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围产期心肌病中心律失常的检测与管理

Detection and management of arrhythmias in peripartum cardiomyopathy.

作者信息

Hoevelmann Julian, Hähnle Lina, Hähnle Julia, Sliwa Karen, Viljoen Charle

机构信息

Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa.

Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.

出版信息

Cardiovasc Diagn Ther. 2020 Apr;10(2):325-335. doi: 10.21037/cdt.2019.05.03.

Abstract

Peripartum cardiomyopathy (PPCM) is an idiopathic dilated cardiomyopathy, in which previously healthy women present with heart failure secondary to left ventricular (LV) systolic dysfunction during the last months of pregnancy or up to 5 months postpartum. PPCM occurs worldwide. The incidence seems to be increasing, possibly due to increasing awareness of the condition and diagnosis thereof. Women diagnosed with PPCM present with symptoms and signs of heart failure, thromboembolism or arrhythmia. Although the incidence of arrhythmias in this condition is not well documented, patients with PPCM often have rhythm disturbances. Indeed, life-threating arrhythmias contribute significantly to sudden cardiac death (SCD) in this population, especially when patients have poor systolic function. In this review, we summarize the evidence on atrial and ventricular arrhythmias in PPCM, as detected by various diagnostic modalities. Furthermore, we summarize the management of arrhythmias in PPCM, as recommended by contemporary guidelines.

摘要

围产期心肌病(PPCM)是一种特发性扩张型心肌病,既往健康的女性在妊娠最后几个月或产后5个月内出现继发于左心室(LV)收缩功能障碍的心力衰竭。PPCM在全球范围内均有发生。其发病率似乎在上升,这可能是由于对该病及其诊断的认识不断提高。被诊断为PPCM的女性会出现心力衰竭、血栓栓塞或心律失常的症状和体征。尽管这种情况下心律失常的发病率尚无充分记录,但PPCM患者常出现节律紊乱。事实上,危及生命的心律失常在该人群的心源性猝死(SCD)中起重要作用,尤其是当患者收缩功能较差时。在本综述中,我们总结了通过各种诊断方式检测到的PPCM中心房和室性心律失常的证据。此外,我们还总结了当代指南推荐的PPCM心律失常的管理方法。

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本文引用的文献

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Electrocardiographic findings in peripartum cardiomyopathy.围生期心肌病的心电图表现。
Clin Cardiol. 2019 May;42(5):524-529. doi: 10.1002/clc.23171. Epub 2019 Mar 29.
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Peripartum Cardiomyopathy.围生期心肌病。
Obstet Gynecol. 2019 Jan;133(1):167-179. doi: 10.1097/AOG.0000000000003011.
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The prognostic significance of the 12-lead ECG in peripartum cardiomyopathy.围生期心肌病 12 导联心电图的预后意义。
Int J Cardiol. 2019 Feb 1;276:177-184. doi: 10.1016/j.ijcard.2018.11.008. Epub 2018 Nov 7.

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