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1p36缺失综合征与主动脉:三例新患者报告及文献综述

1p36 Deletion Syndrome and the Aorta: A Report of Three New Patients and a Literature Review.

作者信息

Lodato Valentina, Orlando Valeria, Alesi Viola, Di Tommaso Silvia, Bengala Mario, Parlapiano Giovanni, Agnolucci Elisa, Cicenia Marianna, Calì Federica, Digilio Maria Cristina, Drago Fabrizio, Novelli Antonio, Baban Anwar

机构信息

The European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart, Pediatric Cardiology and Arrhythmia/Syncope Units, Bambino Gesù Children Hospital and Research Institute, IRCCS, 00165 Rome, Italy.

Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children Hospital and Research Institute, IRCCS, 00165 Rome, Italy.

出版信息

J Cardiovasc Dev Dis. 2021 Nov 19;8(11):159. doi: 10.3390/jcdd8110159.

Abstract

BACKGROUND

Monosomy 1p36 syndrome is now considered the most common terminal deletion syndrome, with an estimated incidence of 1 in 5000. Cardiac involvement is well described in the literature mainly in terms of congenital heart defects (CHDs) and cardiomyopathies (CMPs). Few data in the literature describe the potential progressive nature of aortic dilatation (root and ascending aorta) in 1p36 deletion syndrome. harboured in the deleted region might play a predisposing factor for this aspect.

METHODS

we reviewed the aortic aspect both in the literature and in our cohort, where major attention to the aortic abnormalities was given through dedicated echocardiographic measurements even in previously screened individuals.

RESULTS

aortic involvement in 1p36 deletion syndrome was described in the literature three times within the CHD context. We observed three additional patients from our cohort (three out of nine patients) with aortic dilatation. All patients with dilated aorta had haploinsufficiency within the deleted region.

CONCLUSIONS

at long-term outcome and with a growing population of this rare disease, this association (1p36 deletion and aortic dilatation) might represent a major concern especially in terms of risk stratification and the potential need for specific management (conservative pharmacologic and eventually surgical) whenever indicated. The present study suggests the need for detailed multicentric studies and indication to periodic echocardiographic screening in addition to baseline tests, especially in individuals with deletions harbouring .

摘要

背景

1p36单体综合征现被认为是最常见的末端缺失综合征,估计发病率为1/5000。文献中对心脏受累的描述主要集中在先天性心脏病(CHD)和心肌病(CMP)方面。文献中很少有数据描述1p36缺失综合征中主动脉扩张(根部和升主动脉)的潜在进展性。缺失区域中存在的[相关因素]可能是这方面的一个易感因素。

方法

我们回顾了文献和我们队列中的主动脉情况,在我们的队列中,即使是对先前筛查过的个体,也通过专门的超声心动图测量对主动脉异常给予了主要关注。

结果

在文献中,在CHD背景下有3次描述了1p36缺失综合征中的主动脉受累情况。我们在队列中又观察到3例主动脉扩张患者(9例患者中的3例)。所有主动脉扩张患者在缺失区域均存在单倍剂量不足。

结论

从长期结果来看,随着这种罕见疾病患者数量的增加,这种关联(1p36缺失与主动脉扩张)可能是一个主要问题,特别是在风险分层方面,以及在有指征时可能需要进行特定治疗(保守药物治疗以及最终的手术治疗)。本研究表明需要进行详细的多中心研究,并除了基线检查外,还需定期进行超声心动图筛查,特别是对于存在[相关缺失]的个体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bcd/8618808/1609ac50612a/jcdd-08-00159-g001.jpg

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