Cardiovascular Genetics, Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, NY, USA.
Eur Heart J. 2011 Sep;32(17):2109-18. doi: 10.1093/eurheartj/ehr082. Epub 2011 Apr 9.
Since the discovery of the genetic bases of the long QT syndrome, several new genetically mediated arrhythmias have been described, defining a new group of syndromes, called inherited arrhythmogenic diseases. This allowed clarifying the substrate of several cases of juvenile sudden death, previously defined as 'idiopathic ventricular fibrillation'. Studies derived from this field also contributed to advance the field of electrophysiology, elucidating some of the mechanisms that regulate the cardiac electrical properties of the heart. Recently, new genes and new proteins have been called into play, expanding the knowledge on the complexity of the regulatory processes modulating the cardiac action potential. Moreover, the collaboration between clinicians and basic scientists opened new approaches in the management of patients affected by genetic arrhythmias. This body of knowledge has then moved into the realization that genetic variations may also influence the predisposition to acquired cardiac diseases. The new exciting challenges that investigators are now facing are connected to the possibility of expanding the field towards the use of these information to shape a newer vision in the management and cure of patients.
自从发现长 QT 综合征的遗传基础以来,已经描述了几种新的遗传介导的心律失常,定义了一组称为遗传性心律失常疾病的新综合征。这使得一些以前被定义为“特发性心室颤动”的青少年猝死病例的发病机制得以阐明。该领域的研究也有助于推进电生理学领域的发展,阐明了一些调节心脏电特性的机制。最近,新的基因和新的蛋白质也被发现,扩大了对调节心脏动作电位的调控过程复杂性的认识。此外,临床医生和基础科学家之间的合作也为治疗遗传心律失常患者的方法提供了新的途径。这些知识使人们意识到,遗传变异也可能影响获得性心脏病的易感性。研究人员现在面临的新的令人兴奋的挑战是,有可能将这一领域扩展到利用这些信息来塑造患者管理和治疗的新愿景。