Hänselmann A, Veltmann C, Bauersachs J, Berliner D
Dept. of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Herz. 2020 May;45(3):212-220. doi: 10.1007/s00059-020-04903-5.
Dilated cardiomyopathy (DCM) is the most common form of cardiomyopathy and one of the most common causes of heart failure. It is characterized by left or biventricular dilation and a reduced systolic function. The causes are manifold and range from myocarditis to alcohol and other toxins, to rheumatological, endocrinological, and metabolic diseases. Peripartum cardiomyopathy is a special form that occurs at the end of or shortly after pregnancy. Genetic mutations can be detected in approximately 30-50% of DCM patients. Owing to the growing possibilities of genetic diagnostics, increasingly more triggering variants and hereditary mechanisms emerge. This is particularly important with regard to risk stratification for patients with variants with an increased risk of arrhythmias. Patient prognosis is determined by the occurrence of heart failure and arrhythmias. In addition to the treatment of the underlying disease or the elimination of triggering harmful toxins, therapy consists in guideline-directed heart failure treatment including drug and device therapy.
扩张型心肌病(DCM)是心肌病最常见的形式,也是心力衰竭最常见的病因之一。其特征为左心室或双心室扩张以及收缩功能降低。病因多种多样,包括心肌炎、酒精及其他毒素,以及风湿性、内分泌和代谢性疾病。围产期心肌病是一种在妊娠末期或产后不久发生的特殊形式。在大约30%-50%的DCM患者中可检测到基因突变。由于基因诊断的可能性不断增加,越来越多的触发变异和遗传机制被发现。这对于心律失常风险增加的变异患者的风险分层尤为重要。患者的预后取决于心力衰竭和心律失常的发生情况。除了治疗基础疾病或消除触发有害毒素外,治疗还包括遵循指南的心力衰竭治疗,包括药物和器械治疗。