Stroke Categories Of Non Valvular Atrial Fibrillation And Analyses Of Their Pathogenesis

Objective To probe into the possible pathogenesis and its significance of cerebrovascular disorders of the patients with non-valvular atrial fibrillation (abbreviated to non-VAF) by restropectively analyzing the categories of cerebral infarct and their related pathogenic factors of the non-VAF patients from my hospital.Methods I have screened out the possible etiogenic mechanism of cerbrovascular disorders of the non-VAF patients through investigation into some inpatients and outpatients from my hospital between 2005 and 2007 with auricular fibrillation complicated by cerebrovascular disorders,and by carefully observing and analyzing of the distinctions of the categories of cerebral infarct and their related pathogenesis between stroke patients with valvular auricular fibrillation (abbreviated to VAF) and those with non-VAF.Results Stroke patients with non-VAF and those with VAF fall into different categories. VAF is more likely to occur with aortic embolism, while non-VAF may be accompanied by a wide variety of cerebrovascul-ar disorders,including aortic embolism, cortical branch infarct ,watershed infarct and lacunar infarct and so on ,especially of watershed infarct. Stroke patients with non-VAF and those with VAF share the same hazard factors : heart failure, high fibrinogen; also they have different risk factors: VAF-related cerebrovascular disorders are tightly connected with fast ventricular rhythm, i.e. frequent auricular fibrillation, however, non-VAF-related cerebrovascular disorders are closely connected with hypertension, arteriosclerosis, hyperhipemia and hyperglycemia.Conclusion Non-VAF patients may suffer from a variety of cerebral infarction, whose pathogenesis involves not only cerebral thrombosis caused by scaling-off cardiogenic emboli, but also embolism triggered by some other mechanisms, including hemodynamic changes, atherosclerotic plaque formations or scales-off, hemorheologic changes and so on;while frequently-occurring watershed infarct suggests that hemodynamic changes may be the pathogenesis of cerebral infarct.In the meantime,stroke patients with non-VAF have a higher risk of cocurrently developing hypertention, arteriosclerosis, hyperlipemia, and hyperglycemia. Therefore, preventive measures taken besides specially applying anticoagulants should include good control over ventricular rhythm , blood pressure, and levels of blood sugar and blood fat. The intentional precautions against cerebrovascular disorders can only be fulfilled by imposing integrated controls to improve the state of hemodynamics, to check the hemorheologic factors and to reverse the degree of arteriosclerosis and so on.