Barletta Valentina, Fabiani Iacopo, Lorenzo Conte, Nicastro Irene, Bello Vitantonio Di
Department of Surgery, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.
J Cardiovasc Echogr. 2014 Apr-Jun;24(2):41-51. doi: 10.4103/2211-4122.135611.
Sudden cardiac death (SCD) is defined as natural death due to cardiac causes, heralded by abrupt loss of consciousness within 1 h of the onset of acute symptoms; pre-existing heart disease may have been known to be present but the time and mode of death are unexpected. Prediction and prevention of SCD is an area of active investigation, but considerable challenges persist that limit the efficacy and cost-effectiveness of available methodologies. It was well-recognized that optimization of SCD risk stratification would require integration of multi-disciplinary efforts at the bench and bedside, with studies in the general population. This integration has yet to be effectively accomplished. There is also increasing awareness that more investigation needs to be directed toward the identification of early predictors of SCD. Significant advancements have recently occurred for risk prediction in the inherited channelopathies and other inherited conditions that predispose to SCD, but there is much to be accomplished in this regard for the more common complex phenotypes, such as SCD among patients with coronary artery disease. A multimodality imaging approach is actually the most important tool to provide comprehensive information on different pathophysiological mechanisms related to SCD.
心脏性猝死(SCD)被定义为因心脏原因导致的自然死亡,急性症状发作后1小时内突然意识丧失为其先兆;可能已知存在既往心脏病,但死亡时间和方式出乎意料。SCD的预测和预防是一个积极研究的领域,但仍然存在相当大的挑战,限制了现有方法的有效性和成本效益。人们普遍认识到,优化SCD风险分层需要整合基础研究和临床研究的多学科努力,并在普通人群中开展研究。这种整合尚未有效完成。人们也越来越意识到,需要更多地致力于识别SCD的早期预测因素。最近在遗传性通道病和其他易患SCD的遗传性疾病的风险预测方面取得了重大进展,但在这方面,对于更常见的复杂表型,如冠心病患者中的SCD,仍有许多工作要做。多模态成像方法实际上是提供与SCD相关的不同病理生理机制全面信息的最重要工具。