Calò Leonardo, Peichl Petr, Bulava Alan, Lamberti Filippo, Loricchio Maria Luisa, Castro Antonio, Meo Antonella, Pandozi Claudio, Santini Massimo
Department of Cardiac Diseases, San Filippo Neri Hospital, Rome, Italy.
Ital Heart J. 2003 Sep;4(9):580-8.
The prognosis for patients with idiopathic dilated cardiomyopathy (DCM) has markedly improved during the last decade, mainly because of advancements in therapeutic strategies. However, sudden death still accounts for a significant part of the total mortality in patients with moderate disease. Recent primary prophylactic trials failed to demonstrate any benefit of cardioverter-defibrillator implantation in an unselected group of idiopathic DCM patients and thus the identification of the subgroup of patients at high arrhythmic risk is crucial. Although different risk stratification methods have been evaluated in risk assessment, the reported clinical value differs in studies, mainly because of differences in either methodology and/or patient selection. The present review focuses on arrhythmic events in idiopathic DCM and on the value of noninvasive methods and electrophysiological study in the risk stratification of this group of patients.
在过去十年中，特发性扩张型心肌病（DCM）患者的预后有了显著改善，这主要得益于治疗策略的进步。然而，猝死在中度病情患者的总死亡率中仍占相当大的比例。最近的初级预防试验未能证明在未经选择的特发性DCM患者群体中植入心脏复律除颤器有任何益处，因此识别出心律失常高危患者亚组至关重要。尽管在风险评估中已经对不同的风险分层方法进行了评估，但各研究报告的临床价值有所不同，主要是由于方法学和/或患者选择的差异。本综述聚焦于特发性DCM中的心律失常事件以及非侵入性方法和电生理研究在该组患者风险分层中的价值。
