科学美国人60秒 SSS 放射可以帮助心脏恢复节奏

Radiation Might Help Heart Regain 1 its Rhythm

That beeping sound is the normal beating of a heart.<> But here's what the same heart sounds like, during a bout 2 of ventricular tachycardia, or VT… the racing 3 beats are caused by an electrical short circuit in the muscle. In a moment, a defibrillator is going to zap the heart, to return it to a slow and steady pace.

“ECG心音”嘀嘀声是心脏的正常跳动声音。但这是同样的心音，在一阵心室跳动过速或VT ...心脏跳动的节奏是由肌肉内的电信号短路连接。 一会儿，一个除颤器就会震击心脏，然后心脏慢慢回到稳定、慢速的跳动节奏。

The root cause of VT? "So the villain 4 inside the heart is almost always a scar from a prior injury." Phillip Cuculich, a cardiac electrophysiologist at Washington University in St. Louis. "Most commonly that's a prior heart attack or leftover 5 scar from an infection that somebody might have, or an inflammatory disease someone might have."

VT的根本原因是什么呢?“心脏的有问题之处，几乎总是先前受伤的伤疤。”华盛顿大学圣路易斯分校心脏电生理学家Phillip Cuculich说，“最常见的是先前的心脏病发作或由于某人可能感染的疤痕，或是某人可能患有的一种炎症性疾病导致的。”

That arrhythmia can be treated with drugs, or surgery, too: by inserting catheters up through the leg into the beating heart, and blasting the troublemaking 6 scar tissue with heat. That kills the scar cells, and can coax 7 the heart back to a normal rhythm.

心律失常可以通过药物或手术来治疗：将导管通过支柱插入跳动的心脏中，并用热量将有问题的疤痕组织喷射出来。这样会杀死疤痕细胞，并且可以让心脏恢复正常节奏。

But now Cuculich and his colleague Clifford Robinson are trying to achieve the heat treatment’s effect noninvasively, by blasting those tiny scarred patches of the heart with high-dose radiation… the kind used to destroy brain and lung tumors.

但现在Cuculich和他的同事Clifford Robinson试图通过用高剂量辐射，来轻除掉那些微小的伤痕累累的心脏，以此来破坏脑部和肺部的肿瘤，从而用非侵入性的方法来达到热疗效果。

"You might say that destroying heart doesn't sound appealing, and it doesn't sound like that's a good thing." But in a limited study of five patients who'd run out of other options, the treatment dramatically cut cases of arrhythmia. Before treatment, they collectively suffered more than 6500 bouts 8 of arrhythmia in just three months.

“你可能会说，摧毁心脏听起来并没有很强的说服力，而且这听起来不是什么好事。但是在对五名患者用完其他方案的有限研究中，这种治疗的确大大减少了心律失常的病例。在治疗之前，他们在短短的三个月内共同经历了超过6500次的心律失常问题。

In the six weeks after treatment – the incidents plummeted 9 to only about 700. And in the following year the group experienced only four arrhythmias, collectively…a 99.9 percent reduction. The method, which Cuculich and Robinson have a patent pending 10 on, is described in The New England Journal of Medicine.

在治疗六周后，数量骤减至只有约700人。而在接下来的一年的时间里，这个小组只经历了四次心律失常，总共减少了99.9%。“Cuculich和Robinson正在申请专利的方法，发表在《新英格兰医学》杂志中。

The treatment has advantages: it's just 15 minutes, compared to 6-8 hours on an operating table. It seems at least as effective as the surgical 11 treatment. And though a typical session of this radiation can cost tens of thousands of dollars, the doctors say that might still be cheaper than surgery and the resulting hospital stay.

这种治疗方法的优点是：只需15分钟即可解决问题，而手术台只需6-8小时。但至少和手术治疗一样有效。虽然典型的辐射会花费数万美元，但是医生们说，这可能比手术和由此引发的住院费用要便宜得多。

But there are uncertainties 12, like whether the radiation may contribute to cancer later in life, or damage nearby structures. And one patient had a fatal stroke three weeks after treatment…though it's unclear if the treatment had any connection. Robinson says that the technique might work like surgery, by damaging or killing 13 scar cells, but the mechanism 14 has not been proven.

但是，还有一些不确定性，比如辐射是否会在晚年引发癌症，或者是否会破坏附近的结构组织。 另有一名患者在治疗三周后出现致命性中风......虽然目前还不清楚这与治疗是否有任何联系。Robinson说，这种技术可能像手术一样，通过破坏或杀伤疤痕细胞来达到治疗效果，但其机制尚未得到证实。

"This needs to be investigated in multiple levels, in the preclinical environment, looking at cells or animals. But this also could be investigated further in patients, by understanding what's happening using imaging, after the patient received their treatment. Or looking at how the signals of the heart change after treatment as well."

“这需要从多层面进行调查，在临床前的环境中观察细胞或动物，但是这也可以在患者中进行深入研究，通过在患者接受治疗之后了解正在使用成像的情况，或者观察治疗后心脏信号也会改变。”

But if this radiation method proves safe and effective, it might be a simpler strategy… to help the heart regain its rhythm.

但如果这种辐射方法证明是安全有效的话，那么这可能是帮助心脏恢复跳动的更简便的方法。