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肥厚型心肌病患者的基因筛查——一种用于风险分层的新诊断策略?

Genetic screening of patients with hypertrophic cardiomyopathy--a new diagnostic strategy for risk stratification?

作者信息

Hudecova K, Simkova I, Gardlik R, Bernadic M

机构信息

Department of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia.

出版信息

Bratisl Lek Listy. 2009;110(2):85-92.

Abstract

Hypertrophic cardiomyopathy (HCM) is an autosomal dominant inherited disease of the heart muscle and its main characteristic is unexplained hypertrophy of the left and/or the right ventricle. HCM is the most common genetically determined cardiovascular disease and is prevalent in approximately in 1 of 500 of the population. The most serious complication of HCM is sudden cardiac death (SCD) which can be the first manifestation of the disease. However, there are other forms of benign prognosis which do not jeopardize patient's health or life. The clinical symptoms of HCM are partly dependent on mutations in affected sarcomere genes. Different mutations in the same gene can present as malign with a high risk of SCD, while other mutations can be benign. The clinical symptomatology can also be influenced by other factors such as the presence of polymorphisms in other genes. Nowadays the aim of intensive clinical research is to access the contribution of molecular genetic methods in HCM diagnostics as well as in risk stratification of SCD. It is expected that genetic analyses will have an important consequence in the screening the relatives of HCM patients and also in the prenatal diagnostics and genetic counseling (Tab. 2, Fig. 1, Ref. 45). Full Text (Free, PDF) www.bmj.sk.

摘要

肥厚型心肌病(HCM)是一种常染色体显性遗传性心肌疾病,其主要特征是左心室和/或右心室出现不明原因的肥厚。HCM是最常见的遗传性心血管疾病,在大约每500人中就有1人患病。HCM最严重的并发症是心源性猝死(SCD),这可能是该疾病的首发表现。然而,也有其他预后良好的类型,不会危及患者的健康或生命。HCM的临床症状部分取决于受影响的肌节基因突变。同一基因的不同突变可能表现为恶性,伴有高SCD风险,而其他突变可能是良性的。临床症状学也可能受到其他因素的影响,如其他基因中多态性的存在。如今,深入临床研究的目的是评估分子遗传学方法在HCM诊断以及SCD风险分层中的作用。预计基因分析将在筛查HCM患者亲属、产前诊断和遗传咨询方面产生重要影响(表2,图1,参考文献45)。全文(免费,PDF)www.bmj.sk

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