Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA.
Curr Opin Cardiol. 2010 May;25(3):205-9. doi: 10.1097/HCO.0b013e3283375698.
Hypertrophic cardiomyopathy (HCM), the most common inherited cardiac disorder, exhibits remarkable genetic and clinical heterogeneity. This manuscript reviews recent discoveries of disease-causing genes and their clinical consequences, and provides an overview of research that aims to elucidate how HCM ensues from a single-nucleotide mutation.
The spectrum of genes that are mutated in HCM has expanded. In combination with newly developed sequencing technologies, there are now robust strategies for gene-based diagnosis in HCM. Understanding the molecular pathophysiology of HCM has emerged from the study of genetically engineered animal models of disease, and new data indicate important roles for altered intracellular Ca²⁺ regulation and oxidative stress. Pharmacologic strategies to normalize these processes show promise in attenuating HCM in experimental models.
The current repertoire of HCM genes allows effective gene-based diagnosis, information that enables accurate assessment of disease risk in family members, and provides some insight into clinical course. From mechanistic insights gleaned from fundamental investigations of experimental HCM models, novel therapeutic targets that may provide new benefits for HCM patients have surfaced.
肥厚型心肌病(HCM)是最常见的遗传性心脏病,具有显著的遗传和临床异质性。本文综述了导致疾病的基因突变及其临床后果的最新发现,并概述了旨在阐明 HCM 如何由单个核苷酸突变引起的研究。
导致 HCM 的基因突变谱不断扩大。结合新开发的测序技术,现在有了针对 HCM 的基于基因的诊断的可靠策略。对疾病的基因工程动物模型的研究揭示了 HCM 的分子病理生理学,新数据表明细胞内 Ca²⁺调节和氧化应激的改变起着重要作用。使这些过程正常化的药物治疗策略在实验模型中显示出减轻 HCM 的潜力。
目前的 HCM 基因谱允许进行有效的基于基因的诊断,这些信息能够准确评估家庭成员的疾病风险,并为临床病程提供一些见解。从对实验性 HCM 模型的基础研究中获得的机制见解中,出现了可能为 HCM 患者提供新益处的新治疗靶点。