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青年猝死评估:全球方法。

Evaluation After Sudden Death in the Young: A Global Approach.

机构信息

Cardiology Clinical Academic Group, St. George's University of London (B.G., E.R.B.).

St George's University Hospitals NHS Foundation Trust, London, United Kingdom (B.G., E.R.B.).

出版信息

Circ Arrhythm Electrophysiol. 2019 Aug;12(8):e007453. doi: 10.1161/CIRCEP.119.007453. Epub 2019 Aug 19.

Abstract

Sudden cardiac death is defined as a death occurring usually within an hour of onset of symptoms, arising from an underlying cardiac disease. Sudden cardiac death is a complication of a number of cardiovascular diseases and is often unexpected. In individuals aged <35 years, unexplained sudden cardiac death is the most common presentation. A significant proportion of sudden cardiac death in the young (≤35 years) events may be precipitated by underlying inherited cardiac conditions, including both heritable cardiomyopathies and inherited arrhythmia syndromes (also known as cardiac channelopathies). Tragically, sudden death may be the first manifestation of the disease in a family and, therefore, clinical and genetic evaluation of surviving family members forms a key role in diagnosing the underlying inherited cardiac condition in the family. This is particularly relevant when considering that most inherited cardiac conditions are inherited in an autosomal dominant manner meaning that surviving family members have a 50% chance of inheriting the same disease substrate. This review will outline the underlying causes of sudden cardiac death in the young and outline our universal approach to familial evaluation following a young person's sudden death.

摘要

心源性猝死定义为症状发作后通常在 1 小时内发生的死亡,源于潜在的心脏疾病。心源性猝死是许多心血管疾病的并发症,通常是意外发生的。在年龄<35 岁的个体中,不明原因的心源性猝死是最常见的表现。年轻人(≤35 岁)心源性猝死事件中,很大一部分可能是由潜在遗传性心脏疾病引起的,包括遗传性心肌病和遗传性心律失常综合征(也称为心脏通道病)。不幸的是,心源性猝死可能是家族中该疾病的首次表现,因此对幸存的家族成员进行临床和基因评估对于诊断家族中的潜在遗传性心脏疾病起着关键作用。当考虑到大多数遗传性心脏疾病以常染色体显性方式遗传时,这一点尤其重要,这意味着幸存的家族成员有 50%的机会遗传相同的疾病基础。本综述将概述年轻人心源性猝死的潜在原因,并概述我们在年轻人心源性猝死后对家族进行评估的通用方法。

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