Dyspnea in patients with atrial fibrillation: Mechanisms, assessment and an interdisciplinary and integrated care approach

被引：8

作者：

van der Velden, Rachel M. J. ^{[1
,2
]}

Hermans, Astrid N. L. ^{[1
,2
]}

Pluymaekers, Nikki A. H. A. ^{[1
,2
]}

Gawalko, Monika ^{[1
,2
,3
,4
]}

Elliott, Adrian ^{[5
,6
]}

Hendriks, Jeroen M. ^{[5
,6
,7
]}

Franssen, Frits M. E. ^{[8
,9
,10
]}

Slats, Annelies M. ^{[11
]}

van Empel, Vanessa P. M. ^{[1
,2
]}

Van Gelder, Isabelle C. ^{[12
]}

Thijssen, Dick H. J. ^{[13
]}

Eijsvogels, Thijs M. H. ^{[13
]}

Leue, Carsten ^{[14
,15
]}

Crijns, Harry J. G. M. ^{[1
,2
]}

Linz, Dominik ^{[1
,2
,5
,6
,16
,17
]}

Simons, Sami O. ^{[9
,10
]}

机构：

[1] Maastricht Univ, Dept Cardiol, Med Ctr, Maastricht, Netherlands

[2] Cardiovasc Res Inst Maastricht, Maastricht, Netherlands

[3] Univ Duisburg Essen, West German Heart & Vasc Ctr, Inst Pharmacol, Duisburg, Germany

[4] Med Univ Warsaw, Doctoral Sch, Dept Cardiol 1, Warsaw, Poland

[5] Univ Adelaide, Ctr Heart Rhythm Disorders, Adelaide, SA, Australia

[6] Royal Adelaide Hosp, Adelaide, SA, Australia

[7] Flinders Univ S Australia, Coll Nursing & Hlth Sci, Caring Futures Inst, Adelaide, SA, Australia

[8] Ciro, Dept Res & Dev, Horn, Netherlands

[9] Maastricht Univ, NUTRIM Sch Nutr & Translat Res Metab, Maastricht, Netherlands

[10] Maastricht Univ Med Ctr MUMC, Dept Resp Med, Maastricht, Netherlands

[11] Leiden Univ Med Ctr LUMC, Dept Resp Med, Leiden, Netherlands

[12] Univ Groningen, Univ Med Ctr Groningen, Dept Cardiol, Groningen, Netherlands

[13] Radboud Univ Nijmegen, Radboud Inst Hlth Sci, Dept Physiol, Med Ctr, Nijmegen, Netherlands

[14] Maastricht Univ Med Ctr MUMC, Dept Psychiat & Psychol, Maastricht, Netherlands

[15] Maastricht Univ, Sch Mental Hlth & Neurosci MHeNS, Maastricht, Netherlands

[16] Radboud Univ Nijmegen, Dept Cardiol, Med Ctr, Nijmegen, Netherlands

[17] Univ Copenhagen, Fac Hlth & Med Sci, Dept Biomed Sci, Copenhagen, Denmark

来源：

IJC HEART & VASCULATURE | 2022年 / 42卷

关键词：

Atrial fibrillation; Dyspnea; Exercise intolerance; Symptom assessment; Comorbidities; Mechanisms; PRESERVED EJECTION FRACTION; CHRONIC HEART-FAILURE; QUALITY-OF-LIFE; EXERTIONAL DYSPNEA; SYMPTOM; PREVALENCE; PERSISTENT; MANAGEMENT; CAPACITY; CARDIOVERSION;

D O I：

10.1016/j.ijcha.2022.101086

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Atrial fibrillation (AF) is the most common sustained heart rhythm disorder and is often associated with symptoms that can significantly impact quality of life and daily functioning. Palpitations are the cardinal symptom of AF and many AF therapies are targeted towards relieving this symptom. However, up to two-third of patients also complain of dyspnea as a predominant self-reported symptom. In clinical practice it is often challenging to ascertain whether dyspnea represents an AF-related symptom or a symptom of concomitant cardiovascular and non-cardiovascular comorbidities, since common AF comorbidities such as heart failure and chronic obstructive pulmonary disease share similar symptoms. In addition, therapeutic approaches specifically targeting dyspnea have not been well validated. Thus, assessing and treating dyspnea can be difficult. This review describes the latest knowledge on the burden and pathophysiology of dyspnea in AF patients. We discuss the role of heart rhythm control interventions as well as the management of AF risk factors and comorbidities with the goal to achieve maximal relief of dyspnea. Given the different and often complex mechanistic pathways leading to dyspnea, dyspneic AF patients will likely profit from an integrated multidis-ciplinary approach to tackle all factors and mechanisms involved. Therefore, we propose an interdisciplinary and integrated care pathway for the work-up of dyspnea in AF patients.

引用

页数：7

共 50 条

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Benjamin EJ, 2019, CIRCULATION, V139, pE56, DOI [10.1161/CIR.0000000000000659, 10.1161/CIR.0000000000000746]

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