摘要
左心房逆重构是指左心房结构、功能、电重构发生逆转,左心房形态、功能参数及心肌组织得以恢复,多表示疾病得到改善.射血分数恢复的心力衰竭(HFrecEF)的发展与心肌损伤的性质及严重程度有关,而不仅仅局限于左心室射血分数的变化轨迹.近年来发现左心房逆重构与HFrecEF患者的预后、危险分层、药物选择方面密切相关.本文就左心房逆重构的定义、病理生理学、对心力衰竭患者的评估方法、在HFrecEF患者中的应用以及诊断左心房逆重构存在的争议与思考方面做一综述.
Abstract
Left atrial reverse remodeling refers to the reversal of left atrial structure,function,and electrical remodeling,and the restoration of left atrial morphology,functional parameters,and myocardial tissue,which mostly indicates that the disease is on the way of improvement.Heart failure with recovered ejection fraction (HFrecEF) has become an entity of widespread concern,and the progression of the disease is related to the nature and severity of myocardial injury,rather than being limited to the trajectory of left ventricular ejection fraction (LVEF) changes.In recent years,it has been found that the left atrial reverse remodeling is closely related to the prognosis,risk stratification,and drug selection of patients with HFrecEF.This article reviews the definition,pathophysiology,evaluation methods of left atrial reverse remodeling in patients with heart failure,its application in patients with HFrecEF,and the controversies and related considerations in the diagnosis of left atrial reverse remodeling.
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