Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America.
Prog Cardiovasc Dis. 2019 May-Jun;62(3):217-226. doi: 10.1016/j.pcad.2019.04.002. Epub 2019 Apr 17.
Sudden cardiac death (SCD) is a devastating possible outcome of all cardiomyopathies. The risk of SCD is increased in patients with structural heart disease and continues to increase as ventricular dysfunction worsens. There is, however, a subset of cardiomyopathy, so-called "arrhythmogenic cardiomyopathy" (ACM), that carries an inherent propensity for arrhythmia in all stages of the disease, even preceding ventricular dysfunction. The aim of this review is to identify cardiomyopathies, other than ischemic and dilated cardiomyopathies, that are associated with ventricular arrhythmias (VAs) and SCD. We discuss prevalence, diagnosis, natural history and management of arrhythmogenic right ventricular dysplasia/cardiomyopathy, ACM, and exercise-induced cardiomyopathy, with emphasis on the morbidity and mortality of VAs associated with these cardiomyopathies and how they can be mitigated through lifestyle modification, medical management, and implantation of cardioverter defibrillators.
心脏性猝死(SCD)是所有心肌病的一种毁灭性的可能结局。结构性心脏病患者发生 SCD 的风险增加,随着心室功能障碍的恶化,这种风险持续增加。然而,有一种心肌病,所谓的“心律失常性心肌病”(ACM),在疾病的所有阶段都存在固有发生心律失常的倾向,甚至在心室功能障碍之前就存在。本综述的目的是确定除缺血性和扩张型心肌病以外的与室性心律失常(VA)和 SCD 相关的心肌病。我们讨论了致心律失常性右心室发育不良/心肌病、ACM 和运动诱导型心肌病的患病率、诊断、自然病史和管理,重点是这些心肌病相关的 VA 的发病率和死亡率,以及如何通过生活方式改变、药物治疗和植入心脏复律除颤器来减轻 VA。
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