Shekha Karthik, Ghosh Joydeep, Thekkoott Deepak, Greenberg Yisachar
Department of Cardiology and Clinical Electrophysiology, Maimonides Medical Center (Mount Sinai Health System), Brooklyn, New York 11219, USA.
Indian Pacing Electrophysiol J. 2005 Apr 1;5(2):122-38.
Non ischemic dilated cardiomyopathy (NIDCM) is a disorder of myocardium. It has varying etiologies. Albeit the varying etiologies of this heart muscle disorder, it presents with symptoms of heart failure, and rarely as sudden cardiac death (SCD). Manifestations of this disorder are in many ways similar to its counterpart, ischemic dilated cardiomyopathy (IDCM). A proportion of patients with NIDCM carries a grave prognosis and is prone to sudden cardiac death from sustained ventricular arrhythmias. Identification of this subgroup of patients who carry the risk of sudden cardiac death despite adequate medical management is a challenge. Yet another method is a blanket treatment of patients with this disorder with anti arrhythmic medications or anti tachyarrhythmia devices like implantable cardioverter defibrillators (ICD). However this modality of treatment could be a costly exercise even for affluent economies. In this review we try to analyze the existing data of risk stratification of NIDCM and its clinical implications in practice.
非缺血性扩张型心肌病(NIDCM)是一种心肌疾病。其病因多种多样。尽管这种心肌疾病病因各异,但它表现为心力衰竭症状,很少表现为心源性猝死(SCD)。这种疾病的表现在很多方面与其对应疾病缺血性扩张型心肌病(IDCM)相似。一部分NIDCM患者预后严重,容易因持续性室性心律失常而发生心源性猝死。识别出这一亚组尽管接受了充分药物治疗仍有心脏性猝死风险的患者是一项挑战。另一种方法是对患有这种疾病的患者统一使用抗心律失常药物或植入式心脏复律除颤器(ICD)等抗快速心律失常装置进行治疗。然而,即使对于富裕经济体而言,这种治疗方式也可能成本高昂。在本综述中,我们试图分析NIDCM风险分层的现有数据及其在实际临床中的意义。