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心脏性猝死:流行病学、发病机制与处理。

Sudden cardiac death: epidemiology, pathogenesis and management.

机构信息

Department of Cardiothoracic Surgery, University of Pittsburgh, PA 15213, USA.

Department of Medicine, University of Milan, 21022 Milano, Italy.

出版信息

Rev Cardiovasc Med. 2021 Mar 30;22(1):147-158. doi: 10.31083/j.rcm.2021.01.207.

Abstract

Sudden cardiac death (SCD) is an unexpected sudden death due to a heart condition, that occurs within one hour of symptoms onset. SCD is a leading cause of death in western countries, and is responsible for the majority of deaths from cardiovascular disease. Moreover, SCD accounts for mortality in approximately half of all coronary heart disease patients. Nevertheless, the recent advancements made in screening, prevention, treatment, and management of the underlying causes has decreased this number. In this article, we sought to review established and new modes of screening patients at risk for SCD, treatment and prevention of SCD, and the role of new technologies in the field. Further, we delineate the current epidemiologic trends and pathogenesis. In particular, we describe the advancement in molecular autopsy and genetic testing, the role of target temperature management, extracorporeal membrane oxygenation (ECMO), cardiopulmonary resuscitation (CPR), and transvenous and subcutaneous implantable cardioverter devices (ICDs).

摘要

心源性猝死(SCD)是指由于心脏疾病,在症状出现后 1 小时内突然发生的意外死亡。SCD 是西方国家的主要死亡原因,也是心血管疾病导致的大多数死亡的原因。此外,SCD 约占所有冠心病患者死亡人数的一半。然而,近年来在筛查、预防、治疗和管理潜在病因方面的进展已经减少了这一数字。在本文中,我们试图回顾用于筛查 SCD 风险患者的既定和新方法、SCD 的治疗和预防,以及该领域新技术的作用。此外,我们还阐述了当前的流行病学趋势和发病机制。具体而言,我们描述了分子尸检和基因检测的进展、目标温度管理、体外膜氧合(ECMO)、心肺复苏(CPR)以及经静脉和皮下植入式心脏复律除颤器(ICD)的作用。

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