Kana munhu aine chirwere, kurapa kwakanakisisa (zvose kurapa kwakanyanya, uye kurapwa kunodzivirira imwe shamhu) kunobva pane izvo zvakabudisa chirwere . Saka zvakakosha zvakanyanya kuti vanachiremba vadzike pasi chinokonzera chikonzero chekurohwa kupi zvako.
Zvinosuruvarisa, kusvika ku40 kubva muzana veAmerica vane chirwere chinopera nekugadzirwa kwekristptogenic stroke , izvo zvinoreva kuti kunyange mushure mekuongorora kwehutano zvakakwana chikonzero chekurohwa kwavo hachizivikanwi.
Pasina kuziva chinokonzera, kurapa kwakanaka kwekurohwa kwavo kunogona kungoenderana nekufungidzira.
Kwemakore akawanda vatsvakurudzi vanga vachiedza kunzwisisa kuti zvipi zvirwere zvingangodaro zvinokonzera kushungurudza pasina kusiya chikamu chakajeka, izvo, izvo zvirwere zvingangodaro zvinowanzobudisa cryptogenic strokes. Zvitadzo zviviri izvi zvakanyanya kutarisa ndezvepentent foramen ovale (PFO) uye inrill fibrillation . Kusarudza kana PFO inogona kunge yakakonzera sitiroko ye cryptogenic yakaratidza kuoma uye kukakavara.
Pasina kukakavara ndeyengozi inowanikwa neutrial fibrillation. Stroke, kushungurudzika kunotyisa kwehutachiona hwehutachiona, kunowanzoitika kune varwere vane chirongwa ichi. Uye ikozvino inowanikwa kuti friggrious atrial inogona kuva chikonzero chinowanzovhiringidzika chekurova kwekristptogenic kupfuura kwataimboziva.
Atrial Fibrillation & Cryptogenic Stroke
Kunyange zvazvo inowanzokonzera zviratidzo zvinokosha (zvakadai se palpitations uye kuchena kwepamusoro), zvikamu zvehutachiona hwehutachiona hunogonawo kuitika pasina kubudisa zviratidzo chero chipi zvacho. Mune zviitiko izvi, kunyange murwere kana chiremba angave ane pfungwa yokuti hutachiona hwehutachiona huri kuitika. Ikozvino yava kuwedzera kujekesa kuti zvikamu zvakadaro zve "subclinical" (izvo zvinoreva, zvisingazivikanwi) friction fibrillation ndiyo chikonzero chakakosha cheprisptogenic stroke.
Iyo CRYSTAL-AF yekudzidza, iyo yakaedza kuyera kuti kazhinji sei subclinical atrial fibrillation inogona kunge yakakonzera kushungurudzika kwechemptogenic, yakatarisa 414 vanhu vakange vamboita cryptogenic kurohwa. Vatsvakurudzi vakaisa mutsara, mutsara wechiratidzo chemwoyo-iyo Reveal device (Medtronic, Inc.) - mavari anogona kutarisa mwoyo wemunhu kusvika makore matatu.
Pakupera kwekudzidza, makumi matatu kubva muzana yevarwere vakagadzirirwa kuongorora mwoyo vakave nezvikamu zvepakutanga zvisingazivikanwi neatrial fibrillation. Kusiyana neizvi, muboka rinodzora re 220 varwere vane chirwere checryptogenic chakarongedzwa pasina yakadaro yenguva refu yekucherechedza mwoyo, zvikamu zvehutachiona hwehutachiona zvakaonekwa mune zvisingasviki maviri kubva muzana.
Izvi zvinoratidzira zvinhu zviviri zvitsva nezvehutano hwefridhi uye cryptogenic stroke. Kutanga, maitiro epamusoro ekunyanyisa kweperiyuta inogona kunge ari kukonzerwa nematambudziko akawanda echirwere che cryptogenic kupfuura zvataimboziva. Uye chechipiri, kutarisa kwepfungwa kwenguva refu kunogona kudikanwa kuziva varwere vane dambudziko iri. (Avhareji nguva iyo yakagadziriswa yakagadziriswa yakanga iri panzvimbo ino muchidzidzo mushure mekunyora kwepayirini yakawanikwa yaive mazuva makumi matanhatu.)
Ichi chidzidzo hachiratidzi kuti zvirwere zvepriydriyo zvinokonzera kushungurudzika kwekristptogenic kune avo vose varwere, uye hazviratidzi kuti kushandiswa kwema-anti-clotting drugs kunogona kuvandudza zvigumisiro zvavo.
Nenguva refu-randomized mugumisiro miedzo ichave yakakosha kujekesa zvinhu izvi. Asi isu tinoziva kuti vanhu vane chirwere chekristptogenic vane ngozi yakawanda yekupora, zvakare kuti hutachiona hwepriyuta hunowedzera hutachiwana hwekurohwa, uye kuti kurapwa kwemaawa anochera kunoderedza ngozi yekurohwa muhutayirini. Nezvizivo izvi mupfungwa, 97 muzana yevarwere vari muRCYSTAL-AF yekuongorora avo vakaonekwa seine subclinical atrial fibrillation vakaiswa pamishonga inorambidza-clotting navanachiremba.
Nguva Yakareba Mwoyo Kuongorora
Kubva pane zvatinoziva nhasi, kugara kwenguva refu kwekutsvaga kwemoyo kunofanirwa kuve kwakanyanya kufungidzirwa kune varwere vane chirwere che cryptogenic, kunyanya dai vanachiremba vavo vaizochinja mazano avo ekurapa zvichienderana nemigumisiro yekutarisa kwakadaro.
Nguva yakareba yenguva yekucherechedza kwemoyo inogona kuitika muitiro wenguva dzose yekliniki. Vachapfeka maziso emwoyo vanogona kushandiswa kwemazuva makumi matatu, nguva yekutarisa iyo yakaratidzwa kuti ione huwandu hwevarwere vane subclinical atrial fibrillation. Uye kwenguva yakareba inogadziriswa mwoyo yevatariri vemwoyo-iyo inoshandiswa muR CRYSTAL-AF yekudzidza pamwe chete ne "maduku" anotevera-anowanikwa mukushandiswa kwepiriniki.
Kana iwe kana munhu waunoda ane chirwere chekrisptogenic, uye kana chiremba wako achizochinja chirwere chako zvichienderana nekuti kana kuti kwete yefriday fibrillation inowanikwa, ipapo iwe unofanira kutaura nachiremba pamusoro pekugona kwekugara kwenguva refu mukati memwoyo.
Sources:
Mhinduro dzeR CRYSTAL-AF Trial. International Stroke Conference (ISC) 2014. Abstract LB11. Yakapiwa February 14, 2014.
Liao J, Khalid Z, Scallan C, et al. Noninvasive moyo wekutsvaga kwekuona kuti paroxysmal atrial fibrillation kana mhepo inopera mushure mekuita ischemic stroke: kurongwa kwehurongwa. Stroke 2007; 38: 2935.
Hylek EM, Go AS, Chang Y, et al. Migumisiro yehutano hwemashoko anonyorwa pamusana pekushaya simba uye kuuraya muhutano hwehutachiona. N Engl J Med 2003; 349: 1019.