١٧
ﭗﭼ ﺰﻴﻠﻫد ﻞﺧاد ﻪﺘﺨﻟ ﺮﺑ ﺮﺛﺆﻣ ﻞﻣاﻮﻋ ﻲﺳرﺮﺑ
ﻪﺘﻓﺮﮔ راﺮﻗ لاﺮﺘﻴﻣ ﻪﭽﻳرد ﻲﺣاﺮﺟ ﻞﻤﻋ ﺖﺤﺗ ﻪﻛ ﻲﻧارﺎﻤﻴﺑ رد ﺪﻧا
.
ﻲﻳازﺮﻴﻣ ﷲا ﺪﺳا ﺮﺘﻛد -1
ﻲﻤﻇﺎﻛ ﻲﺑﻮﻃ ﺮﺘﻛد 2
هﺪﻴﻜﭼ
فﺪﻫ و ﻪﻨﻴﻣز بﻮﺴﺤﻣ ﻪﻌﻣﺎﺟ ﺖﻣﻼﺳ ياﺮﺑ ﻲﻤﻬﻣ ﺮﻄﺧ ﺖﻓﺮﺸﻴﭘ لﺎﺣ رد يﺎﻫرﻮﺸﻛ رد ﺐﻠﻗ ﻲﻤﺴﻴﺗﺎﻣور يرﺎﻤﻴﺑ:
ﻲﻣ دﻮﺷ . د ﻲﮕﻨﺗ رد ﻲﻟﻮﺒﻣآ ﻮﺒﻣوﺮﺗ ﻞﻠﻋ زا ﻲﻜﻳ و ﺐﻠﻗ ﻲﻤﺴﻴﺗﺎﻣور يرﺎﻤﻴﺑ عاﻮﻧا ﻦﻳﺮﺘﻌﻳﺎﺷ زا ﻲﻜﻳ لاﺮﺘﻴﻣ ﻪﭽﻳر
ﻲﻣ ﺎﻣ رﻮﺸﻛ ﺪﺷﺎﺑ
. ﺪﺷ مﺎﺠﻧا لاﺮﺘﻴﻣ ﻪﭽﻳرد يرﺎﻤﻴﺑ ﺎﺑ ﭗﭼ ﺰﻴﻠﻫد ﻪﺘﺨﻟ طﺎﺒﺗرا ﻲﺳرﺮﺑ فﺪﻫ ﺎﺑ ﺮﺿﺎﺣ ﺶﻫوﮋﭘ .
ﻲﺳرﺮﺑ شور درﻮﻣ ﻪﻌﻟﺎﻄﻣ ﻦﻳا :
- ﺖﺤﺗ لﺎﺳ ﺞﻨﭘ ﻲﻃ رد ﻪﻛ ﻲﻧارﺎﻤﻴﺑ ﻲﻣﺎﻤﺗ يور ﺮﺑ يﺪﻫﺎﺷ ﻲﺣاﺮﺟ ﻞﻤﻋ
ﺪﺷ مﺎﺠﻧا ،ﺪﻧدﻮﺑ ﻪﺘﻓﺮﮔ راﺮﻗ لاﺮﺘﻴﻣ ﻪﭽﻳرد .
ﺎﻬﻧآ ﭗﭼ ﺰﻴﻠﻫد ﻞﺧاد رد ،زﺎﺑ ﺐﻠﻗ ﻲﺣاﺮﺟ ﻞﻤﻋ ﻦﻴﺣ رد ﻪﻛ ﻲﻧارﺎﻤﻴﺑ
ﻮﺒﻣوﺮﺗ ﻪﻘﺑﺎﺳ ﺎﻳ و ﺪﺸﻧ هﺪﻫﺎﺸﻣ ﺎﻬﻧآ ﭗﭼ ﺰﻴﻠﻫد رد ﻪﺘﺨﻟ ﻪﻛ ﻲﻧارﺎﻤﻴﺑ و درﻮﻣ هوﺮﮔ ناﻮﻨﻋ ﻪﺑ ،ﺪﺷ هﺪﻫﺎﺸﻣ ﻪﺘﺨﻟ ﺪﺷ بﺎﺨﺘﻧا ﺪﻫﺎﺷ هوﺮﮔ ناﻮﻨﻋ ﻪﺑ ،ﺪﻨﺘﺷاﺪﻧ ﻲﻟﻮﺒﻣآ ﺪﻧ
. و ﻲﻓاﺮﮔﻮﻳدرﺎﻛوﺮﺘﻜﻟا ،يدﺮﻓ تﺎﻋﻼﻃا ،ﻲﻨﻴﻟﺎﺑ تﺎﻨﻳﺎﻌﻣ
ﺪﻧﺪﺷ ﻪﺴﻳﺎﻘﻣ ﻢﻫ ﺎﺑ نارﺎﻤﻴﺑ ﻲﻓاﺮﮔﻮﻳدرﺎﻛﻮﻛا .
ﻊﻤﺟ تﺎﻋﻼﻃا مﺮﻧ زا هدﺎﻔﺘﺳا ﺎﺑ هﺪﺷ يروآ
راﺰﻓا يﺎﻬﻧﻮﻣزآ وSPSS
يرﺎﻣآ
Chi-Square
و ﻲﻨﻌﻣ ﺢﻄﺳ ردt
يراد 05 / 0
P<
ﺪﻨﺘﻓﺮﮔ راﺮﻗ ﻞﻴﻠﺤﺗ و ﻪﻳﺰﺠﺗ درﻮﻣ .
ﻪﺘﻓﺎﻳ ﺎﻫ ﺣ ﻪﻌﻟﺎﻄﻣ رد: ﻪﻄﺑار ﭗﭼ ﺰﻴﻠﻫد سﻮﺒﻣوﺮﺗ و ﺲﻨﺟ ﻦﻴﺑ ﺮﺿﺎ
ﺪﺸﻧ هﺪﻫﺎﺸﻣ يا )
1 / 45 % و نز درﻮﻣ هوﺮﮔ
33 / 47 % نز ﺪﻫﺎﺷ هوﺮﮔ ) (
25 / 0
= .(P
ﻦﺴﻣ ،درﻮﻣ هوﺮﮔ نارﺎﻤﻴﺑ ﺪﻧدﻮﺑ ﺮﺗ
) درﻮﻣ هوﺮﮔ رد ﻲﻨﺳ ﻦﻴﮕﻧﺎﻴﻣ 24
/ 37 لﺎﺳ
ﺪﻫﺎﺷ هوﺮﮔ رد و 25
/ 32 لﺎﺳ ) ( 01 / 0
= (P
يﺰﻴﻠﻫد نﻮﻴﺳﻼﻳﺮﺒﻴﻓ ؛ )
5 / 74 % ،درﻮﻣ هوﺮﮔ رد 63
% ﮔ رد ﺪﻫﺎﺷ هوﺮ (
) 001 / 0
P<
( لاﺮﺘﻴﻣ ﺪﻳﺪﺷ ﻲﮕﻨﺗ ، )
57 / 88 % ،درﻮﻣ هوﺮﮔ رد 49
/ 65 % ﺪﻫﺎﺷ هوﺮﮔ رد ) (
025 / 0
= (P
ﻞﻣاﻮﻋ ناﻮﻨﻋ ﻪﺑ ،
دﻮﺑ ﺮﺘﺸﻴﺑ ﺪﻫﺎﺷ هوﺮﮔ رد لاﺮﺘﻴﻣ ﺪﻳﺪﺷ ﻲﻳﺎﺳرﺎﻧ ﺎﻣا ؛ﺪﻧﺪﺷ هﺪﻫﺎﺸﻣ ﭗﭼ ﺰﻴﻠﻫد سﻮﺒﻣوﺮﺗ ﺎﺑ هاﺮﻤﻫ ﺮﻄﺧ )
93 / 25 % رد
و درﻮﻣ هوﺮﮔ 6
/ 39 % ﺪﻫﺎﺷ هوﺮﮔ رد ) (
05 / 0
= .(P
ﻪﺠﻴﺘﻧ يﺮﻴﮔ ﻲﻣ دﺎﻬﻨﺸﻴﭘ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ ﺞﻳﺎﺘﻧ ﻖﺒﻃ : نﻮﻴﺳﻼﻳﺮﺒﻴﻓ ،لاﺮﺘﻴﻣ ﻪﭽﻳرد ﺪﻳﺪﺷ ﻲﮕﻨﺗ ﻪﻛ ﻲﻧارﺎﻤﻴﺑ دﻮﺷ
ﻲﺘﻧآ ﺎﺑ ﻚﻴﺘﻛﻼﻴﻓوﺮﭘ نﺎﻣرد ﺖﺤﺗ ﺪﻧراد ﻻﺎﺑ ﻦﺳ و يﺰﻴﻠﻫد ﻻﻮﮔاﻮﻛ
ﺎﻬﻧآ رد ﻲﻟﻮﺒﻣآ ﻮﺒﻣوﺮﺗ ﺮﻄﺧ ﺎﺗ ﺪﻧﺮﻴﮔ راﺮﻗ ﺖﻧ
ﺪﺑﺎﻳ ﺶﻫﺎﻛ .
هژاو يﺪﻴﻠﻛ يﺎﻫ ﻴﻓ ؛لاﺮﺘﻴﻣ ﻲﮕﻨﺗ ؛ﭗﭼ ﺰﻴﻠﻫد ﻞﺧاد ﻪﺘﺨﻟ:
يﺰﻴﻠﻫد نﻮﻴﺳﻼﻳﺮﺒ
ﺪﻨﺟﺮﻴﺑ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﻤﻠﻋ ﻪﻠﺠﻣ )
هرود 11 هرﺎﻤﺷ ، 3 لﺎﺳ ، 1383 (
ا ؛قوﺮﻋ و ﺐﻠﻗ ﻲﺣاﺮﺟ ﺺﺼﺨﺗ قﻮﻓ ؛لوﺆﺴﻣ هﺪﻨﺴﻳﻮﻧ1
ﺪﻬﺸﻣ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،ﻲﻜﺷﺰﭘ هﺪﻜﺸﻧاد ،قوﺮﻋ و ﺐﻠﻗ ﻲﺣاﺮﺟ ﻲﺷزﻮﻣآ هوﺮﮔ رﺎﻳدﺎﺘﺳ
سردآ : ﺪﻬﺸﻣ - دﺎﺑآﺪﻤﺣا نﺎﺑﺎﻴﺧ -
ﻢﺋﺎﻗ نﺎﺘﺳرﺎﻤﻴﺑ -
ﺐﻠﻗ ﻲﺣاﺮﺟ هوﺮﮔ
ﻦﻔﻠﺗ : 8543301 - 0511 ﺑﺎﻤﻧ ﺮ : 8816439 - 0511 ﻚﻴﻧوﺮﺘﻜﻟا ﺖﺴﭘ :
د ﻲﺷزﻮﻣآ هوﺮﮔ رﺎﻳدﺎﺘﺳا ؛قوﺮﻋ و ﺐﻠﻗ ﺺﺼﺨﺘﻣ2
ﺪﻨﺟﺮﻴﺑ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،ﻲﻜﺷﺰﭘ هﺪﻜﺸﻧاد ،ﻲﻠﺧا
١٨ ﻪﻣﺪﻘﻣ ﻮﺒﻣوﺮﺗ س ﻪﺘﺨﻟ ﻞﻜﺷ ﻪﺑ ﻪﻛ ﺖﺳا ﻚﻳژﻮﻟﻮﺗﺎﭘ ﺪﻨﻳاﺮﻓ ﻚﻳ
ﻲﺒﻠﻗ ﻢﺘﺴﻴﺳ ﻞﺧاد رد نﻮﺧ -
ﻲﻣ ﺖﻟﺎﺧد ﻲﻗوﺮﻋ ﻪﻧﺎﺸﻧ و ﺪﻨﻛ
ﺖﺳا ﻲﻌﻴﺒﻃ زﺎﺘﺳﻮﻤﻫ رد لﻼﺘﺧا .
زﺎﺘﺳا ،مﻮﻴﻠﺗوﺪﻧآ ﻪﺑ ﻪﻣﺪﺻ
ا ﺶﻳاﺰﻓا و نﻮﺧ ﻪﻛ ﺪﻨﺘﺴﻫ ﻢﻬﻣ ﻞﻣﺎﻋ ﻪﺳ ،نﻮﺧ يﺮﻳﺬﭘدﺎﻘﻌﻧ
ﻮﺒﻣوﺮﺗ ياﺮﺑ ار ﻪﻨﻴﻣز س
ﻲﻣ ﻢﻫاﺮﻓ ﺪﻨﻨﻛ
) 1 .(
ضراﻮﻋ زا يﺰﻐﻣ ﻲﻟﻮﺒﻣآ صﻮﺼﺨﺑ ﻚﻴﻤﺘﺴﻴﺳ ﻲﻟﻮﺒﻣآ ﭗﭼ ﺰﻴﻠﻫد هﮋﻳﻮﺑ ﻲﻗوﺮﻋ ﻲﺒﻠﻗ ﻢﺘﺴﻴﺳ ﻞﺧاد رد ﻪﺘﺨﻟ ﻞﻴﻜﺸﺗ
ﻲﻣ ﺪﺷﺎﺑ ) 2 .(
يرﺎﻤﻴﺑ ﺎﺑ نارﺎﻤﻴﺑ رد ﭗﭼ ﺰﻴﻠﻫد سﻮﺒﻣوﺮﺗ
ﻪﭽﻳرد ﻫد نﻮﻴﺳﻼﻳﺮﺒﻴﻓ ﺎﻳ و ﺐﻠﻗ يﺎﻫ ﻪﭽﻳرد ﺮﻴﻏ يﺰﻴﻠ
يا
ﻲﻣ قﺎﻔﺗا ﺪﺘﻓا
. ﻦﻳﺮﺒﻴﻓ ﺪﻴﻟﻮﺗ و نﻮﺧ زﺎﺘﺳا ًﻻﺎﻤﺘﺣا ﻲﻠﺻا ﺰﻧژﻮﺗﺎﭘ
ﺖﺳا ) 3 .(
ﻒﻠﺘﺨﻣ يﺎﻬﻳرﺎﻤﻴﺑ و ﭗﭼ ﺰﻴﻠﻫد سﻮﺒﻣوﺮﺗ عﻮﻴﺷ
ﻲﺒﻠﻗ - ﺖﺳا ﺚﺤﺑ درﻮﻣ ﻲﻗوﺮﻋ .
رد ﻪﻛ ﺖﺳا هﺪﺷ شراﺰﮔ
،ﺐﻠﻗ ﻲﻤﺴﻴﺗﺎﻣور نارﺎﻤﻴﺑ ﻲﺴﭘﻮﺗا 50
% ﺎﺑ نارﺎﻤﻴﺑ زا
ﺎﺑ ﻪﺴﻳﺎﻘﻣ رد يﺰﻴﻠﻫد نﻮﻴﺳﻼﻳﺮﺒﻴﻓ 15
% ﻢﺘﻳر ﺎﺑ نارﺎﻤﻴﺑ زا
ﻪﺘﺷاد يﺰﻴﻠﻫد سﻮﺒﻣوﺮﺗ ،ﻲﺳﻮﻨﻴﺳ ﺪﻧا
) 4 .(
ﻚﻳدﺰﻧ 15 % ﺰﻴﻠﻫد سﻮﺒﻣوﺮﺗ لاﺮﺘﻴﻣ ﻲﮕﻨﺗ ﺎﺑ نارﺎﻤﻴﺑ زا
ﻲﻣ ﻪﺑﺮﺠﺗ ار نآ ضراﻮﻋ و ﭗﭼ ﺪﻨﻨﻛ
) 5 .(
ﻦﻳا رد ﻲﻟﻮﺒﻣآ ﺮﻄﺧ
ﻦﺳ ﺶﻳاﺰﻓا ﺎﺑ نارﺎﻤﻴﺑ )
7،6 ( نوﺮﺑ ﺎﺑ و سﻮﻜﻌﻣ ﻪﻄﺑار ﻲﺒﻠﻗ هد
دراد ) 8 ( دﻮﺟو ﺎﺑ ﻲﻟﻮﺒﻣآ ﺮﻄﺧ ﻦﻴﻨﭽﻤﻫ ؛ يﺰﻴﻠﻫد نﻮﻴﺳﻼﻳﺮﺒﻴﻓ
ﻲﻣ ﺮﺑاﺮﺑ ﺪﻨﭼ نﺎﻣﺰﻤﻫ (AF) دﻮﺷ
) 9 - 11 ( نز ﺲﻨﺟ ، )
12 (
ﭗﭼ ﺰﻴﻠﻫد هزاﺪﻧا ﺶﻳاﺰﻓا )
13 - 16 ( ﻪﭽﻳرد ﺢﻄﺳ ﺶﻫﺎﻛ ،
لاﺮﺘﻴﻣ ) 17 ( ﻪﺑدﻮﺧ ﺖﺳاﺮﺘﻨﻛ دﻮﺟو ، ﻮﻛا رد يدﻮﺧ
(SEC)
) 8،4،2 ( ﺶﻴﭘ ﻞﻣاﻮﻋ ناﻮﻨﻋ ﻪﺑ ﻲﻨﻴﺑ
ﭗﭼ ﺰﻴﻠﻫد سﻮﺒﻣوﺮﺗ هﺪﻨﻨﻛ
شراﺰﮔ ﻚﻴﻤﺘﺴﻴﺳ ﻲﻟﻮﺒﻣآ ﺮﻄﺧ ﻪﺠﻴﺘﻧ رد و هﺪﺷ
ﺪﻧا .
ياﺮﺑ يﺮﺘﻤﻛ ﺮﻄﺧ لاﺮﺘﻴﻣ ﻲﮕﻨﺗ ﻪﺑ ﺖﺒﺴﻧ لاﺮﺘﻴﻣ ﻲﻳﺎﺳرﺎﻧ دراد ﻚﻴﻤﺘﺴﻴﺳ ﻲﻟﻮﺒﻣآ .
لاﺮﺘﻴﻣ ﻲﻳﺎﺳرﺎﻧ تﺎﻌﻟﺎﻄﻣ زا ﻲﻀﻌﺑ رد
ﺖﻈﻓﺎﺤﻣ ﻞﻣﺎﻋ ﻚﻳ ناﻮﻨﻋ ﻪﺑ سﻮﺒﻣوﺮﺗ ﻞﻴﻜﺸﺗ ﺮﺑاﺮﺑ رد هﺪﻨﻨﻛ
ﺖﺳا هﺪﺷ شراﺰﮔ ﭗﭼ ﺰﻴﻠﻫد )
17،15،14،12 .(
و لاﺮﺘﻴﻣ ﻪﭽﻳرد يﺎﻬﻳرﺎﻤﻴﺑ يﻻﺎﺑ عﻮﻴﺷ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﺨﺑ ﻞﻣاﻮﻋ ﻲﺳرﺮﺑ فﺪﻫ ﺎﺑ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ ،لاﺮﺘﻴﻣ ﻲﮕﻨﺗ صﻮﺼ ﺖﺤﺗ ﻪﻛ ﻲﻧارﺎﻤﻴﺑ رد ﭗﭼ ﺰﻴﻠﻫد سﻮﺒﻣوﺮﺗ ﺎﺑ هاﺮﻤﻫ ازﺮﻄﺧ
ﻪﺘﻓﺮﮔ راﺮﻗ زﺎﺑ ﺐﻠﻗ ﻞﻤﻋ ﻲﺣاﺮﺟ ﻞﻤﻋ ﺪﺷ مﺎﺠﻧا ،ﺪﻧا
.
ﻲﺳرﺮﺑ شور
درﻮﻣ ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد -
يﺎﻬﻟﺎﺳ ﻲﻃ رد ،يﺪﻫﺎﺷ 1377
ﺎﺗ
1381 ﺐﻠﻗ ﻲﺣاﺮﺟ ﺶﺨﺑ رد ﻪﻛ ﻲﻧارﺎﻤﻴﺑ ﻲﻣﺎﻤﺗ ، ,
ﺎﺘﺳرﺎﻤﻴﺑ ن
ﻢﺋﺎﻗ ﺘﺴﺑاو ﻪ ﺪﻬﺸﻣ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻪﺑ ﻞﻤﻋ ﺖﺤﺗ ،
راﺮﻗ ﻪﻌﻟﺎﻄﻣ درﻮﻣ ،ﺪﻧدﻮﺑ ﻪﺘﻓﺮﮔ راﺮﻗ لاﺮﺘﻴﻣ ﻪﭽﻳرد ﻲﺣاﺮﺟ ﺪﻨﺘﻓﺮﮔ . ﺪﻧﺪﺷ ﻪﻨﻳﺎﻌﻣ ﻲﻨﻴﻟﺎﺑ ﺮﻈﻧ زا نارﺎﻤﻴﺑ .
ﻲﻓاﺮﮔﻮﻳدرﺎﻛﻮﻛا
مﺎﺠﻧا ﻦﻴﻐﻟﺎﺑ بوﺮﭘ ﺎﺑ و قوﺮﻋ و ﺐﻠﻗ ﺺﺼﺨﺘﻣ ﻚﻳ ﻂﺳﻮﺗ ﺪﺷ . يﻮﻛا ﻂﺳﻮﺗ لاﺮﺘﻴﻣ ﻪﭽﻳرد M-Mode
ﻌﺑ ود يﻮﻛا و يﺪ
ﺢﻄﺳ و ﺖﻓﺮﮔ راﺮﻗ ﻲﺳرﺮﺑ درﻮﻣ رد لاﺮﺘﻴﻣ ﻪﭽﻳرد
View Apical-Four Chamber ,
ﺮﻠﭘاد يﻮﻠﻓ زا هدﺎﻔﺘﺳا ﺎﺑ
هزاﺪﻧا مواﺪﻣ ﺪﺷ ﻢﻴﺴﻘﺗ هوﺮﮔ ﻪﺳ ﻪﺑ و يﺮﻴﮔ
. ﻪﭽﻳرد ﺢﻄﺳ
زا ﺶﻴﺑ لاﺮﺘﻴﻣ cm2
2 ﻦﻴﺑ لاﺮﺘﻴﻣ ﻪﭽﻳرد ﺢﻄﺳ ،ﻒﻴﻔﺧ ﻲﮕﻨﺗ
cm2
2 - 1 ﺎﻳ ﺮﺘﻤﻛ لاﺮﺘﻴﻣ ﻪﭽﻳرد ﺢﻄﺳ و ﻂﺳﻮﺘﻣ ﻲﮕﻨﺗ
يوﺎﺴﻣ cm2
1 ﺪﺷ ﻪﺘﻓﺮﮔ ﺮﻈﻧ رد ﺪﻳﺪﺷ ﻲﮕﻨﺗ .
لاﺮﺘﻴﻣ ﻲﻳﺎﺳرﺎﻧ
هوﺮﮔ ﻪﺳ ﻪﺑ ﻲﮕﻧر ﺮﻠﭘاد يﻮﻠﻓ سﺎﺳا ﺮﺑ ترﻮﺋآ ﻲﻳﺎﺳرﺎﻧ و ﻒﻴﻔﺧ , ﺪﺷ ﻢﻴﺴﻘﺗ ﺪﻳﺪﺷ و ﻂﺳﻮﺘﻣ )
18 .(
و ﺐﻠﻗ ﺺﺼﺨﺘﻣ ﻂﺳﻮﺗ ﺰﻴﻧ نارﺎﻤﻴﺑ ﻲﻓاﺮﮔﻮﻳدرﺎﻛوﺮﺘﻜﻟا ﻞﺧاد ﻞﻤﻋ ﻦﻴﺣ رد ﻪﻛ ﻲﻧارﺎﻤﻴﺑ ﺲﭙﺳ ؛ﺪﺷ ﺮﻴﺴﻔﺗ قوﺮﻋ
ﺪﺷ هﺪﻫﺎﺸﻣ ﻪﺘﺨﻟ ﺎﻬﻧآ ﭗﭼ ﺰﻴﻠﻫد )
51 ﺑ رﺎﻤﻴ ( هوﺮﮔ ناﻮﻨﻋ ﻪﺑ
ﭗﭼ ﺰﻴﻠﻫد ﻞﺧاد رد ﻪﺘﺨﻟ ،ﻞﻤﻋ ﻦﻴﺣ رد ﻪﻛ ﻲﻧارﺎﻤﻴﺑ و درﻮﻣ ﺪﻨﺘﺷاﺪﻧ ﻲﻟﻮﺒﻣآﻮﺒﻣوﺮﺗ ﻪﻘﺑﺎﺳ ﺎﻳ و ﺪﺸﻧ هﺪﻫﺎﺸﻣ ﺎﻬﻧآ )
153 ﺮﻔﻧ (
ﺪﻧﺪﺷ بﺎﺨﺘﻧا ﺪﻫﺎﺷ هوﺮﮔ ناﻮﻨﻋ ﻪﺑ .
ﻪﻣﺎﻨﺸﺳﺮﭘ يﺎﻬﻳرﺎﻤﻴﺑ ﻪﻘﺑﺎﺳ ،يدﺮﻓ تﺎﻋﻼﻃا ﻞﻣﺎﺷ يا
ﻲﺒﻠﻗ , وراد فﺮﺼﻣ ,
ﻓاﺮﮔﻮﻳدرﺎﻛوﺮﺘﻜﻟا ﺮﻴﺴﻔﺗ ﻪﺠﻴﺘﻧ و ﻲ
ﺎﺑ يﺪﻨﺑﺪﻛ زا ﺲﭘ تﺎﻋﻼﻃا و ﺪﺷ ﻞﻴﻤﻜﺗ ﻲﻓاﺮﮔﻮﻳدرﺎﻛﻮﻛا راﺰﻓا مﺮﻧ زا هدﺎﻔﺘﺳا يرﺎﻣآ يﺎﻬﻧﻮﻣزآ وSPSS
Chi-Square
و ﻲﻨﻌﻣ ﺢﻄﺳ ﺎﺑ t يراد
05 / 0 P<
راﺮﻗ ﻞﻴﻠﺤﺗ و ﻪﻳﺰﺠﺗ درﻮﻣ
ﺪﻨﺘﻓﺮﮔ .
١٩
ﻪﺘﻓﺎﻳ ﺎﻫ
زا 51
،درﻮﻣ هوﺮﮔ رﺎﻤﻴﺑ 28
ﺮﻔﻧ ) 9 / 54 (%
و دﺮﻣ 23 ﺮﻔﻧ
) 1 / 45 (%
ﺪﻧدﻮﺑ نز .
ﺎﺷ هوﺮﮔ رد زا ﺪﻫ
153 رﺎﻤﻴﺑ 81 ﺮﻔﻧ
) 67 / 52 (%
و دﺮﻣ 72 ﺮﻔﻧ ) 33 / 47 (%
ﺪﻧدﻮﺑ نز .
ﺲﻨﺟ ﺮﻈﻧ زا
ﻲﻨﻌﻣ فﻼﺘﺧا هوﺮﮔ ود ﻦﻴﺑ ﺪﺸﻧ هﺪﻫﺎﺸﻣ يراد
) 25 / 0
= ،P
1
= ،df 9 / 0 χ2= .(
يﺎﻬﻟوﺪﺟ رد 1
و 2 ﻪﺘﻓﺎﻳ ، نارﺎﻤﻴﺑ ﻲﻓاﺮﮔﻮﻳدرﺎﻛﻮﻛا يﺎﻫ
ﺖﺳا هﺪﺷ ﻪﺴﻳﺎﻘﻣ .
ترﻮﺋآ ﻲﻳﺎﺳرﺎﻧ و
رد يﻮﻳر نﻮﻴﺴﻧﺎﺗﺮﭙﻴﻫ
ﺸﻴﺑ ﺪﻫﺎﺷ هوﺮﮔ دﻮﺑ ﺮﺘ
. و درﻮﻣ هوﺮﮔ رد ﺪﻳﺪﺷ لاﺮﺘﻴﻣ ﻲﮕﻨﺗ
دﻮﺑ ﺮﺘﻌﻳﺎﺷ ﺪﻫﺎﺷ هوﺮﮔ رد ﺪﻳﺪﺷ لاﺮﺘﻴﻣ ﻲﻳﺎﺳرﺎﻧ .
درﻮﻣ هوﺮﮔ رد ﻲﻨﺳ ﻦﻴﮕﻧﺎﻴﻣ 76
/
±9 24 / 37 رد و لﺎﺳ
ﺪﻫﺎﺷ هوﺮﮔ 6
/
±10 25 / 32 دﻮﺑ لﺎﺳ )
01 / 0
= .(P هوﺮﮔ نارﺎﻤﻴﺑ
ﻦﺴﻣ درﻮﻣ ﺪﻧدﻮﺑ ﺮﺗ
. يرﺎﺸﻓﺮﭘ ﻪﻘﺑﺎﺳ ،ﻲﻧﺪﺑ هدﻮﺗ ﺺﺧﺎﺷ ﺮﻈﻧ زا
ﻟا فﺮﺼﻣ ﻪﻘﺑﺎﺳ ،نﻮﺧ ،ﻲﻣﺪﻴﭙﻴﻟﺮﭙﻴﻫ ﻪﻘﺑﺎﺳ ،رﺎﮕﻴﺳ و ﻞﻜ
ﻲﻨﻌﻣ فﻼﺘﺧا هوﺮﮔ ود ﻦﻴﺑ ﺪﺒﻛ و يﻮﻴﻠﻛ يﺎﻬﻳرﺎﻤﻴﺑ يراد
ﺪﺸﻧ هﺪﻫﺎﺸﻣ .
ﻲﻓاﺮﮔﻮﻳدرﺎﻛوﺮﺘﻜﻟا رد (ECG)
دﻮﺟو
يﺰﻴﻠﻫد نﻮﻴﺳﻼﻳﺮﺒﻴﻓ ﺖﻓﺮﮔ راﺮﻗ ﻲﺳرﺮﺑ درﻮﻣ(AF)
. هوﺮﮔ رد
درﻮﻣ 5 / 74 ) % 38 ﺮﻔﻧ ( ﺪﻫﺎﺷ هوﺮﮔ رد و 63
) % 96 ﺮﻔﻧ ( رد
ﻢﺘﻳر ،ECG ﺪﻨﺘﺷادAF
) 001 / 0 P<
.(
ﻪﺠﻴﺘﻧ و ﺚﺤﺑ يﺮﻴﮔ
ﺪﻨﺘﺷاد ﭗﭼ ﺰﻴﻠﻫد ﻞﺧاد ﻪﺘﺨﻟ ﻪﻛ ﻲﻧارﺎﻤﻴﺑ ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد ﺖﻴﻌﺿو ﺮﻈﻧ زا ،ﺪﻨﺘﺷاﺪﻧ ﭗﭼ ﺰﻴﻠﻫد ﻞﺧاد ﻪﺘﺨﻟ ﻪﻛ ﻲﻧﺎﺴﻛ و
ﺪﻨﺘﻓﺮﮔ راﺮﻗ ﻪﺴﻳﺎﻘﻣ درﻮﻣ ﻲﻓاﺮﮔﻮﻳدرﺎﻛوﺮﺘﻜﻟا تاﺮﻴﻴﻐﺗ و ﻲﻨﻴﻟﺎﺑ .
ﻲﻨﻌﻣ فﻼﺘﺧا ﺲﻨﺟ ﺮﻈﻧ زا ﻖﻴﻘﺤﺗ ﻦﻳا رد ود ﻦﻴﺑ يراد
ﺟو ﺪﻫﺎﺷ و درﻮﻣ هوﺮﮔ ﺖﺷاﺪﻧ دﻮ
. ﺰﻴﻧ ﺮﮕﻳد تﺎﻌﻟﺎﻄﻣ ﺮﺘﺸﻴﺑ رد
ﺖﺳا هﺪﺸﻧ هرﺎﺷا ﺮﻄﺧ ﻞﻣﺎﻋ ناﻮﻨﻋ ﻪﺑ ،ﺲﻨﺟ ﺮﻴﻐﺘﻣ ﻪﺑ
) 7 - 11 ( ﺎﻣا Darison و
Geenland ﻪﻓﺮﻃ ﻚﻳ ﺰﻴﻟﺎﻧآ رد
يا
ﺎﻣا ؛ﺪﻧدﺮﻛ حﺮﻄﻣ ﻞﻣﺎﻋ ﻚﻳ ناﻮﻨﻋ ﻪﺑ ار ﺲﻨﺟ ،ﺪﻧداد مﺎﺠﻧا ﻪﻛ ﺪﻳﺪﺷ ﻲﮕﻨﺗ ﻞﻣﺎﻋ ود ﻂﻘﻓ ﻚﻴﺘﺴﺟﻮﻟ نﻮﻴﺳﺮﮔر ﺰﻴﻟﺎﻧآ رد ﻢﺘﻳر و لاﺮﺘﻴﻣ ﻪﺘﺨﻟ ياﺮﺑ ﻞﻘﺘﺴﻣ ﺮﻄﺧ ﻞﻣاﻮﻋ ناﻮﻨﻋ ﻪﺑ AF
ﺪﻧﺪﺷ حﺮﻄﻣ ﺰﻴﻠﻫد ﻞﺧاد )
12 .(
ﭗﭼ ﺰﻴﻠﻫد ﻞﺧاد رد ﻪﺘﺨﻟ ﻪﻛ يداﺮﻓا ،ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ رد ﺪﻨﺘﺷاد ) درﻮﻣ هوﺮﮔ (
ﻦﺴﻣ ، ﺪﻧدﻮﺑ ﺮﺗ . تﺎﻌﻟﺎﻄﻣ رد Goswami
و
يور ﺮﺑ نارﺎﻜﻤﻫ 200
ﻪﺑ ﻻﺎﺑ ﻦﺳ ،لاﺮﺘﻴﻣ ﻲﮕﻨﺗ ﺎﺑ رﺎﻤﻴﺑ
ﻴﻠﻫد ﻞﺧاد ﻪﺘﺨﻟ دﺎﺠﻳا رد يﺮﻄﺧ ﻞﻣﺎﻋ ناﻮﻨﻋ ﺪﺷ حﺮﻄﻣ يﺰ
) 10،6 .(
ﺎﺑ لاﺮﺘﻴﻣ ﻪﭽﻳرد ﻲﮕﻨﺗ تﺪﺷ ﻪﻛ ﻪﺘﻜﻧ ﻦﻳا ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﻲﻣ ﺮﺘﺸﻴﺑ نﺎﻣز ﺖﺷﺬﮔ ﻪﺘﺨﻟ ﺮﻄﺧ ،ﺖﺒﺴﻧ نﺎﻤﻫ ﻪﺑ و دﻮﺷ
ﻲﻣ ﺶﻳاﺰﻓا يﺰﻴﻠﻫد ﻞﺧاد ﺘﻧا ،ﺪﺑﺎﻳ
ﻈ ﻲﻣ رﺎ رد ﻪﻛ يداﺮﻓا دور
ﻦﺴﻣ ،ﺪﻧراد ﻪﺘﺨﻟ ،دﻮﺧ ﭗﭼ ﺰﻴﻠﻫد ﻞﺧاد ﺪﻨﺷﺎﺑ ﺮﺗ
.
ﻧارﺎﻤﻴﺑ ﻲﻓاﺮﮔﻮﻳدرﺎﻛوﺮﺘﻜﻟا ،ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد ﻦﻴﺣ رد ﻪﻛ ﻲ
ﺎﺑ ،ﺪﺷ هﺪﻫﺎﺸﻣ ﻪﺘﺨﻟ ،ﺎﻬﻧآ ﭗﭼ ﺰﻴﻠﻫد ﻞﺧاد رد ﻲﺣاﺮﺟ ﻞﻤﻋ ﻪﺘﻓﺎﻳ ﺎﻬﻨﺗ ؛ﺪﺷ ﻪﺴﻳﺎﻘﻣ ﺪﻫﺎﺷ هوﺮﮔ ﺎﺑ نارﺎﻤﻴﺑ رد ﻪﻛ يا
ﻢﺘﻳر ،ﺪﺷ هﺪﻫﺎﺸﻣ سﻮﺒﻣوﺮﺗ دﻮﺑ AF
. ﻪﻌﻟﺎﻄﻣ رد Acarturk
ﻪﻛ نارﺎﻜﻤﻫ و 168
ﻲﻟﻮﺒﻣآ ﺮﻈﻧ زا ار لاﺮﺘﻴﻣ ﻲﮕﻨﺗ ﺎﺑ رﺎﻤﻴﺑ
رد ،ﺪﻧدﺮﻛ ﻲﺳرﺮﺑ ﻚﻴﻤﺘﺴﻴﺳ 8
/ 45 % اﺮﻓا ﭗﭼ ﺰﻴﻠﻫد رد ﻪﻛ يد
ﻢﺘﻳر ،ﺪﻨﺘﺷاد ﻪﺘﺨﻟ ،دﻮﺧ و ﺪﺷ هﺪﻫﺎﺸﻣ AF
ناﻮﻨﻋ ﻪﺑ AF
ﺰﻴﻠﻫد ﻞﺧاد ﻪﺘﺨﻟ ﻞﻴﻜﺸﺗ ياﺮﺑ ﻞﻘﺘﺴﻣ و ﻢﻬﻣ يﺮﻄﺧ ﻞﻣﺎﻋ ﺪﺷ شراﺰﮔ ﭗﭼ )
3 .(
لوﺪﺟ 1 - ﻪﺘﻓﺎﻳ ﻪﺴﻳﺎﻘﻣ ﻪﻌﻟﺎﻄﻣ درﻮﻣ هوﺮﮔ ود رد ﻲﻓاﺮﮔﻮﻳدرﺎﻛﻮﻛا يﺎﻫ
ﻪﺘﻓﺎﻳ
ﻲﻓاﺮﮔﻮﻳدرﺎﻛﻮﻛا يﺎﻫ
هوﺮﮔ ﻲﻳﺎﺳرﺎﻧ
ﺋآ ترﻮ ﻲﻳﺎﺳرﺎﻧ
ﺪﻴﭙﺳﻮﻜﻳﺮﺗ نﻮﻴﺴﻧﺎﺗﺮﭙﻴﻫ
يﻮﻳر نﻮﻴﺳﺎﻜﻴﻔﻴﺴﻠﻛ
لاﺮﺘﻴﻣ ﻪﭽﻳرد
درﻮﻣ 22
) 14 / 43 (%
20 ) 39.22 (%
18 ) 29 / 35 (%
30 ) 37 / 59 (%
ﺪﻫﺎﺷ 117
) 51 / 76 (%
78 ) 41 / 51 (%
77 ) 30 / 51 (%
95 ) 53 / 62 (%
ﻲﻨﻌﻣ ﺢﻄﺳ يراد
001*
/ 0 4 <
/ 0 09
/ 0 5
/ 0
ﻲﻨﻌﻣ يرﺎﻣآ ﺮﻈﻧ زا*
ﺖﺳا راد .
٢٠
لوﺪﺟ 2 - ﻳﺎﻘﻣ ﻪﻌﻟﺎﻄﻣ درﻮﻣ هوﺮﮔ ود رد لاﺮﺘﻴﻣ ﻲﻳﺎﺳرﺎﻧ و لاﺮﺘﻴﻣ ﻲﮕﻨﺗ تﺪﺷ ﻪﺴ
يرﺎﻤﻴﺑ تﺪﺷ
هوﺮﮔ لاﺮﺘﻴﻣ ﻲﮕﻨﺗ
لاﺮﺘﻴﻣ ﻲﻳﺎﺳرﺎﻧ
ﺧ ﻒﻴﻔ ﻂﺳﻮﺘﻣ
ﺪﻳﺪﺷ ﺧ
ﻒﻴﻔ ﻂﺳﻮﺘﻣ
ﺪﻳﺪﺷ
درﻮﻣ 0
5 ) 43 / 11 (%
46 ) 57 / 88 (%
20 ) 74 / 40 (%
17 ) 33 / 33 (%
14 ) 93 / 25 (%
ﺪﻫﺎﺷ 21
) 16 / 14 (%
31 ) 35 / 20 (%
101 ) 49 / 65 (%
39 ) 74 / 25 (%
53 ) 66 / 34 (%
61 ) 6 / 39 (%
ﻲﻨﻌﻣ ﺢﻄﺳ يراد
025*
/ 0 05*
/ 0
ﻲﻨﻌﻣ يرﺎﻣآ ﺮﻈﻧ زا*
ﺖﺳا راد .
ﻢﺘﻳر ﺰﻴﻧ ﺮﮕﻳد تﺎﻌﻟﺎﻄﻣ ﺐﻠﻏا ﺮﻄﺧ ﻞﻣﺎﻋ ناﻮﻨﻋ ﻪﺑ ارAF
هدﺮﻛ شراﺰﮔ ﭗﭼ ﺰﻴﻠﻫد سﻮﺒﻣوﺮﺗ ﺪﻧا
) 6،4 ، 9 - 11 .(
ﻪﺟﻮﺗ ﺎﺑ
رﻮﻀﺣ رد يﺰﻴﻠﻫد ضﺎﺒﻘﻧا ﻦﺘﻓر ﻦﻴﺑ زا ﻪﺑ رد نﻮﺧ زﺎﺘﺳا ،AF
ﺧاد ﻲﻣ نآ ﻞﺧاد رد ﻪﺘﺨﻟ ﻞﻴﻜﺸﺗ ﺚﻋﺎﺑ ﭗﭼ ﺰﻴﻠﻫد ﻞ و دﻮﺷ
ﻪﺑ ؛دﻮﺑ ﺪﻫاﻮﺧ ﺮﺘﺸﻴﺑ نارﺎﻤﻴﺑ ﻦﻳا رد ﻚﻴﻟﻮﺒﻣآ ثداﻮﺣ ﺮﻄﺧ ﻢﺘﻳر ﻪﻛ ﻲﻧارﺎﻤﻴﺑ رد ﺖﻠﻋ ﻦﻴﻤﻫ ﻪﺑ ﻪﺟﻮﺗ نوﺪﺑ ،ﺪﻧراد AF
ﻪﭽﻳرد يرﺎﻤﻴﺑ ناﻮﻨﻋ ﻪﺑ ﻲﻛارﻮﺧ دﺎﻘﻌﻧا ﺪﺿ ﺰﻳﻮﺠﺗ ،هاﺮﻤﻫ يا
رﺎﻤﻴﺑ ﻢﺘﻳر ﻪﻛ ﻲﻧﺎﻣز ﺎﺗ ﻚﻴﻟﻮﺒﻣآ ثداﻮﺣ زا يﺮﻴﮕﺸﻴﭘ سﻮﻨﻴﺳ
ﻲﻣ ﻪﻴﺻﻮﺗ ،ﺖﺳا هﺪﺸﻧ دﻮﺷ
) 9،5 .(
رد لاﺮﺘﻴﻣ ﻲﮕﻨﺗ تﺪﺷ ،ﻲﻓاﺮﮔﻮﻳدرﺎﻛﻮﻛا رد ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد دﻮﺑ ﺮﺘﺸﻴﺑ ،ﺪﻨﺘﺷاد يﺰﻴﻠﻫد ﻞﺧاد ﻪﺘﺨﻟ ﻪﻛ ﻲﻧارﺎﻤﻴﺑ .
ﻪﻌﻟﺎﻄﻣ رد
Sanada يور نارﺎﻜﻤﻫ و
142 ،لاﺮﺘﻴﻣ ﻪﭽﻳرد ﻲﮕﻨﺗ ﺎﺑ رﺎﻤﻴﺑ
ﻪﻄﺑار لاﺮﺘﻴﻣ ﻲﮕﻨﺗ تﺪﺷ ﺎﺑ ﭗﭼ ﺰﻴﻠﻫد ﻞﺧاد ﻪﺘﺨﻟ عﻮﻴﺷ ﻢﻴﻘﺘﺴﻣ ﺖﺷاد ) 17 .(
هدﺮﻛ شراﺰﮔ ار ﻪﺑﺎﺸﻣ ﺞﻳﺎﺘﻧ يﺮﮕﻳد دﺪﻌﺘﻣ تﺎﻌﻟﺎﻄﻣ ﺪﻧا
) 16،13،3 .(
ﺎﺑ ،ﺪﻧراد لاﺮﺘﻴﻣ ﻪﭽﻳرد ﻲﮕﻨﺗ ﻪﻛ ﻲﻧارﺎﻤﻴﺑ رد
ﺶﻳاﺰﻓا ﭗﭼ ﺰﻴﻠﻫد ﻞﺧاد رﺎﺸﻓ ،لاﺮﺘﻴﻣ ﻲﮕﻨﺗ تﺪﺷ ﺶﻳاﺰﻓا ﻢﺘﻳر لﺎﻤﺘﺣا ،هﺪﺷ ﺮﺘﮔرﺰﺑ ﭗﭼ ﺰﻴﻠﻫد ،ﻪﺘﻓﺎﻳ ﻦﻳا رد AF
ﺪﻧا ﻦﻳا ﺮﺑ هوﻼﻋ ؛دﻮﺑ ﺪﻫاﻮﺧ ﺮﺘﺸﻴﺑ نارﺎﻤﻴﺑ دﻮﺧ ،ﭗﭼ ﺰﻴﻠﻫد هزا
ﭗﭼ ﺰﻴﻠﻫد ﻞﺧاد رد ﻪﺘﺨﻟ ﻞﻴﻜﺸﺗ ياﺮﺑ ﻞﻘﺘﺴﻣ ﻲﻠﻣﺎﻋ ﻲﻣ ﺪﺷﺎﺑ ) 13 - 16 .(
هوﺮﮔ ود رد لاﺮﺘﻴﻣ ﻲﻳﺎﺳرﺎﻧ تﺪﺷ ،ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ رد
لاﺮﺘﻴﻣ ﺪﻳﺪﺷ ﻲﻳﺎﺳرﺎﻧ و ﺪﺷ ﻪﺴﻳﺎﻘﻣ ﺪﻫﺎﺷ هوﺮﮔ رد (MR)
دﻮﺑ ﺮﺘﺸﻴﺑ .
Kranidis ﻪﻌﻟﺎﻄﻣ ،نارﺎﻜﻤﻫ و
فﺪﻫ ﺎﺑ ار يا
ﻲﺘﻇﺎﻔﺣ ﺮﺛا ﻲﺳرﺮﺑ ﻮﺒﻣوﺮﺗ ﺮﺑMR
س ﺪﻧداد مﺎﺠﻧا ﭗﭼ ﺰﻴﻠﻫد
رد ﭗﭼ ﺰﻴﻠﻫد ﻞﺧاد ﻪﺘﺨﻟ دﺎﺠﻳا لﺎﻤﺘﺣا ﻪﻛ ﺪﻧدﺮﻛ شراﺰﮔ و ﺎﺑ نارﺎﻤﻴﺑ ﻪﻛ ﻲﻃﺮﺷ ﻪﺑ ﻪﺘﺒﻟا ؛دﻮﺑ ﺪﻫاﻮﺧ ﺮﺘﻤﻛ ،ﺮﺗﺪﻳﺪﺷ MR
زا ﭗﭼ ﺰﻴﻠﻫد هزاﺪﻧا 60
ﺪﺷﺎﺑ ﺮﺘﻤﻛ ﺮﺘﻤﻴﻠﻴﻣ )
15 .(
ﺮﻈﻧ ﻪﺑ
ﻲﻣ ﻞﺧاد ﻪﺑ ﻲﺘﺸﮔﺮﺑ نﻮﺧ نﺎﻳﺮﺟ ﻪﻛ ﻦﻳا ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﺪﺳر
نﺎﻳﺮﺟ رد ﭗﭼ ﺰﻴﻠﻫد ﺎﺑ MR
نﻮﺧ زﺎﺘﺳا زا يﺮﻴﮔﻮﻠﺟ ﺚﻋ
ﻲﺘﻇﺎﻔﺣ ﺮﺛا ياﺮﺑ ﻲﻬﻴﺟﻮﺗ ،ﺪﺷ ﺪﻫاﻮﺧ ﺪﺷﺎﺑMR
.
ﻲﻣ دﺎﻬﻨﺸﻴﭘ ،ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ ﺞﻳﺎﺘﻧ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﻲﻧارﺎﻤﻴﺑ ،دﻮﺷ
ﻢﺘﻳر نﺎﻣﺰﻤﻫ و ﺪﻧراد لاﺮﺘﻴﻣ ﺪﻳﺪﺷ ﻲﮕﻨﺗ ﻪﻛ ﭗﭼ ﺰﻴﻠﻫد ،AF
دﺎﻘﻌﻧا ﺪﺿ ﺎﺑ ﻲﻳوراد نﺎﻣرد ﺖﺤﺗ ،ﺪﻧراد ﻻﺎﺑ ﻦﺳ ﺎﻳ و گرﺰﺑ ﺸﺗ ﺮﻄﺧ ﺎﺗ ﺪﻧﺮﻴﮔ راﺮﻗ ﻲﻛارﻮﺧ و يﺰﻴﻠﻫد ﻞﺧاد ﻪﺘﺨﻟ ﻞﻴﻜ
ﺪﺑﺎﻳ ﺶﻫﺎﻛ ﺎﻬﻧآ رد يﺰﻐﻣ ﻲﻟﻮﺒﻣآ ﺺﺧﻻﺎﺑ ﻚﻴﻤﺘﺴﻴﺳ ﻲﻟﻮﺒﻣآ .
ﺮﻜﺸﺗ و ﺮﻳﺪﻘﺗ
ﻲﻣ مزﻻ دﻮﺧﺮﺑ ﻪﻟﺎﻘﻣ ﻦﻳا نﺎﮔﺪﻨﺴﻳﻮﻧ ﺮﺘﻛد ﻢﻧﺎﺧ زا ﺪﻨﻧاد
ﺐﻠﻗ ﻲﺣاﺮﺟ ﺶﺨﺑ مﺮﺘﺤﻣ نﺎﻨﻛرﺎﻛ و يﺮﻛﺎﺷ ﻪﺒﻴﺒﺣ ﺖﻳﺎﻬﻧ ﻖﻴﻘﺤﺗ ﻦﻳا مﺎﺠﻧا رد ﻪﻛ ﺪﻬﺸﻣ ﻢﺋﺎﻗ نﺎﺘﺳرﺎﻤﻴﺑ ﺷاد لوﺬﺒﻣ ار دﻮﺧ يرﺎﻜﻤﻫ ﺪﻨﻳﺎﻤﻧ ﺮﻜﺸﺗ ،ﺪﻨﺘ
.
ﻊﺑﺎﻨﻣ :
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9 ﺎﺿﺮﻣﻼﻏ ﻲﻗدﺎﺻ ،ﺎﺿرﺪﻤﺤﻣ زاﺮﻓا ،ﻦﻳدﺮﻓ كﻮﻠﺑ ﺮﻴﻣ ـ .
ﻚﻴﻤﺘﺴﻴﺳ ﻲﻟﻮﺒﻣآﻮﺒﻣوﺮﺗ و يﺰﻴﻠﻫد نﻮﻴﺳﻼﻳﺮﺒﻴﻓ عﻮﻴﺷ رد هاﺮﻤﻫ ﻞﻣاﻮﻋ ﻲﺳرﺮﺑ )
ﺰﻐﻣ ﻪﺘﻜﺳ ي ( يرﺎﻤﻴﺑ ﻪﺑ ﻼﺘﺒﻣ نارﺎﻤﻴﺑ رد
ﻪﭽﻳرد ﻲﻤﺴﻴﺗﺎﻣور ﺐﻠﻗ يا
. نﻼﻴﮔ ﻲﻜﺷﺰﭘ هﺪﻜﺸﻧاد ﻪﻠﺠﻣ .
1373 . هرﺎﻤﺷ 15 و 14 . ﻪﺤﻔﺻ 11 - 17.
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1-5.
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Predictors of left artrial clot in patients with mitral valve surgery-a case control study
A. Mirzaee*, T. Kazemi**
* Assistant Professor, Department of Cardiac Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
** Assistant Professor, Department of Cardiology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
Abstract
Background and Aim: Rheumatic heart disease (RHD) is a serious health problem in developing countries. Mitral stenosis is one of the most prevalent forms of RHD and one of the causes of systemic thromboembolism in Iran. The present study was conducted to evaluate the relationship between left atrial clot and mitral valve disease.
Materials and Methods: This case-control study was done on all patients who had undergone mitral valve surgery during 5 years in Ghaem hospital. Patients who had left atrial thrombus (LAT) were in the case group and patients with no LAT and no history of thromboembolism in the control group. Personal history, clinical examination, electrocardiography (ECG) and Echocardiography (Echo) were compared in the two groups. Then the data were analyzed using SPSS software and statistical χ2and t test. Thus P<0.05 was taken significant level.
Results: There was no relationship between sex and LAT [females 45.1% in case, 47.33% in control group, P=0.25]. The patients in the case group were older (mean age in the case 37.24 years, in the control group 32.23 years, P=0.01). Atrial fibrillation (AF) (74.5% in the case, 63% in the control group, P<0.001) and severe mitral stenosis (88.57% in the case, 65.49% in the control group, P=0.25) were risk factors for LAT but severe mitral regurgitation was more in the control group (25.93% in the case, 39.6% in the control group, P=0.05).
Conclusion: According to the results of the present study, it is recommended that patients with severe mitral stenosis, AF and at old age take prophylactic anticoagulation so that the risk of thromboembolism would decrease in them.
Key Words: Left atrium clot; Mitral stenosis; Atrial fibrillation
