Атриопатия и фибрилляция предсердий. Часть II*
DOI:
https://doi.org/10.21638/spbu11.2023.104Аннотация
В основе фибрилляции предсердий лежат различные формы врожденной и приобретенной патологий. При выборе способа лечения важно понимание не только причины развития аритмии у конкретного больного, но и особенностей ее механизма и факторов прогрессирования. Очевидно, что существует различие в механизмах пароксизмальной и непароксизмальной форм фибрилляции предсердий. Очень важное клиническое значение имеют критерии и способы оценки стадии возможных обратных структурных и функциональных изменений в предсердии после стабилизации
сердечного ритма. Во второй части обзора обсуждаются непосредственные причины атриопатии, в частности амилоидоз сердца, мутации гена-предшественника натрий-уретического пептида А, наследственные миодистрофии, хроническая сердечная недостаточность, обструктивное апноэ сна, лекарственные вещества, миокардит, генетические нарушения реполяризации, старение, артериальная гипертензия, ожирение, сахарный диабет, пороки сердца, собственно фибрилляция предсердий. Описываются способы качественной и количественной оценки фиброза предсердий, возможности обратного ремоделирования. Рассматривается возможное значение фиброза как не-
посредственной причины системных тромбоэмболий и ишемического инсульта при фибрилляции предсердий. Обсуждаются пути профилактики и лечения атриопатии. Представлен алгоритм оценки степени тяжести атриопатии и вероятности сохранения синусового ритма.
Ключевые слова:
антикоагулянты, атриопатия, воспаление, инсульт, кардиомиопатия, катетерная аблация, левое предсердие, ремоделирование, тромбоэмболия, фибрилляция предсердий, фиброз
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References
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Загрузки
Опубликован
16.06.2023
Как цитировать
Яшин, С. ., & Шубик , Ю. . (2023). Атриопатия и фибрилляция предсердий. Часть II*. Вестник Санкт-Петербургского университета. Медицина, 18(1), 38–62. https://doi.org/10.21638/spbu11.2023.104
Выпуск
Раздел
Кардиология
Лицензия
Статьи журнала «Вестник Санкт-Петербургского университета. Медицина» находятся в открытом доступе и распространяются в соответствии с условиями Лицензионного Договора с Санкт-Петербургским государственным университетом, который бесплатно предоставляет авторам неограниченное распространение и самостоятельное архивирование.
