心房颤动应该被认为是一种血管疾病吗?需要一个全面的血管途径。

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Expert Review of Cardiovascular Therapy Pub Date : 2023-07-01 Epub Date: 2023-12-10 DOI:10.1080/14779072.2023.2272652
Carlos Escobar-Cervantes, Antonio Pose Reino, Pablo Díez-Villanueva, Lorenzo Facila, Román Freixa-Pamias, Alfonso Valle, Manuel Almendro-Delia, Clara Bonanad, David Vivas, Carmen Suarez
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引用次数: 0

摘要

引言:心房颤动(AF)不能被认为是一种孤立的疾病。房颤患者应采用综合方法进行治疗,而不限于预防中风。涵盖的领域:在这篇手稿中,回顾了房颤作为一种血管疾病的潜在作用,作为整体方法的一部分进行管理。专家意见:尽管进行了适当的抗凝治疗,但房颤患者中风的残余风险每年达到1-2%。此外,房颤患者可能通过与中风无关的途径发展为认知障碍。此外,房颤患者在各种血管床上发生动脉粥样硬化性血管疾病和慢性肾脏疾病的风险可能更高;相反,动脉粥样硬化性疾病患者可能会增加发生房颤的风险。房颤应被视为一种真正的全身性血管疾病,因为它会引起多种血液动力学和全身性变化,包括炎症、氧化应激、肾素-血管紧张素-醛固酮和交感系统的激活,以及血栓前状态和内皮功能障碍。在这方面,房颤患者应基于整体方法进行治疗,该方法不仅限于口服抗凝,还包括完全的血管保护。
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Should atrial fibrillation be considered a vascular disease? The need for a comprehensive vascular approach.

Introduction: Atrial fibrillation (AF) cannot be considered an isolated disease. Patients with AF should be managed using a comprehensive approach that is not limited to stroke prevention.

Areas covered: In this manuscript, the potential role of AF as a vascular disease that is managed as part of a holistic approach was reviewed.

Expert opinion: The residual risk of stroke in patients with AF reaches 1-2% annually, despite appropriate anticoagulation therapy. Additionally, patients with AF may develop cognitive impairment through stroke-independent pathways. Furthermore, patients with AF may have a higher risk of developing atherosclerotic vascular disease in various vascular beds and chronic kidney disease; conversely, patients with atherosclerotic disease may have an increased risk of developing AF. AF should be considered a truly systemic vascular disease, since it brings together several hemodynamic and systemic changes, including inflammation, oxidative stress, activation of the renin-angiotensin-aldosterone and sympathetic systems, as well as a prothrombotic state and endothelial dysfunction. In this regard, patients with AF should be treated based on a holistic approach that is not limited to oral anticoagulation but includes complete vascular protection.

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来源期刊
Expert Review of Cardiovascular Therapy
Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.70
自引率
0.00%
发文量
82
期刊介绍: Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.
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