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[心脏淀粉样变性]

[Amyloidosis of the heart].

作者信息

Kristen A V, Röcken C

机构信息

Abteilung für Innere Medizin III (Kardiologie, Angiologie, Pneumologie), Medizinische Universitätsklinik Heidelberg, Heidelberg, Deutschland.

出版信息

Pathologe. 2012 May;33(3):236-44. doi: 10.1007/s00292-011-1558-4.

Abstract

Amyloidosis is a heterogeneous group of diseases characterized by the pathological deposition of autologous proteins in an antiparallel β-sheet confirmation forming non-branching linear fibrils of indefinite length and an approximate diameter of 10-12 nm. Cardiac amyloidosis is caused by deposits in the heart and may lead to cardiac arrhythmia and low output failure. Following the diagnosis, classification of the amyloid protein and evaluation of further organ involvement is mandatory. Treatment approaches are based on reduction of the production of amyloid precursor proteins. Standard heart failure treatment is usually not well tolerated and the underlying disease remains unaffected. Cardiac amyloidosis, especially of the light chain type, is associated with a poor outcome. The clinical picture is uncharacteristic, therefore correct diagnosis of cardiac amyloidosis is often delayed in many patients. Combination of clinical symptoms of different organ systems should alert the physician to the diagnosis of amyloidosis.

摘要

淀粉样变性是一组异质性疾病,其特征在于自体蛋白质以反平行β-折叠结构进行病理性沉积,形成长度不定且直径约为10 - 12纳米的无分支线性纤维。心脏淀粉样变性由心脏中的沉积物引起,可能导致心律失常和低输出量衰竭。诊断后,必须对淀粉样蛋白进行分类并评估是否有其他器官受累。治疗方法基于减少淀粉样前体蛋白的产生。标准的心力衰竭治疗通常耐受性不佳,且潜在疾病仍未得到改善。心脏淀粉样变性,尤其是轻链型,预后较差。临床表现不典型,因此许多患者的心脏淀粉样变性诊断常常延迟。不同器官系统的临床症状组合应提醒医生注意淀粉样变性的诊断。

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