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扩张型心肌病(dilated cardiomyopathy,DCM)患者心腔内血栓发生率及临床血栓栓塞事件发生率均较高。心腔内血栓形成与多种因素有关,如心脏扩大、心内膜面改变、心肌运动减弱、血流淤滞、心律失常、血液高凝状态等。目前针对扩张型心肌病患者加用抗凝剂治疗的专家建议是:左心室射血分数(left ventricular ejection fraction,LVEF)<30%,有栓塞表现的病史,或超声心动图发现附壁血栓形成。心脏扩大患者有报道把阿司匹林或阿司匹林联合水蛭素类药等纳入常规治疗方案,合并房颤(atrial fibrillation,AF)则加用华法林或新型口服抗凝药(novel oral anticoagulants,NOACs)治疗,本文仅对扩张型心肌病患者栓塞风险流行病学、发生机制和防治进行综述。
The incidence of intracardiac thrombosis and clinical thromboembolism in patients with dilated cardiomyopathy (DCM) were higher. Cardiac thrombosis and a variety of factors, such as heart enlargement, endocardial surface changes, myocardial weakness, blood stasis, arrhythmia, blood hypercoagulability state. Current expert recommendations for anticoagulant therapy in patients with dilated cardiomyopathy are: Left ventricular ejection fraction (LVEF) <30%, history of embolization, or echocardiographic findings of mural thrombosis . Patients with enlarged heart have been reported to incorporate aspirin or aspirin with hirudin in routine regimens. Atrial fibrillation (AF) with warfarin or novel oral anticoagulants (NOACs) This article reviews only the risk of embolism in patients with dilated cardiomyopathy Epidemiology, pathogenesis and prevention.