Perez Antonio L, Tang W H Wilson
Section of Advanced Heart Failure and Transplantation, Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH, 44195, USA.
Curr Treat Options Cardiovasc Med. 2015 May;17(5):381. doi: 10.1007/s11936-015-0381-2.
The pathogenesis of idiopathic cardiomyopathies is likely highly complex and remains elusive. Environmental toxins have been hypothesized to possibly cause a subset of cardiomyopathies. Epidemiological, preclinical, and small clinical studies have investigated the role of numerous elements and compounds in the pathogenesis of these myocardial disorders. In this review, we present the evidence implicating elements and environmental compounds in myocardial toxicity, including antimony, cobalt, mercury, aluminum, copper, and acrolein. We discuss their sources, toxic effects, and epidemiology, as well as identify groups at risk for toxic exposure. Through our discussion, we highlight areas where further investigation into the clinical effects of these possible toxins is warranted.
特发性心肌病的发病机制可能高度复杂，仍不明确。有假说认为环境毒素可能导致一部分心肌病。流行病学、临床前和小型临床研究已经调查了多种元素和化合物在这些心肌疾病发病机制中的作用。在本综述中，我们展示了涉及元素和环境化合物导致心肌毒性的证据，包括锑、钴、汞、铝、铜和丙烯醛。我们讨论了它们的来源、毒性作用和流行病学，以及确定有接触毒素风险的人群。通过我们的讨论，我们强调了有必要对这些可能毒素的临床影响进行进一步研究的领域。
