一項(xiàng)新研究顯示，左房容積(LAV)測(cè)定是一種很有前途的有效的評(píng)估檢測(cè)房顫(AF)患者工具。

在這項(xiàng)研究中，Mayo診所(Rochester, MN, USA)的科研人員對(duì)46例患房顫的患者進(jìn)行了長(zhǎng)期(中位數(shù)時(shí)間：27年)的隨訪。 23例患者(50%)經(jīng)歷過(guò)心血管事件。在7例患者中發(fā)生了腦梗塞，11例發(fā)生心肌梗塞，16例出現(xiàn)充血性心臟衰竭。

為了探討為什么良性AF會(huì)進(jìn)展至風(fēng)險(xiǎn)相關(guān)的AF，Mayo研究小組測(cè)定了LAV的變化。無(wú)并發(fā)癥的AF患者心房體積正常，并在數(shù)十年內(nèi)保持不變，風(fēng)險(xiǎn)極低。只有在心房變大后，心房壓顯著增加，開(kāi)始出現(xiàn)腦卒中和心臟衰竭。

在多變量分析中，患者的LAV指數(shù)是32ml/m2或者更大，無(wú)事件生存率顯著惡化。所有這些患者都出現(xiàn)了腦梗塞。這些研究結(jié)果發(fā)表在2005年12月《歐洲心臟期刊》。

 
 
Atrial Volume Predicts Cardiovascular Events
 
Left atrial volume (LAV) measurement is a promising and powerful tool for the evaluation and monitoring of patients with atrial fibrillation (AF), a new study suggests.

In this study, scientists at the Mayo Clinic (Rochester, MN, USA) conducted a long-range (median of 27 years) follow-up of 46 patients with lone AF. Twenty-three of the patients (50%) experienced cardiovascular events. Cerebral infarction occurred in seven patients, myocardial infarction occurred in 11, and congestive heart failure in 16.

In an attempt to find out why a benign lone AF may evolve into a risk-associated AF, the Mayo group measured the changes in LAV. Patients with ‘uncomplicated’ lone AF had normal atrial size, which remained unchanged for decades, signifying very low risk. Only when the atria became large, signifying increased atrial pressure, did stroke and heart failure begin to occur.

In a multivariate analysis, patients with an LAV index of 32 ml/m2 or greater had a significantly worse event-free survival. All the cerebral infarctions occurred in these patients. The results were published in the December 2005 edition of the European Heart Journal.