Laszlo Roman, Busch Mathias C, Schreieck Jüergen
Abteilung für Kardiologie und Kreislauferkrankungen, Klinikum der Eberhard-Karls-Universität Tübingen, 72076 Tübingen, Germany.
ISRN Cardiol. 2011;2011:457247. doi: 10.5402/2011/457247. Epub 2011 Apr 18.
More and more implantable cardioverter-defibrillators (ICDs) are implanted as primary prevention of sudden cardiac death (SCD). However, major problem in practice is to identify high-risk patients for SCD. Different methods for noninvasive risk stratification do not have a sufficient positive or negative predictive value. Since current approaches lead to implantation of ICDs in a large number of patients who will never suffer an arrhythmic event and simultaneously patients still die of SCD who currently did not seem eligible for primary preventive ICD implantation, there is a need for additional tools for risk stratification. Epidemiological studies point to a hereditary risk of SCD. Different susceptibility of each person concerning arrhythmogenic events might be explained by genetic polymorphisms. By obtaining an individual "pattern" of polymorphisms of genes encoding for proteins which are important in arrhythmogenesis in one patient, risk stratification in primary prevention of SCD might by improved.
越来越多的植入式心脏复律除颤器（ICD）被植入用于心脏性猝死（SCD）的一级预防。然而，实践中的主要问题是识别SCD的高危患者。不同的无创风险分层方法没有足够的阳性或阴性预测价值。由于目前的方法导致大量不会发生心律失常事件的患者植入了ICD，同时仍有一些目前似乎不符合ICD一级预防植入标准的患者死于SCD，因此需要额外的风险分层工具。流行病学研究指出SCD存在遗传风险。每个人对致心律失常事件的不同易感性可能由基因多态性来解释。通过获取一名患者中对心律失常发生起重要作用的蛋白质编码基因的多态性个体“模式”，可能会改善SCD一级预防中的风险分层。
