ТРОМБОЗ ЛЕВОГО ПРЕДСЕРДИЯ У БОЛЬНЫХ С РЕВМАТИЧЕСКИМИ МИТРАЛЬНЫМИ ПОРОКАМИ
https://doi.org/10.17650/1818-8338-2012-1-4-9
Аннотация
Системные тромбоэмболии — довольно частое осложнение митральных пороков, нередко приводящее к инвалидизирующим или фатальным последствиям для больного. Источником эмболий в большинстве случаев являются тромбы, локализующиеся в левом предсердии. В обзоре отражены основные взгляды на патогенез, диагностику, вопросы лечения и профилактики внутрипредсердного тромбоза с учетом новых научных достижений. Использованы статьи (обзоры, метаанализы и оригинальные исследования) из базы данных Pub Med, а также отечественные литературные источники.
Об авторах
Н. Д. КаверинРоссия
О. А. Хрусталев
Россия
кафедра терапии
Список литературы
1. Saito T., Tamura K., Uchida D., et al. Histopatological evalution of left atrial appendage thrombogenesis removed during surgery for atrial fibrillation. Am Heart J 2007;153(4):704−11.
2. Levin H.J. Which atrial fibrillation patient should be on chronic anticoagulation. J Cardiovasc Med 1981;6:483−7.
3. Abernathy W.S., Willis III P.W. Thromboembolic complications of rheumatic heart disease. Cardiovasc Clin 1973;5:131−75.
4. Панченко Е.П. Профилактика кардиоэмболического инсульта у больных мерцательной аритмией. Кардиоваскулярная терапия и профилактика 2002;(3):64−9.
5. Topaloglu S., Boyaci A., Ayaz S., et al. Coagulation, fibrinolytic system activation and endothelial dysfunction in patient with mitral stenosis and sinus rhythm. Angiology 2007;58(1):85−91.
6. Lip G.Y.H., Lip P.L., Zarifis J., et al. Fibrin D‑dimer and b‑thromboglobulin as markers of thrombogenesis and platelet activation in atrial fibrillation. Effects of introducing ultra‑low‑dose
7. warfarin and aspirin. Circulation 1996; 94:425−31.
8. Goldsmith I., Kumar P., Carter P., et al. Atrial endocardial changes in mitral valve disease: a scanning electron microscopy study. Am Heart J 2000;140(5):777−84.
9. Алексеевская И.Н., Персидских Ю.А., Корнелюк И.В. и др. Факторы, ассоциированные с возникновением тромбоза ушка левого предсердия у пациентов с персистирующей фибрилляцией предсердий. Вестник аритмологии 2009;(56):20−4.
10. Панченко Е.П., Добровольский А.Б. Тромбозы в кардиологии. Механизмы развития и возможности терапии. М.: Спорт и культура, 1999.
11. Kaymaz C., Ozdemir N., Kirma C., et al. Location, size and morphological characteristics
12. of left atrial thrombi as assessed by echocardiography in patients with rheumatic mitral valve
13. disease. J Echocardiogr 2001;2(4):270−6.
14. Koca V., Bozat T., Akkaya V., et al. Left atrial thrombus detection with multiplane transesophageal echocardiography: an echocardiographic study with surgical verification. J Heart Valve Dis 1999;8(1):63−6.
15. Acar J., Cormier B., Grimberg D., et al. Diagnosis of left atrial thrombi in mitral stenosis — usefulness of ultrasound techniques compared with other methods. Eur Heart J1991;12(Suppl B):70−6.
16. Kaymaz C. Location, size and morphological characteristics of left atrial thrombi as assessed by echocardiography in relation to systemic embolism in patients with rheumatic mitral valve disease.
17. Am J Cardiol 2003;91:765−9.
18. Саидова М.А. Трехмерная эхокардиография: вчера, сегодня, завтра. Consilium med 2006;8(5):127−32.
19. Алехин М.Н., Сидоренко Б.А. Использование в клинической практике трехмерной эхокардиографии в реальном времени. Кардиология 2008;48(6):4−10.
20. Asch F.M., Bieganski S.P., Panza J.A., et al. Real‑time 3‑dimensional echocardiography evaluation of intracardiac masses. Echocardiography 2006;3:218−24.
21. Исаева М.Ю., Зотова И.В., Алехин М.Н. и др. Выявление тромба ушка левого предсердия у больных с мерцательной аритмией и факторами риска развития тромбоэмболических осложнений: роль чреспищеводной эхокардиографии и мультиспиральной компьютерной томографии. Кардиология 2007;47(5):40−5.
22. Shapiro M.D., Neilan T.G., Jassal D.S., et al. Multidetector computed tomography for the detection of left atrial appendage thrombus: a comparative study with transesophageal echocardiography. J Comput Assist Tomogr 2007;6:905−9.
23. Бокерия Л.А., Макаренко В.Н., Александрова С.А. и др. Диагностика тромбоза ушка левого предсердия методом мультидетекторной компьютерной томографии. Грудная и сердечно-сосудистая хирургия 2010;(3):4−7.
24. Davison G., Greenland P. Predictors of left atrial thrombus in mitral valve disease. J Gen Intern Med 1991;6(2):108−12.
25. Goswami K.C., Yadav R., Bahl V.K. Predictors of left atrial appendage clot: a transesophageal echocardiographic study of left atrial appendage function in patients with severe mitral stenosis. Indian Heart J 2004;56(6):628−35.
26. Boonyasirinant T., Phankinthongkum R., Komoltri C. Clinical and echocardiographic parameters and score for the left atrial thrombus formation prediction in the patient with mitral stenosis. J Med Assoc Thai 2007; 90(Suppl 2): 9−18.
27. Goswami K.C., Yadav R., Rao M.B., et al. Clinical and echocardiographic predictors of left atrial clot and spontaneous echo contrast in patients with severe mitral stenosis: a prospective study in 200 patients by transesophageal echocardiographic. Int J Cardiol 2000;73(3):273−9.
28. Farman M.T., Sial J.A., Khan N., et al. Severe mitral stenosis with atrial fibrillation — a harbinger of thromboembolism. J Pak Med Assoc 2010;60(6):439−43.
29. Коноплева Ю.Л., Мазур А.А. Клинико-эхокардиографическая оценка факторов риска возникновения тромбоза левого предсердия у пациентов с митральным стенозом. Украинский ревматологический журнал 2002;4(10):41−3.
30. Stroke Risk in Atrial Fibrillation Working Group. Independent predictors of stroke in patient with atrial fibrillation: a systematic review. Neurology 2007;69:546−54.
31. Mutlu B., Karabulut M., Eroglu E., et al. Fibrillatory wave amplitude as a marker of left atrial appendage function, and a predictor of thromboembolic risk in patient with rheumatic
32. mitral stenosis. Int J Cardiol 2003;91(2−3):179−86.
33. Hwang J.J., Kuan P., Chen J.J., et al. Significance of left atrial spontaneous echo contrast in rheumatic mitral valve disease as a predictor of systemic arterial embolization: a transesophageal echocardiographic study. Am Heart J 1994;127(4 Pt 1):880−5.
34. Daniel W.G., Nellessen U., Schröder E., et al. Left atrial spontaneous echo contrast in mitral valve disease: an indicator for an increased thromboembolic risk. J Am Coll Cardiol 1988;11(6):1204−11.
35. Gonzalez‑Torrecilla E., Garcia‑Fernandez M.A., Perez‑David E., et al. Predictors of left atrial spontaneous echo contrast and thrombi in patients with mitral stenosis and atrial fibrillation. Am J Cardiol 2000;86(5):529−34.
36. Hwang J.J., Li Y.H., Lin J.M., Wang T.L. Left atrial appendage function determined by transesophageal echocardiography in patients with rheumatic mitral valve disease. Cardiology
37. ;85(2):121−8.
38. Golbasi Z., Cicek D., Canbay A. Left atrial appendage function in patients with mitral stenosis in sinus rhythm. Eur J Echocardiogr 2002;3(1):39−43.
39. Agarwal A.K., Venugopalan P. Left atrial spontaneous echo contrast in patients with rheumatic mitral valve stenosis in sinus rhythm: relationship to mitral valve and left atrial measurements. Int J Cardiol 2001;77(1):63−8.
40. Wanishsawad C., Weathers L.B., Puavilai W. Mitral regurgitation and left atrial thrombus in rheumatic mitral valve disease. A clinicopathologic study. Chest 1995;108(3):677−81.
41. Karatasakis G.T., Gotsis A.C., Cokkinos D.V. Influence of mitral regurgitation on left atrial thrombus and spontaneous echocardiographic contrast in patients with rheumatic mitral valve disease. Am J Cardiol 1995;76(4):279−81.
42. Sanada J., Komaki S., Sannou K., et al. Significance of atrial fibrillation, left atrial thrombus and severity of stenosis for risk of systemic embolism in patients with mitral stenosis. J Cardiol 1999;33(1):1−5.
43. Kandpal B., Garg N., Anand K.V., et al. Role of oral anticoagulation and inoue balloon mitral valvulotomy in presence of left atrial thrombus: a prospective serial transesophageal echocardiographic study. J Heart Valve Dis 2002;11(4):594−600.
44. Srimannarayana J., Varma R.S., Satheesh S., et al. Prevalence of left atrial thrombus in rheumatic mitral stenosis with atrial fibrillation and its response to anticoagulation: a transesophageal echocardiographic study. Indian Heart J 2003;55(4):358−61.
45. Hase M., Tsuchihashi K., Yonekura S., et al. Serial changes of left atrial thrombus in mitral
46. stenosis: transesophageal echocardiographic studies in candidates for balloon mitral commissurotomy. Can J Cardiol 1996;12(3):278−84.
47. Silaruks S., Thinkhamrop B., Kiatchoosakun S., et al. Resolution of left atrial thrombus after 6 months of anticoagulation in candidates for percutaneous transvenous mitral commissurotomy. Ann Intern Med 2004;140(2):101−5.
48. Hwang J.J., Kuan P., Tzou S.S., et al. Resolution of left atrial thrombi after anticoagulant therapy in patients with rheumatic mitral stenosis: report of four cases. J Formos Med Assoc 1993;92(1):72−7.
49. Bonow R.O., Carabello B.A., Chatterjee K., et al.; American College of Cardiology /American Heart Association Task Force on Practice Guidelines. 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American
50. College of Cardiology /American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2008;52(13):1−142.
51. Perez‑Gomes F., Salvador A., Zumalde J., et al. Effect of antithrombotic therapy in patients
52. with mitral stenosis and atrial fibrillation: a sub‑analysis of NASPEAF randomized trial. Eur Heart J 2006;8:960−7.
53. Levine H.J., Pauker S.G., Eckman M.N. Antithrombotic therapy in valvular heart disease. Chest 1995;108:360−70.
54. Adams G.F., Merrett J.D., Hutchinson W.M., et al. Cerebral embolism and mitral stenosis: survival with and without anticoagulants. J Neurol Neurosurg Psych 1974;37:378−83.
55. Pengo V., Barbero F., Biasilio A., et al. Prevention of thromboembolism in patients with mitral stenosis and associated atrial fibrillation: effectiveness of low intensity (INR target 2) oral
56. anticoagulation treatment. Thromb Haemost 2003;89:760−4.
57. Vahanian A., Baumgartner H., Bax J., et al.; Task Force on the Management of Valvular Hearth Disease of the European Society of Cardiology; ESC Committee for Practice Guidelines. Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J 2007;2:230−68.
58. Chiang C.W., Lo S.K., Ko Y.S., et al. Predictors of systemic embolism in patients with
59. mitral stenosis. A prospective study. Ann Intern Med 1998;128(11):885−9.
60. Derevall P.B., Olley P.M., Smith D.R., et al. Incidence of systemic embolism before and after
61. mitral valvotomy. Thorax 1968;23:530−6.
62. Nakajima H., Kobayashi J., Bando K.,et al. Consequence of atrial fibrillation and the risk of embolism after percutaneous mitral commissurotomy: the necessity of the maze procedure. Ann Thorac Surg
63. ;78(3):800−5.
64. Coulshed N., Epstein E.J., McKendrick C.S., et al. Systemic embolism in mitral valve disease.
65. Br Heart J 1970;32:26−34.
66. Salem D.N., O’Gara P.T., Madias C., Pauker S.G.; American College of Chest Physicians. Valvular and structural heart disease: American College of Chest Phisicians Evedense-Based Clinical Practice Guidelines (8th ed). Chest 2008;133(6 Suppl):593−629.
Рецензия
Для цитирования:
Каверин Н.Д., Хрусталев О.А. ТРОМБОЗ ЛЕВОГО ПРЕДСЕРДИЯ У БОЛЬНЫХ С РЕВМАТИЧЕСКИМИ МИТРАЛЬНЫМИ ПОРОКАМИ. Клиницист. 2012;6(1):4-9. https://doi.org/10.17650/1818-8338-2012-1-4-9
For citation:
Kaverin N.D., Hrustalev O.A. LEFT ATRIUM THROMBOSIS IN PATIENTS WITH RHEUMATIC MITRAL VALVULAR DISEASE. The Clinician. 2012;6(1):4-9. (In Russ.) https://doi.org/10.17650/1818-8338-2012-1-4-9