[脑淀粉样血管病和左心耳闭塞:心脏病学和神经学合作方法的证据和可能的治疗]。

IF 0.7 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Andrea Lalario, Enrico Fabris, Serena Rakar, Laura Massa, Alberto Benussi, Gianfranco Sinagra
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引用次数: 0

摘要

这篇综述强调了与管理脑淀粉样血管病(CAA)和心房颤动患者相关的流行病学和临床挑战。随着人口老龄化,临床医生越来越需要为这一特定的患者亚群设计适当的管理策略。这些患者不仅面临与口服抗凝治疗相关的脑出血风险,而且还面临CAA引起的并发症。CAA是一种与年龄相关的小血管疾病,其特征是β-淀粉样蛋白沉积在皮层和小脑膜动脉、小动脉和毛细血管的壁上。这种情况会逐渐削弱血管完整性,从而增加大出血事件的风险。由于缺乏随机临床试验,需要采用多参数和多学科的方法来评估血管病变的程度,平衡血栓栓塞和出血风险,旨在为每位患者量身定制最有效的管理策略。在处理此类病例时,关键是要解决伴随的危险因素,并考虑药物和非药物干预措施,如左心耳闭塞,以减轻卒中的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Cerebral amyloid angiopathy and left atrial appendage occlusion: evidence and possible management for a collaborative approach between Cardiology and Neurology].

This review highlights the epidemiological and clinical challenge associated with managing patients who have cerebral amyloid angiopathy (CAA) and atrial fibrillation. As the population ages, clinicians are increasingly required to devise appropriate management strategies for this specific patient subgroup. These patients face not only the risk of intracerebral hemorrhage associated with oral anticoagulant therapy but also complications due to CAA. CAA is an age-related small vessel disease characterized by the deposition of β-amyloid in the walls of cortical and leptomeningeal arteries, arterioles, and capillaries. This condition progressively weakens the vascular integrity, thereby increasing the risk of major bleeding events. The lack of randomized clinical trials necessitates a multiparametric and multidisciplinary approach to assess the extent of vasculopathy and balance thromboembolic and hemorrhagic risks, aiming to tailor the most effective management strategy for each patient. In managing such cases, it is crucial to address concomitant risk factors and consider both pharmacological and non-pharmacological interventions, such as left atrial appendage occlusion, to mitigate the risk of stroke.

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来源期刊
Giornale italiano di cardiologia
Giornale italiano di cardiologia CARDIAC & CARDIOVASCULAR SYSTEMS-
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