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心肌病转化登记研究(TORCH)——原理与初步结果

TranslatiOnal Registry for CardiomyopatHies (TORCH) - rationale and first results.

作者信息

Seyler Claudia, Meder Benjamin, Weis Tanja, Schwaneberg Thea, Weitmann Kerstin, Hoffmann Wolfgang, Katus Hugo A, Dösch Andreas

机构信息

Department of Cardiology, Medical University Hospital Heidelberg, Germany.

DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Heidelberg, Germany.

出版信息

ESC Heart Fail. 2017 Aug;4(3):209-215. doi: 10.1002/ehf2.12145. Epub 2017 Mar 14.

Abstract

AIMS

Non-ischemic cardiomyopathies (CMPs) comprise heart muscle disorders of different causes with high variability in disease phenotypes and clinical progression. The lack of national structures for the efficient recruitment, clinical and molecular classification, and follow-up of patients with non-ischemic CMPs limit the thorough analysis of disease mechanisms and the evaluation of novel diagnostic and therapeutic strategies. This paper describes a national, prospective, multicenter registry for patients with non-ischemic CMPs. The main objective of this registry is to create a central hub for clinical outcome studies, a joint resource for diagnostic and therapeutic trials, a common biomaterial bank, and a resource for detailed molecular analyses utilizing patients' biomaterials.

METHODS AND RESULTS

A comprehensive characterization of the register population and patients' subgroups is planned. First analyses will include descriptive methods evaluating the distribution of outcome variables and possible risk factors followed by test statistics in a cross-sectional design. The aim of the current study is to recruit 2300 patients all over Germany. Eligible participants are patients with primary non-ischemic cardiomyopathies, including hereditary and inflammatory dilated CMP (DCM), left-ventricular noncompaction CMP (LVNC), hypertrophic CMP (HCM), arrhythmogenic right-ventricular CMP (ARVC), myocarditis, and amyloidosis. Of already recruited patients 70% are male and 30% female. With 56% of patients included, DCM is most common.

CONCLUSION/OUTCOME: The primary outcome is all-cause death. Key secondary endpoints are cardiovascular death, adequate ICD shock, survived sudden cardiac death, syncope, documented potentially life-threatening arrhythmia, cardiac transplantation, hospitalization due to worsening of heart failure (HF), and any non-elective cardiovascular hospitalization.

摘要

目的

非缺血性心肌病(CMP)包括由不同病因引起的心肌疾病,其疾病表型和临床进展具有高度变异性。缺乏针对非缺血性CMP患者进行有效招募、临床和分子分类以及随访的国家性架构,限制了对疾病机制的深入分析以及对新型诊断和治疗策略的评估。本文描述了一个针对非缺血性CMP患者的全国性、前瞻性、多中心注册研究。该注册研究的主要目标是创建一个用于临床结局研究的中心枢纽、一个用于诊断和治疗试验的联合资源、一个共同的生物样本库以及一个利用患者生物材料进行详细分子分析的资源。

方法与结果

计划对注册人群和患者亚组进行全面特征描述。首次分析将包括评估结局变量分布和可能危险因素的描述性方法,随后在横断面设计中进行检验统计。当前研究的目标是在德国各地招募2300名患者。符合条件的参与者为原发性非缺血性心肌病患者,包括遗传性和炎性扩张型CMP(DCM)、左心室致密化不全CMP(LVNC)、肥厚型CMP(HCM)、致心律失常性右心室CMP(ARVC)、心肌炎和淀粉样变性。在已招募的患者中,70%为男性,30%为女性。DCM最为常见,占纳入患者的56%。

结论/结果:主要结局是全因死亡。关键次要终点包括心血管死亡、适当的植入式心脏复律除颤器(ICD)电击、心脏性猝死存活、晕厥、记录到的潜在危及生命的心律失常、心脏移植、因心力衰竭(HF)恶化住院以及任何非选择性心血管住院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95be/5747042/94f1a336f801/EHF2-4-209-g001.jpg

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