窦性心率振荡现象

如何识别心脏病中的高危患一直是心血管医生关注的热点。起初人们把左室功能、心律失常诱发频度以及心肌传导异常作为评判的基础。近来人们逐渐认识到高危的心脏病患存在自主神经平衡的破坏，以此为基础建立了2个检测指标：心率变异性(heart rate variability，HRV)和压力反射敏感性(baroreflex sensitivity，BRS)。HRV反应的是窦房结对内外源性刺激整体的调节程度，而BRS常用的测量方法是应用苯福林来观察血压与心动周期之间的关系。他们均不能精确地反应内源性刺激所触发的反射性调节。     

心脏淋巴管新生与心脏疾病

淋巴管广泛分布于人体各部,其重要作用是维持组织液体平衡和参与免疫反应。心脏内同样存在丰富的淋巴管,它在心脏疾病中的角色正在不断被认知。本文从心脏淋巴管的结构、病理生理学、检测方法及在心脏疾病中的作用进行综述。     

心脏瓣膜置换术

我院自1980～1981年共做心脏瓣膜置换术8例(男6例,女2例),年龄18～44岁,体重50～67公斤。瓣膜病理改变均属风湿性,二尖瓣狭窄合并关闭不全7例,二尖     

心脏猝死

心脏猝死是指自然发生、出乎意料和突然的死亡。世界卫生组织关于心脏猝死的定义是在起病后6小时以内死亡。我们认为应该是在症状发作后1小时内死亡者。在美国,每年约有70万人死于冠心病,其中65％是猝死。在所有死亡者中,32％是由于心脏病猝死,因此,这一问题比肿瘤更为重要。男女两性的平均寿命是男性70岁,女性76岁,主要是因男性猝死较女性高4倍。如果呼吸道疾病能被控制,则寿命可延长2年;如肿瘤能被控制,则可延长3年,如冠心病可被控制,     

心脏肿瘤

心脏肿瘤相对少见,但为一组重要的心血管异常,心脏肿瘤可为良性,但也有恶性,本文对各种心脏肿瘤综述如下。 1原发性良性肿瘤 1.1粘液瘤:是最常见的心脏肿瘤,约占全部心脏肿瘤的25%,占心脏良性肿瘤的50%,尸检发现率为0.03%。大多数粘液瘤患者为30～60岁,但7～95岁都可发生,欧美女性发生率高,日本以男性为多。发生在左房占92%或3/4,右房占15%～     

心脏震荡

本文就心脏震荡的定义、发病机制、临床特点、鉴别诊断及防治进行综述.     

Cardiac Denervation and Cardiac Function

With respect to neural control of the heart, intrathoracic ganglia and their interconnections form the final common pathway for autonomic modulation of regional cardiac function. In this review, data are presented indicating that such ganglia that include those distributed on the heart contain afferent (sensory) and efferent (motor) neurons that intercommunicate via local circuit neurons. The intrathoracic reflexes involving these neurons function in a coordinated fashion with central neurons located in the spinal cord, brain stem, and supraspinal central neuronal regions to regulate cardiac output on a beat-to-beat basis. The focus of this review is the putative role that these various populations of intrathoracic neurons play in regulating normal cardiac function and, in particular, how their interactions can become altered following their decentralization or in the presence of altered regional cardiac function. It is proposed that a thorough understanding of the interactions that occur among the hierarchy of neurons within intrinsic cardiac and intrathoracic extracardiac ganglia is required in order to assess cardiac regulation in normal as well as diseased states.     

Primary Cardiac Angiosarcoma Accompanying Cardiac Tamponade

A de novo cardiac malignant tumor is rare and sometimes challenging to diagnose. We encountered a 67-year-old man without any medical history complaining of dyspnea on effort. On admission, his hemodynamics were deteriorated due to cardiac tamponade, which was improved by percutaneous drainage of 1,200 mL pericardial effusion, showing 11.0 g/dL of hemoglobin. We suspected primary cardiac malignancy following multidisciplinary tests, and a cardiac biopsy via sternotomy demonstrated the definitive diagnosis of primary malignant tumor (angiosarcoma) infiltrating the right atrial myocardium. We initiated weekly paclitaxel therapy. Further studies are warranted to establish the optimal diagnostic and therapeutic strategy for de novo cardiac malignancy.     

心律失常与心脏再同步化治疗无反应性的相关性

虽然基于肾素-血管紧张素-醛固酮抑制剂、β受体阻滞剂的药物治疗使心力衰竭治疗取得了很大进展,但心力衰竭患者的发病率及病死率仍居高不下.心脏再同步化治疗是近年心力衰竭非药物治疗上的重大进展.但是研究表明心脏再同步化治疗后,仍有约30%的心力衰竭患者对心脏再同步化无反应.现综述了心脏再同步化治疗无反应与心律失常之间的关系,并简要讨论对心脏再同步化治疗无反应的可能机制及预防策略.