McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21209, USA.
Annu Rev Genomics Hum Genet. 2012;13:223-39. doi: 10.1146/annurev-genom-090711-163841. Epub 2012 Jun 11.
Sudden cardiac death (SCD), a sudden pulseless condition due to cardiac arrhythmia, remains a major public health problem despite recent progress in the treatment and prevention of overall coronary heart disease. In this review, we examine the evidence for genetic susceptibility to SCD in order to provide biological insight into the pathogenesis of this devastating disease and to explore the potential for genetics to impact clinical management of SCD risk. Both candidate gene approaches and unbiased genome-wide scans have identified novel biological pathways contributing to SCD risk. Although risk stratification in the general population remains an elusive goal, several studies point to the potential utility of these common genetic variants in high-risk individuals. Finally, we highlight novel methodological approaches to deciphering the molecular mechanisms involved in arrhythmogenesis. Although further epidemiological and clinical applications research is needed, it is increasingly clear that genetic approaches are yielding important insights into SCD that may impact the public health burden imposed by SCD and its associated outcomes.
尽管在整体冠状动脉心脏病的治疗和预防方面取得了一些进展,但由于心脏性心律失常而导致的突发性无脉搏状况的突发性心脏死亡(SCD)仍然是一个重大的公共卫生问题。在这篇综述中,我们检查了对 SCD 遗传易感性的证据,以便为这种破坏性疾病的发病机制提供生物学见解,并探讨遗传学对 SCD 风险的临床管理产生影响的潜力。候选基因方法和无偏基因组扫描都已经确定了导致 SCD 风险的新的生物学途径。尽管在一般人群中进行风险分层仍然是一个难以实现的目标,但有几项研究指出这些常见遗传变异在高危个体中的潜在应用价值。最后,我们强调了破译心律失常发生中涉及的分子机制的新方法。尽管需要进一步的流行病学和临床应用研究,但越来越清楚的是,遗传方法正在为 SCD 提供重要的见解,这可能会影响 SCD 及其相关结果所带来的公共卫生负担。