Richard P, Fressart V, Charron P, Hainque B
Service de Biochimie Métabolique, UF de Cardiogénétique et Myogénétique Moléculaire et Cellulaire, Hôpital de la Pitié-Salpêtrière, AP-HP, 75013 Paris, France.
Pathol Biol (Paris). 2010 Oct;58(5):343-52. doi: 10.1016/j.patbio.2009.10.010. Epub 2009 Nov 25.
Hereditary cardiomyopathy is a primitive disorder in which the heart muscle is structurally and functionally abnormal in the absence of any other cause of cardiomyopathy. They are separated into four phenotypic groups, hypertrophic cardiomyopathy, dilated cardiomyopathy, restrictive cardiomyopathy and arrhythmogenic cardiomyopathy of the right ventricle. Hypertrophic cardiomyopathy was the first identified at the molecular level and then the first to benefit of molecular testing. The molecular analyses were then extended the following years to the dilated cardiomyopathy and restrictive cardiomyopathy. The arrhythmogenic right ventricular cardiomyopathy was the latest to be analyzed at the molecular level because the identification of genes involved in that phenotype was published only in 2002 to 2006. The genetics analysis of these diseases has developed over the past decade and, although still complex, is now available in current hospital practice. The objectives of these tests are to confirm a diagnosis difficult to achieve by classic clinical approach and to perform predictive and presymptomatic diagnosis in families when the mutation was identified. This allows for appropriate care of patients at risk, and may respond to a request for prenatal diagnosis in particularly serious forms. These tests are framed in the context of genetic counselling consultation and patients are the subjects of a multidisciplinary care in reference centres.
遗传性心肌病是一种原发性疾病,其中心肌在没有任何其他心肌病病因的情况下出现结构和功能异常。它们被分为四个表型组,即肥厚型心肌病、扩张型心肌病、限制型心肌病和致心律失常性右室心肌病。肥厚型心肌病是第一个在分子水平上被识别的,也是第一个受益于分子检测的。随后几年,分子分析扩展到了扩张型心肌病和限制型心肌病。致心律失常性右室心肌病是最后一个在分子水平上进行分析的,因为涉及该表型的基因鉴定直到2002年至2006年才发表。这些疾病的遗传学分析在过去十年中得到了发展,虽然仍然复杂,但现在在当前医院实践中已经可以进行。这些检测的目的是通过经典临床方法难以确诊时进行确诊,并在家族中当突变被识别时进行预测性和症状前诊断。这使得能够对有风险的患者进行适当的护理,并可能对特别严重形式的产前诊断请求做出回应。这些检测是在遗传咨询的背景下进行的,患者是参考中心多学科护理的对象。