基于心脏代谢的慢性疾病、肥胖和糖代谢异常的驱动因素：JACC 最新综述。
Cardiometabolic-Based Chronic Disease, Adiposity and Dysglycemia Drivers: JACC State-of-the-Art Review.
机构信息
Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, New York.
Peter Munk Cardiac Centre and the Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, Ontario, Canada.
出版信息
J Am Coll Cardiol. 2020 Feb 11;75(5):525-538. doi: 10.1016/j.jacc.2019.11.044.
A new cardiometabolic-based chronic disease (CMBCD) model is presented that provides a basis for early and sustainable, evidence-based therapeutic targeting to promote cardiometabolic health and mitigate the development and ravages of cardiovascular disease. In the first part of this JACC State-of-the-Art Review, a framework is presented for CMBCD, focusing on 3 primary drivers (genetics, environment, and behavior) and 2 metabolic drivers (adiposity and dysglycemia) with applications to 3 cardiovascular endpoints (coronary heart disease, heart failure, and atrial fibrillation). Specific mechanistic pathways are presented configuring early primary drivers with subsequent adiposity, insulin resistance, β-cell dysfunction, and metabolic syndrome, leading to cardiovascular disease. The context for building this CMBCD model is to expose actionable targets for prevention to achieve optimal cardiovascular outcomes. The tactical implementation of this CMBCD model is the subject of second part of this JACC State-of-the-Art Review.
提出了一种新的心代谢性慢性疾病（CMBCD）模型，为早期和可持续的循证治疗提供了基础，以促进心代谢健康，并减轻心血管疾病的发展和肆虐。在这篇 JACC 最新综述的第一部分中，提出了 CMBCD 的框架，重点关注 3 个主要驱动因素（遗传、环境和行为）和 2 个代谢驱动因素（肥胖和糖代谢异常），并应用于 3 个心血管终点（冠心病、心力衰竭和心房颤动）。提出了具体的机制途径，将早期主要驱动因素与随后的肥胖、胰岛素抵抗、β细胞功能障碍和代谢综合征联系起来，导致心血管疾病。建立这个 CMBCD 模型的背景是为了揭示可预防的靶点，以实现最佳的心血管结局。这个 CMBCD 模型的战术实施是这篇 JACC 最新综述第二部分的主题。
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