Experimental & Molecular Cardiology Group, Academic Medical Center, Amsterdam, The Netherlands.
Circ J. 2007;71 Suppl A:A12-9. doi: 10.1253/circj.71.a12.
Inherited cardiac arrhythmia syndromes have received a lot of attention in recent years, particularly the molecular genetic basis, which has been unraveled to a great extent in the past years. Disease entities have been subdivided based on their causal gene defect, which, indeed, has been shown to impact on disease expression, clinical characteristics, prognosis and treatment. This particularly holds for the long QT syndrome. Studies in other, more recently described, disease entities, such as Brugada syndrome, catecholaminergic polymorphic ventricular arrhythmias and the short QT syndrome, are ongoing. For some of them the heterogenetic nature has just very recently been established. For these reasons, genetic testing has been introduced to clinical practice in several countries, which enables timely treatment of affected individuals and reassurance of those not inheriting the causal gene defect. Presymptomatic testing, however, is not without drawbacks. Psychosocial studies are needed in this field and should be promoted. It is likely that this development will further increase the knowledge of the (patho-) physiology of these disease entities, but also of more common arrhythmia syndromes.
近年来,遗传性心律失常综合征受到了广泛关注,尤其是其分子遗传学基础,近年来已在很大程度上得到阐明。疾病实体已根据其致病基因缺陷进行了细分,实际上,这已被证明会影响疾病的表现、临床特征、预后和治疗。长 QT 综合征尤其如此。对其他最近描述的疾病实体(如 Brugada 综合征、儿茶酚胺多形性室性心动过速和短 QT 综合征)的研究正在进行中。对于其中一些疾病实体,其异质性性质刚刚得到证实。由于这些原因,遗传检测已在多个国家引入临床实践,这可以使受影响的个体得到及时治疗,并使未遗传致病基因缺陷的个体得到安心。然而,症状前检测并非没有缺点。该领域需要进行心理社会研究,并应予以推广。这种发展很可能会进一步增加对这些疾病实体(病理)生理学的了解,也会增加对更常见心律失常综合征的了解。