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心肌病的遗传学:基因分型与遗传咨询。

The genetics of cardiomyopathy: genotyping and genetic counseling.

作者信息

Fowler Steven J, Napolitano Carlo, Priori Silvia G

机构信息

New York University Langone Medical Center, Leon H. Carney Division of Cardiology, Smilow Research Building, Room 701, 522 First Avenue, New York, NY 10016, USA.

出版信息

Curr Treat Options Cardiovasc Med. 2009 Dec;11(6):433-46. doi: 10.1007/s11936-009-0046-0.

Abstract

Three decades of ongoing research into the identification of genes responsible for both cardiomyopathies and ion channel diseases has facilitated a progressive understanding of the pathophysiology of inherited arrhythmogenic diseases. Recent discoveries in the area of genetics promise to significantly change the current clinical practice of cardiology, as rapid advances in technology and a coincident reduction of costs associated with sequencing have pushed the "translation" of genomic information from bench to bedside. In turn, clinicians have at their disposal new tools for more accurate diagnosis of diseases, as well as for better calculation of health risks for affected families. It is clear, however, that the integration of genetic analysis into frontline clinical cardiology has not yet occurred, especially for heritable cardiomyopathic processes; no one simplified method exists for diagnosing these complex cardiac disease states. It therefore is important to assess the present and future roles of genetic analysis and counseling in clinical practice and how to assist the transition of genetic screening into current care to ensure the appropriate practical use of genetic tests in the routine clinical setting. The purpose of this discussion is to provide a concise review of recent developments in the field of heritable cardiomyopathies, with specific regard to genetic testing and genetic counseling.

摘要

三十年来,针对心肌病和离子通道疾病相关基因的持续研究促进了对遗传性心律失常疾病病理生理学的逐步理解。遗传学领域的最新发现有望显著改变当前心脏病学的临床实践,因为技术的快速进步以及测序相关成本的同步降低推动了基因组信息从实验室到临床的“转化”。相应地,临床医生有了新工具,可更准确地诊断疾病,并更好地计算患病家庭的健康风险。然而,很明显,基因分析尚未融入一线临床心脏病学,尤其是对于遗传性心肌病过程;目前还没有一种简化方法来诊断这些复杂的心脏疾病状态。因此,评估基因分析和咨询在临床实践中的当前及未来作用,以及如何协助将基因筛查过渡到当前护理中,以确保基因检测在常规临床环境中的合理实际应用,就显得尤为重要。本次讨论的目的是简要回顾遗传性心肌病领域的最新进展,特别是基因检测和遗传咨询方面。

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