR Complicated with Atrial Fibrillation[J].Advances in Cardiovascular Diseases,2022,(5):695.[doi:10.16806/j.cnki.issn.1004-3934.2022.08.007]
[7]魏志梁 孙雨可 尹月娇 孙守刚.心房颤动合并慢性肾脏病患者的左心耳封堵治疗研究进展[J].心血管病学进展,2022,(9):783.[doi:10.16806/j.cnki.issn.1004-3934.2022.09.005]
 WEI Zhiliang,SUN Yuke,YIN Yuejiao,et al.Left Atrial Appendage Closure in Patients with Atrial Fibrillation Complicated with Chronic Kidney Disease[J].Advances in Cardiovascular Diseases,2022,(5):783.[doi:10.16806/j.cnki.issn.1004-3934.2022.09.005]
[8]加依娜·加尔肯 汤宝鹏 周贤惠 李耀东 芦颜美.非瓣膜性心房颤动患者“一站式”手术策略的有效性和安全性:单中心经验[J].心血管病学进展,2022,(12):1141.[doi:10.16806/j.cnki.issn.1004-3934.2022.12.019]
 Jiayina Jiaerken,TANG Baopeng,ZHOU Xianhui,et al.Effectiveness and Safety of "One-Step" Procedure in Patients with Non-Valvular Atrial Fibrillation:A Single Center Experience?/html>[J].Advances in Cardiovascular Diseases,2022,(5):1141.[doi:10.16806/j.cnki.issn.1004-3934.2022.12.019]
[9]许溪麟 李小明.艾多沙班在心血管疾病应用的研究进展[J].心血管病学进展,2024,(5):451.[doi:10.16806/j.cnki.issn.1004-3934.2024.05.016]
 XU Xilin,LI Xiaoming.Application of Edoxaban in Cardiovascular Disease[J].Advances in Cardiovascular Diseases,2024,(5):451.[doi:10.16806/j.cnki.issn.1004-3934.2024.05.016]
[10]彭金华,王平,胡婧,等.左心耳封堵术对非瓣膜性心房颤动患者心脏利尿钠肽分泌功能的影响[J].心血管病学进展,2019,(6):873.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.009]
 PENG Jinhua,WANG PingHU Jing,YANG Jingqi,et al.Effect of Left Atrial Appendage Closure on Cardiac Natriuretic Peptide Secretion in Patients with Nonvalvular Atrial Fibrillation[J].Advances in Cardiovascular Diseases,2019,(5):873.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.009]
[11]金铁托 阮中宝.左心耳封堵术对患者系统内稳态的影响[J].心血管病学进展,2020,(12):1268.[doi:10.16806/j.cnki.issn.1004-3934.2020.12.011]
 JIN Tietuo,RUAN Zhongbao.Effect of Left Atrial Appendage Closure on Systemic Homeostasis in Patients[J].Advances in Cardiovascular Diseases,2020,(5):1268.[doi:10.16806/j.cnki.issn.1004-3934.2020.12.011]
[12]邓蕊 李洪仕 蔡衡.左心耳封堵术对非瓣膜性心房颤动合并冠状动脉性心脏病的价值[J].心血管病学进展,2022,(11):966.[doi:10.16806/j.cnki.issn.1004-3934.2022.11.002]
 DENG Rui,LI Hongshi,CAI Heng.Value of Left Atrial Appendage Closure on Non-Valvular Atrial Fibrillation with Coronary Heart Disease[J].Advances in Cardiovascular Diseases,2022,(5):966.[doi:10.16806/j.cnki.issn.1004-3934.2022.11.002]

更新日期/Last Update: 2024-06-28