风湿性二尖瓣狭窄二尖瓣成形术后影响房颤自然转复的因素分析
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摘要
目的:探讨风湿性心脏病二尖瓣狭窄合并心房颤动患者,行经皮球囊二尖瓣成形术(Percutaneous Balloon Mitral Valvuloplasty,PBMV)或二尖瓣替换术后影响房颤自然转复的因素。方法:将我院1994年1月至2006年6月12年间行PBMV或二尖瓣置换术的402例风湿性二尖瓣狭窄合并房颤的患者进行回顾性研究(其中行PBMV者65例,行二尖瓣置换术者337例)。根据患者的病史、超声心动图、临床资料和随访结果对手术后房颤自然转复为窦性心律的比例及影响因素进行分析。结果:经皮二尖瓣球囊成形术后65例患者,术后2周内转复为窦性心律者15例(23%),上述患者随访3～6个月后仍维持窦性心律者10例(15%);二尖瓣置换术后337例患者,转复为窦性心律者98例(29%),上述患者随访3～6个月后仍维持窦性心律者47例(14%)。经皮球囊二尖瓣成形术和二尖瓣置换术后影响房颤转归的独立危险因素为:年龄(P＜0.01,OR 1.24)、术前房颤持续时间(P＜0.01,OR 1.18)、术前左心房内径(P＜0.01,OR 1.28)和术后左心房内径(P＜0.01,OR 1.72)。结论:无论经皮球囊二尖瓣成形术还是二尖瓣置换术仅能使少部分风湿性二尖瓣狭窄合并房颤的患者恢复窦性心律。年龄、术前房颤持续时间、手术前后左房内径是影响术后房颤自然转复的独立危险因素。
Objective:To evaluate the effective factors of natural conversion of atrial fibrillation(AF)by percutaneous balloon mitral valvuloplasty(PBMV)or mitral valve replacement in patients with rheumatic mitral stenosis.Methods:From January 1994 to June 2006,65.consecutive patients with rheumatic mitral stenosis and atrial fibrillation who underwent PBMV and 337 patients who underwent mitral valve replacement were analysed retrospectively.In this study,clinical histories,echocardiograms,clinical datas, and follow-up data were viewed to evaluate the rate and predict the natural restoration of sinus rhythm.Results:15 patients(23%)of 65 patients regained sinus rhythm after PBMV within two weeks,during the follow-up period(3-6 months)only 10 patients(15%) maintained sinus rhythm;98 patients(29%)of 337 patients regained sinus rhythm after mitral valve replacement within two weeks,during the follow-up period(3-6 months) only 47 patients(14%)maintained sinus rhythm.Age(P＜0.01,OR 1.24),duration of AF (P＜0.01,OR 1.18),left atrail size before PBMV or mitral valve replacement(P＜0.01,OR 1.28)and left atrail size after PBMV or mitral valve replacement(P＜0.01,OR1.72)were independent dangerous factors of affecting AF conversion.Conclusion:AF can restore sinus rhythm in some patients with rheumatic mitral stenosis after PBMV or mitral valve replacement.Age,duration of AF,and left atrail size are dependent dangerous factors to influence natural convertion of AF.
Objective:To evaluate the effective factors of natural conversion of atrial fibrillation(AF)by percutaneous balloon mitral valvuloplasty(PBMV)or mitral valve replacement in patients with rheumatic mitral stenosis.Methods:From January 1994 to June 2006,65.consecutive patients with rheumatic mitral stenosis and atrial fibrillation who underwent PBMV and 337 patients who underwent mitral valve replacement were analysed retrospectively.In this study,clinical histories,echocardiograms,clinical datas, and follow-up data were viewed to evaluate the rate and predict the natural restoration of sinus rhythm.Results:15 patients(23%)of 65 patients regained sinus rhythm after PBMV within two weeks,during the follow-up period(3-6 months)only 10 patients(15%) maintained sinus rhythm;98 patients(29%)of 337 patients regained sinus rhythm after mitral valve replacement within two weeks,during the follow-up period(3-6 months) only 47 patients(14%)maintained sinus rhythm.Age(P＜0.01,OR 1.24),duration of AF (P＜0.01,OR 1.18),left atrail size before PBMV or mitral valve replacement(P＜0.01,OR 1.28)and left atrail size after PBMV or mitral valve replacement(P＜0.01,OR1.72)were independent dangerous factors of affecting AF conversion.Conclusion:AF can restore sinus rhythm in some patients with rheumatic mitral stenosis after PBMV or mitral valve replacement.Age,duration of AF,and left atrail size are dependent dangerous factors to influence natural convertion of AF.
引文
[1]周自强,胡大一,陈捷,等.中国心房颤动现状的流行病学研究[J].中华内科杂志,2004,43:491-494
[2]Go AS,Hylek EM,Phillips KA,et al.Prevalence of diagnosed Atrial fibrillation in Adults National Implications for Rhythm Management and Stroke[J]Prevention:the Anticoagulation ang Risk Factors in Atrial Fibrillation(ATRIA)Study.JAMA,2001,285:2370-2375
[3]Kaplan JA.Cardiac anesthesia.4 th ed.Philadelphia[J]:WB Saunders,1999.766
[4]Erdem D,Sinan A,Murat O,ct al.Prevalence and predictors of atrial fibrillation in rheumatic valvular heart disease[J].Am J Cardiol,1996,77:96-98
[5]Shcrrid MV,Clarck RD,Cohn K.Echocardiographic analysis of left atrial size before and after operation in mitral valve disease[J].Am J Cardiol,1979,43:171-178
[6]Cairns J A,Cormolly SJ.Nonrheumatic atrial fibrillation of stroke and role of the antithromabotic therapy[J].Circulation,1991,84(2):469-481
[7]Wolf PA,Kannel W B,Mcgee DL,et all Duration of atrial fibrillation and imminence of stroke:The Framingham study[J].Stroke,1983,14:665
[8][8]Moe GK,Abildskov JA.Atrial fibrillation as a self-sustaining arrhythmia independent of focal discharge.AmHear[J]t J,1959,58:59-70
[9]Scherf D.Studies on auricular tachycardia caused by aconitine administration[J].Proc Exp Biol Med,1947,64:233-239
[10]Prystowsky EN,Benson JD,Woodrow MD,et al.Management of patients with atrial fibrillation:astatement for healthcare eprofessionals from the subcommittee on electrocardiography and electrophysiology[J],American Heart Association.Circulation,1996,93:1262-1277
[11]Harada A,Sassaki K,Fukushima T,et al.Atrial activation during chronic atrial fibrillation in patients with isolated mitral valve disease[J].Ann Thorac Surg,1999,61:104-112
[12]Haissaguerre M,Jais P,Shah DC,et al.Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins[J].NEngl J Med,1998,339:659-666
[13]Nattel S.Nature[J],2002;415(6868):219-226
[14]Weber KT.Cardiac interstitium in health and disease:the fibrillar collagen network[J].J Am Coil Cardiol,1989,13:1637 1652
[15]Eghbali M,Blumenfenfeld OO,SeifterS,et al:Loc aliza-tion of type Ⅰ,Ⅲ and Ⅳcollagen Mma in rat heart cells by insituhybridization[J].J Mol CellCardiol,1989,21:103
[16]Kawara T,Derksen R,de Groot[J]JR,et al.Circulation,2001;104:3069-3075
[17]Xu J,Cui G,Esmailian F,et al.Atrial extra cellular matrix remodeling and the maintenance of atrial fibrillation[J].Circulation,2004,109:363-368
[18]柯丹,许春萱,林亚洲,等.心房颤动患者心房纤维化分子基础的临床研究[J].中华心血管杂志,2005,33(5):459-463
[19]Goette A,Staack T,Rocken C,et al.Increased expression of extracellular during atrial fibrillation[J].J Am Coll Cardiol,2000,35:1669
[20]伍伟锋,黄从新,刘唐威,等.风湿性心脏病心房颤动患者心房细胞外信号调节蛋白与纤维化的关系[J].中国心脏起搏与心电生理杂志 2002,16(2):100-103
[21]王祥,戴友平,扬杪,等.心房颤动心房组织内细胞外信号调节激酶和血管紧张素转化酶表达的研究[J].中华心血管病杂志 2004,32(3):207-210
[22]Cheruku KK,Ghani A,Ahmad F,et al Efficacy of nonsteroidal anti inflammatory medicationsfor prevention of atrial fibrillation following coronary artery bypass surgery[J]Prev Cardiol,2004,7:11-16
[23]Demellis JM,Paneratou MP Relationship between C reactive protein concentrations during glucocorticoid the rapy and recurrent atrial fibrillation Eur Heart[J]J,2004,25:1100-1107
[24]王长华,胡大一,汤楚中,等.风湿性心脏瓣膜病慢性心房颤动患者白细胞介素-1β和肿瘤坏死因子-α蛋白表达的研究[J].中华心血管病杂志,2005,33(6):522-525
[25]Dupont E,Yushien K,Stephen R,et al.The gap junctional protein connexin40 is elevated in patient susceptible to postoperative atrial fibrillation[J].Circulation,2001,103:842-849
[26]Polontchouk L,Haefliger JA,Ebelt B,et al.Effeets of chronic atrial fibrillation on gap junction distribution in human and rat atria[J].J Am Coil Cardiol,2001,38:883-891
[27]Goette A,Honeycutt C,Langberg JJ.Electrical remodeling in atrial fibrillation:Time course and mechanisms[J].Circulation,1996,94:2968-2974
[28]Grammer JB,Zeng X,Bosch RF,et al.Atrial L-type Ca~(2+)-channel,beta-adrenorecptor,and 5-hydroxytryptam ine type 4 receptor mRNAs in human atrial fibrillation[J].Basic Res Cardiol,2001,96(1):82-90
[29]Helmcke F,Nanda NC,Hsiung MC,et al.Color doppler assessment of mitral regurgitation with orthogonal planes[J].Circulation,1987,75:175-183
[30]Sato S,Kawashima Y,Hirose H,et al.Long term results of di-rectcurrent cardioversion after open commissurotomy for mi-tral stenosis[J].Am J Cardiol,1986,57;629
[31]Petersen P,Godtfredsen J.Risk factors for stroke in chronic atrial fibrillation[J].Eurheart J,1988,9:21
[32]Chua YL,Schaff HV,Orszulak TA,et al.Outcome of mitralval-ve repair in patients with preoperative atrial fibrillation.Should the maze procedure be combined with mitra lvalvuloplasty?[J]J Thorac Cardiovasc Surg,1994,107:408
[33]Graffigna A,Pagani F,Minzioni G,et al.left atrial isolation asso-ciated with mitral valve operations[J].Arm Thorac Surg,1992,54:1093
[34]侯晓彤,孙衍庆,李潮等.二尖瓣替换术后房颤转复为窦性心律的临床分析[J].心肺血管病杂志,1997,16(2):124-126
[35]莫绪明,夏求明,姚志发.瓣膜替换术对心房纤颤转归的影响[J].中国胸心血管外科临床杂志,1995,2(1):3-5
[36]游斌权,苏唏,汪敏等.风湿性心脏病瓣膜置换术后心房颤动复律的临床分析[J].中国心血管杂志,2003,10(8):342-344
[37]吴海,尹瑞兴,陶新智等.二尖瓣狭窄并发心房颤动的危险因素探讨[J].中国介入心脏病学杂志,2000,11(8):203-205
[38]Henry WL,Morganroth J,Pearlman AS.Relation between echocardiographically determined left atrial size and atrial fibrillation[J],Circulation,1976,53:273-279
[39]Unerferth DV,Fertel RH,Unerferth BJ,et al.Atrial fibrillation in mitral stenosis:Histologic hemodnamic and metabolic factors[J].Int J Cardiol,1984,5:143-154
[40]丁鸿钧,郑兴,章同华等.风湿性心脏病换瓣术后心房纤维颤动177例电复律早期疗效及其影响因素[J].第二军医大学学报,1995,16(3):280-281
[41]刘成华,肖兴花.PBMV术后心房颤动复律时机分析[J].山东医药,2005,45(29):63-64
[1]Cairns J A,Connolly SJ.Nonrheumatic atrial fibrillation of stroke and role of the antithromabotie therapy[J].Circulation,1991,84(2):469-481
[2]Kaplan JA.Cardiac anesthesia[J].4 th ed.Philadelphia:WB Saunders,1999.766
[3]Erdem D,Sinan A,Murat O,ct al.Prevalence and predictors of atrial fibrillation in rheumatic valvular heart disease[J].Am J Cardiol,1996,77:96-98
[4]Shcrrid MV,Clarek RD,Cohn K.Echocardiographic analysis of left atrial size before and after operation in mitral valve disease[J].Am J Cardiol,1979,43:171-178
[5]Moe GK,Abildskov JA.Atrial fibrillation as a self-sustaining arrhythmia independent of focal diseharge[J].AmHeart J,1959,58:59-70
[6]Scheff D.Studies on auricular taehyeardia caused by aeonitine administration[J].Proc Exp Biol Meal,1947,64:233-239
[7]Yue L,Feng J,Gaspo R,et al.Ionic remodeling under lying action potential changes in acanine model of atrial fibrillation[J].CireRes,1997,81:512-525
[8]Prystowsky EN,Benson JD,Woodrow MD,et al.Management of patients with atrial fibrillation:astatement for healthcare eprofessionals from the subcommittee on electrocardiography and electrophysiology,American Heart Association[J].Circulation,1996,93:1262-1277
[9]Moe GK,Abildskov JA.Atrial fibrillation as a self-sustaining arrhythmia independent of focal discharge[J].AmHeart J,1959,58:59-70
[10]Harada A,Sassaki K,Fukushima T,et al.Atrial activation during chronic atrial fibrillation in patients with isolated mitral valve disease[J].Ann Thorae Surg,1999,61:104-112
[11]Haissaguerre M,Jais P,Shah DC,et ai.Spontaneous initiation of atrial fibrillation by eetopic beats originating in the pulmonary veins[J].NEngl J Meal,1998,339:659-666
[12]Nattel S.Nature[J],2002;415(6868):219-226
[13]Frustaci A,Chimenti C,Bellocci F,et al.Histological substrate of atrial biopsies inpatients with lone atrial fibrillation[J].Cireulation,1997,96:1180-1184
[14]Hoit BD.Matrixmetalloproteinase and atrial structural remodeling[J].J Am Coll Cardiol,2003,42:345-347
[15]Weber KT.Cardiac interstitium in health and disease:the fibrillar collagen network[J].J Am Coll Cardiol,1989,13:1637-1652
[16]Eghbali M,Blumenfenfeld OO,SeifterS,et al:Loc aliza-tion of type Ⅰ,Ⅲ and Ⅳcollagen Mrna in rat heart cells by insituhybridization[J].JM ol CellCardiol,1989,21:103
[17]Kawara T,Derksen R,de Groot JR[J],et al.Circulation,2001;104:3069-3075
[18]Xu J,Cui G,Esmailian F,et al.Atrial extra cellular matrix remodeling and the maintenance of atrial fibrillation[J].Circulation,2004,109:363-368
[19]柯丹,许春萱,林亚洲,等.心房颤动患者心房纤维化分子基础的临床研究.中华心血管杂志[J],2005,33(5):459-463
[20]Goette A,Staack T,Rocken C,et al.Increased expression of extracellular during atrial fibrillation[J].J Am Coll Cardiol,2000,35:1669
[21]伍伟锋,黄从新,刘唐威,等.风湿性心脏病心房颤动患者心房细胞外信号调节蛋白与纤维化的关系.中国心脏起搏与心电生理杂志[J]2002,16(2):100-103
[22]王祥,戴友平,扬杪,等.心房颤动心房组织内细胞外信号调节激酶和血管紧张素转化酶表达的研究[J].中华心血管病杂志 2004,32(3):207-210
[23]Koichiro K,Hideko N,Hidenori U,et al Effects of angiotensin Ⅱ type 1 receptor antagonist on electrical and structural remodeling in atrial fibrillation[J]J Am Coll Cardiol,2003,41:2197-2204
[24]Cheruku KK,Ghani A,Ahrnad F,et al Efficacy of nonsteroidal anti inflammatory medicationsfor prevention of atrial fibrillation following coronary artery bypass surgery[J]Prev Cardiol,2004,7:11-16
[25]Demellis JM,Paaeratou MP Relationship between C reactive protein concentrations during glucocorticoid the rapy and recurrent atrial fibrillation[J]Eur Heart J,2004,25:1100-1107
[26]王长华,胡大一,汤楚中,等.风湿性心脏瓣膜病慢性心房颤动患者白细胞介素-1β和肿瘤坏死因子-α蛋白表达的研究[J].中华心血管病杂志 2005,33(6):522-525
[27]Allessie M,Ausma J,Sehotten U E lectrical,contractile and structural remodeling during atrial fibrillation[J]Cardiovasc Res,2002,54:230-246
[28]Monica R,Luis M,Vanesa E,et al Cotmeetive tissue growth factor is a mediator of angiotensin Ⅱ -induced fibrosis[J]Circulation,2003,108:1499-1505
[29]Morello CA,Klelin GJ,Jones DL,et al.Chronic rapid pacing strut tural,functional and eletrophysological characteristics of a new model of sustained atrial fibrillation[J].Circulation,1995,91:1588
[30]Dupont E,Yushien K,Stephen R,et al.The gap junctional protein eormexin40 is elevated in patient susceptible to postoperative atrial fibrillation[J].Circulation,2001, 103:842-849
[31]Potontchouk L,Haefliger JA,Ebelt B,et al.Effects of chronic atrial fibrillation on gap junction distribution in human and rat atria.J Am Coil Cardiol,2001,38:883-891
[32]伍伟锋,黄从新,刘唐威,等.心房颤动患者心房组织连接蛋白40和连接蛋白43基因转录表达的研究[J].中华心血管病杂志,2002,30:221-224
[33]贾玉和,张澍,王方正,等.瓣膜病慢性心房颤动心房肌缝隙连接CX43和CX40的重构[J].中华心律失常学杂,2004,8(4):223-227
[34]Allessie M,Konings K,Wijffels M.Electrophysiological mechanism of atrial fibrillation[A].In:DiMarco JP,prystw sky EN,eds.Atrial Arrhythmias:State of the Art[C].Arm onk,NY:Futura Publishing Co,1995,155-161
[35]Janse.M J.Mechanism of atrial fibrillation[A].In:Zipes DP,Jalife J,eds.Cardiac Electrophysiology:From Cell to Bedside[C].Phiadelphia,Pa:WB Saunders CO,2000:476-482
[36]Goette A,Honeycutt C,Langberg JJ.Electrical remodeling in atrial fibrillation:Time course and mechanisms[J].Circulation,1996,94:2968-2974
[37]Goette A,Honeycutt C,Langberg JJ.Electrical remodeling in atrial fibrillation:Time course and mechanisms[J].Circulation,1996,94:2968-2974.
[38]Grammer JB,Zeng X,Bosch RF,et al.Atrial L-type Ca~(2+)-channel,beta-adrenorecptor,and 5-hydroxytryptam ine type 4 receptor mRNAs in human atrial fibrillation[J].Basic Res Cardiol,2001,96(1):82-90
[39]Van der Velden HMW,van der Zee L,Wijffels MC,et al.Atrial fibrillation in the goat induces changes in monophasic action potential and mRNA expression of ion channels involved in repolarization[J].J Cardiovasc Electrophysiol.2000,11(11):1262-1269
[2]Go AS,Hylek EM,Phillips KA,et al.Prevalence of diagnosed Atrial fibrillation in Adults National Implications for Rhythm Management and Stroke[J]Prevention:the Anticoagulation ang Risk Factors in Atrial Fibrillation(ATRIA)Study.JAMA,2001,285:2370-2375
[3]Kaplan JA.Cardiac anesthesia.4 th ed.Philadelphia[J]:WB Saunders,1999.766
[4]Erdem D,Sinan A,Murat O,ct al.Prevalence and predictors of atrial fibrillation in rheumatic valvular heart disease[J].Am J Cardiol,1996,77:96-98
[5]Shcrrid MV,Clarck RD,Cohn K.Echocardiographic analysis of left atrial size before and after operation in mitral valve disease[J].Am J Cardiol,1979,43:171-178
[6]Cairns J A,Cormolly SJ.Nonrheumatic atrial fibrillation of stroke and role of the antithromabotic therapy[J].Circulation,1991,84(2):469-481
[7]Wolf PA,Kannel W B,Mcgee DL,et all Duration of atrial fibrillation and imminence of stroke:The Framingham study[J].Stroke,1983,14:665
[8][8]Moe GK,Abildskov JA.Atrial fibrillation as a self-sustaining arrhythmia independent of focal discharge.AmHear[J]t J,1959,58:59-70
[9]Scherf D.Studies on auricular tachycardia caused by aconitine administration[J].Proc Exp Biol Med,1947,64:233-239
[10]Prystowsky EN,Benson JD,Woodrow MD,et al.Management of patients with atrial fibrillation:astatement for healthcare eprofessionals from the subcommittee on electrocardiography and electrophysiology[J],American Heart Association.Circulation,1996,93:1262-1277
[11]Harada A,Sassaki K,Fukushima T,et al.Atrial activation during chronic atrial fibrillation in patients with isolated mitral valve disease[J].Ann Thorac Surg,1999,61:104-112
[12]Haissaguerre M,Jais P,Shah DC,et al.Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins[J].NEngl J Med,1998,339:659-666
[13]Nattel S.Nature[J],2002;415(6868):219-226
[14]Weber KT.Cardiac interstitium in health and disease:the fibrillar collagen network[J].J Am Coil Cardiol,1989,13:1637 1652
[15]Eghbali M,Blumenfenfeld OO,SeifterS,et al:Loc aliza-tion of type Ⅰ,Ⅲ and Ⅳcollagen Mma in rat heart cells by insituhybridization[J].J Mol CellCardiol,1989,21:103
[16]Kawara T,Derksen R,de Groot[J]JR,et al.Circulation,2001;104:3069-3075
[17]Xu J,Cui G,Esmailian F,et al.Atrial extra cellular matrix remodeling and the maintenance of atrial fibrillation[J].Circulation,2004,109:363-368
[18]柯丹,许春萱,林亚洲,等.心房颤动患者心房纤维化分子基础的临床研究[J].中华心血管杂志,2005,33(5):459-463
[19]Goette A,Staack T,Rocken C,et al.Increased expression of extracellular during atrial fibrillation[J].J Am Coll Cardiol,2000,35:1669
[20]伍伟锋,黄从新,刘唐威,等.风湿性心脏病心房颤动患者心房细胞外信号调节蛋白与纤维化的关系[J].中国心脏起搏与心电生理杂志 2002,16(2):100-103
[21]王祥,戴友平,扬杪,等.心房颤动心房组织内细胞外信号调节激酶和血管紧张素转化酶表达的研究[J].中华心血管病杂志 2004,32(3):207-210
[22]Cheruku KK,Ghani A,Ahmad F,et al Efficacy of nonsteroidal anti inflammatory medicationsfor prevention of atrial fibrillation following coronary artery bypass surgery[J]Prev Cardiol,2004,7:11-16
[23]Demellis JM,Paneratou MP Relationship between C reactive protein concentrations during glucocorticoid the rapy and recurrent atrial fibrillation Eur Heart[J]J,2004,25:1100-1107
[24]王长华,胡大一,汤楚中,等.风湿性心脏瓣膜病慢性心房颤动患者白细胞介素-1β和肿瘤坏死因子-α蛋白表达的研究[J].中华心血管病杂志,2005,33(6):522-525
[25]Dupont E,Yushien K,Stephen R,et al.The gap junctional protein connexin40 is elevated in patient susceptible to postoperative atrial fibrillation[J].Circulation,2001,103:842-849
[26]Polontchouk L,Haefliger JA,Ebelt B,et al.Effeets of chronic atrial fibrillation on gap junction distribution in human and rat atria[J].J Am Coil Cardiol,2001,38:883-891
[27]Goette A,Honeycutt C,Langberg JJ.Electrical remodeling in atrial fibrillation:Time course and mechanisms[J].Circulation,1996,94:2968-2974
[28]Grammer JB,Zeng X,Bosch RF,et al.Atrial L-type Ca~(2+)-channel,beta-adrenorecptor,and 5-hydroxytryptam ine type 4 receptor mRNAs in human atrial fibrillation[J].Basic Res Cardiol,2001,96(1):82-90
[29]Helmcke F,Nanda NC,Hsiung MC,et al.Color doppler assessment of mitral regurgitation with orthogonal planes[J].Circulation,1987,75:175-183
[30]Sato S,Kawashima Y,Hirose H,et al.Long term results of di-rectcurrent cardioversion after open commissurotomy for mi-tral stenosis[J].Am J Cardiol,1986,57;629
[31]Petersen P,Godtfredsen J.Risk factors for stroke in chronic atrial fibrillation[J].Eurheart J,1988,9:21
[32]Chua YL,Schaff HV,Orszulak TA,et al.Outcome of mitralval-ve repair in patients with preoperative atrial fibrillation.Should the maze procedure be combined with mitra lvalvuloplasty?[J]J Thorac Cardiovasc Surg,1994,107:408
[33]Graffigna A,Pagani F,Minzioni G,et al.left atrial isolation asso-ciated with mitral valve operations[J].Arm Thorac Surg,1992,54:1093
[34]侯晓彤,孙衍庆,李潮等.二尖瓣替换术后房颤转复为窦性心律的临床分析[J].心肺血管病杂志,1997,16(2):124-126
[35]莫绪明,夏求明,姚志发.瓣膜替换术对心房纤颤转归的影响[J].中国胸心血管外科临床杂志,1995,2(1):3-5
[36]游斌权,苏唏,汪敏等.风湿性心脏病瓣膜置换术后心房颤动复律的临床分析[J].中国心血管杂志,2003,10(8):342-344
[37]吴海,尹瑞兴,陶新智等.二尖瓣狭窄并发心房颤动的危险因素探讨[J].中国介入心脏病学杂志,2000,11(8):203-205
[38]Henry WL,Morganroth J,Pearlman AS.Relation between echocardiographically determined left atrial size and atrial fibrillation[J],Circulation,1976,53:273-279
[39]Unerferth DV,Fertel RH,Unerferth BJ,et al.Atrial fibrillation in mitral stenosis:Histologic hemodnamic and metabolic factors[J].Int J Cardiol,1984,5:143-154
[40]丁鸿钧,郑兴,章同华等.风湿性心脏病换瓣术后心房纤维颤动177例电复律早期疗效及其影响因素[J].第二军医大学学报,1995,16(3):280-281
[41]刘成华,肖兴花.PBMV术后心房颤动复律时机分析[J].山东医药,2005,45(29):63-64
[1]Cairns J A,Connolly SJ.Nonrheumatic atrial fibrillation of stroke and role of the antithromabotie therapy[J].Circulation,1991,84(2):469-481
[2]Kaplan JA.Cardiac anesthesia[J].4 th ed.Philadelphia:WB Saunders,1999.766
[3]Erdem D,Sinan A,Murat O,ct al.Prevalence and predictors of atrial fibrillation in rheumatic valvular heart disease[J].Am J Cardiol,1996,77:96-98
[4]Shcrrid MV,Clarek RD,Cohn K.Echocardiographic analysis of left atrial size before and after operation in mitral valve disease[J].Am J Cardiol,1979,43:171-178
[5]Moe GK,Abildskov JA.Atrial fibrillation as a self-sustaining arrhythmia independent of focal diseharge[J].AmHeart J,1959,58:59-70
[6]Scheff D.Studies on auricular taehyeardia caused by aeonitine administration[J].Proc Exp Biol Meal,1947,64:233-239
[7]Yue L,Feng J,Gaspo R,et al.Ionic remodeling under lying action potential changes in acanine model of atrial fibrillation[J].CireRes,1997,81:512-525
[8]Prystowsky EN,Benson JD,Woodrow MD,et al.Management of patients with atrial fibrillation:astatement for healthcare eprofessionals from the subcommittee on electrocardiography and electrophysiology,American Heart Association[J].Circulation,1996,93:1262-1277
[9]Moe GK,Abildskov JA.Atrial fibrillation as a self-sustaining arrhythmia independent of focal discharge[J].AmHeart J,1959,58:59-70
[10]Harada A,Sassaki K,Fukushima T,et al.Atrial activation during chronic atrial fibrillation in patients with isolated mitral valve disease[J].Ann Thorae Surg,1999,61:104-112
[11]Haissaguerre M,Jais P,Shah DC,et ai.Spontaneous initiation of atrial fibrillation by eetopic beats originating in the pulmonary veins[J].NEngl J Meal,1998,339:659-666
[12]Nattel S.Nature[J],2002;415(6868):219-226
[13]Frustaci A,Chimenti C,Bellocci F,et al.Histological substrate of atrial biopsies inpatients with lone atrial fibrillation[J].Cireulation,1997,96:1180-1184
[14]Hoit BD.Matrixmetalloproteinase and atrial structural remodeling[J].J Am Coll Cardiol,2003,42:345-347
[15]Weber KT.Cardiac interstitium in health and disease:the fibrillar collagen network[J].J Am Coll Cardiol,1989,13:1637-1652
[16]Eghbali M,Blumenfenfeld OO,SeifterS,et al:Loc aliza-tion of type Ⅰ,Ⅲ and Ⅳcollagen Mrna in rat heart cells by insituhybridization[J].JM ol CellCardiol,1989,21:103
[17]Kawara T,Derksen R,de Groot JR[J],et al.Circulation,2001;104:3069-3075
[18]Xu J,Cui G,Esmailian F,et al.Atrial extra cellular matrix remodeling and the maintenance of atrial fibrillation[J].Circulation,2004,109:363-368
[19]柯丹,许春萱,林亚洲,等.心房颤动患者心房纤维化分子基础的临床研究.中华心血管杂志[J],2005,33(5):459-463
[20]Goette A,Staack T,Rocken C,et al.Increased expression of extracellular during atrial fibrillation[J].J Am Coll Cardiol,2000,35:1669
[21]伍伟锋,黄从新,刘唐威,等.风湿性心脏病心房颤动患者心房细胞外信号调节蛋白与纤维化的关系.中国心脏起搏与心电生理杂志[J]2002,16(2):100-103
[22]王祥,戴友平,扬杪,等.心房颤动心房组织内细胞外信号调节激酶和血管紧张素转化酶表达的研究[J].中华心血管病杂志 2004,32(3):207-210
[23]Koichiro K,Hideko N,Hidenori U,et al Effects of angiotensin Ⅱ type 1 receptor antagonist on electrical and structural remodeling in atrial fibrillation[J]J Am Coll Cardiol,2003,41:2197-2204
[24]Cheruku KK,Ghani A,Ahrnad F,et al Efficacy of nonsteroidal anti inflammatory medicationsfor prevention of atrial fibrillation following coronary artery bypass surgery[J]Prev Cardiol,2004,7:11-16
[25]Demellis JM,Paaeratou MP Relationship between C reactive protein concentrations during glucocorticoid the rapy and recurrent atrial fibrillation[J]Eur Heart J,2004,25:1100-1107
[26]王长华,胡大一,汤楚中,等.风湿性心脏瓣膜病慢性心房颤动患者白细胞介素-1β和肿瘤坏死因子-α蛋白表达的研究[J].中华心血管病杂志 2005,33(6):522-525
[27]Allessie M,Ausma J,Sehotten U E lectrical,contractile and structural remodeling during atrial fibrillation[J]Cardiovasc Res,2002,54:230-246
[28]Monica R,Luis M,Vanesa E,et al Cotmeetive tissue growth factor is a mediator of angiotensin Ⅱ -induced fibrosis[J]Circulation,2003,108:1499-1505
[29]Morello CA,Klelin GJ,Jones DL,et al.Chronic rapid pacing strut tural,functional and eletrophysological characteristics of a new model of sustained atrial fibrillation[J].Circulation,1995,91:1588
[30]Dupont E,Yushien K,Stephen R,et al.The gap junctional protein eormexin40 is elevated in patient susceptible to postoperative atrial fibrillation[J].Circulation,2001, 103:842-849
[31]Potontchouk L,Haefliger JA,Ebelt B,et al.Effects of chronic atrial fibrillation on gap junction distribution in human and rat atria.J Am Coil Cardiol,2001,38:883-891
[32]伍伟锋,黄从新,刘唐威,等.心房颤动患者心房组织连接蛋白40和连接蛋白43基因转录表达的研究[J].中华心血管病杂志,2002,30:221-224
[33]贾玉和,张澍,王方正,等.瓣膜病慢性心房颤动心房肌缝隙连接CX43和CX40的重构[J].中华心律失常学杂,2004,8(4):223-227
[34]Allessie M,Konings K,Wijffels M.Electrophysiological mechanism of atrial fibrillation[A].In:DiMarco JP,prystw sky EN,eds.Atrial Arrhythmias:State of the Art[C].Arm onk,NY:Futura Publishing Co,1995,155-161
[35]Janse.M J.Mechanism of atrial fibrillation[A].In:Zipes DP,Jalife J,eds.Cardiac Electrophysiology:From Cell to Bedside[C].Phiadelphia,Pa:WB Saunders CO,2000:476-482
[36]Goette A,Honeycutt C,Langberg JJ.Electrical remodeling in atrial fibrillation:Time course and mechanisms[J].Circulation,1996,94:2968-2974
[37]Goette A,Honeycutt C,Langberg JJ.Electrical remodeling in atrial fibrillation:Time course and mechanisms[J].Circulation,1996,94:2968-2974.
[38]Grammer JB,Zeng X,Bosch RF,et al.Atrial L-type Ca~(2+)-channel,beta-adrenorecptor,and 5-hydroxytryptam ine type 4 receptor mRNAs in human atrial fibrillation[J].Basic Res Cardiol,2001,96(1):82-90
[39]Van der Velden HMW,van der Zee L,Wijffels MC,et al.Atrial fibrillation in the goat induces changes in monophasic action potential and mRNA expression of ion channels involved in repolarization[J].J Cardiovasc Electrophysiol.2000,11(11):1262-1269