Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, Canada.
Curr Opin Cardiol. 2011 Mar;26(2):155-64. doi: 10.1097/HCO.0b013e3283439797.
This review will provide an overview of the genetic basis of cardiomyopathy with an emphasis on the clinically relevant breakthroughs that have occurred recently and their role in the evaluation of patients with cardiomyopathy.
Recent developments that have occurred in genetic cardiomyopathy include the finding of a shared genetic basis of familial dilated cardiomyopathy in at least a subset of cases of peripartum cardiomyopathy; the increased yield for the diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) when genetic testing is incorporated into Task Force Criteria; and the value of testing a spectrum of implicated genes in hypertrophic cardiomyopathy and ARVC because of the severe phenotype associated with compound mutations.
Recent progress in genetic cardiomyopathy points to the potential value of genetic testing in shaping the clinician's ability to diagnose and understand the pathogenetic basis of the inherited cardiomyopathies. The rapid rate at which the field is progressing emphasizes the importance of referral of such patients to multidisciplinary teams equipped to address the complex biological, social and psychological issues that accompany the genetic diagnosis of inherited cardiomyopathy.
本文将概述心肌病的遗传学基础,重点介绍最近取得的临床相关突破及其在心肌病患者评估中的作用。
遗传型心肌病领域最近的进展包括:在至少一部分围产期心肌病患者中发现家族性扩张型心肌病具有共同的遗传基础;将基因检测纳入工作组标准后,心律失常性右室心肌病/发育不良(ARVC/D)的诊断率提高;由于与复合突变相关的严重表型,对肥厚型心肌病和 ARVC 中一系列相关基因进行检测具有重要价值。
遗传型心肌病的最新进展表明基因检测可能有助于临床医生诊断和了解遗传性心肌病的发病机制。该领域的快速发展强调了将此类患者转介给多学科团队的重要性,以便解决遗传诊断伴随的复杂生物学、社会和心理问题。