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[心脏淀粉样变性的诊断与治疗:欧洲心脏病学会心肌和心包疾病工作组2021年立场声明]

[Diagnosis and treatment of cardiac amyloidosis : A position statement of the ESC working group on myocardial and pericardial diseases 2021].

作者信息

Pankuweit Sabine, Dörr Rolf

机构信息

Klinik für Innere Medizin - Kardiologie, Philipps-Universität Marburg, Baldinger Str. 1, 35043, Marburg, Deutschland.

Praxisklinik Herz und Gefäße, Kardiologie • Angiologie • Radiologie • Nuklearmedizin, Akademische Lehrpraxisklinik, TU Dresden, Forststr. 3, 01099, Dresden, Deutschland.

出版信息

Herz. 2022 Feb;47(1):41-47. doi: 10.1007/s00059-021-05085-4. Epub 2021 Dec 8.

Abstract

Cardiac amyloidosis is still considered a rare disease, although recent data show that it is the cause of cardiac dysfunction more frequently than expected. The diagnosis of cardiac amyloidosis is based on the detection of extracellular deposits of misfolded proteins in the myocardium. This detection can be made invasively or noninvasively and is based on a tentative diagnosis that forms the foundation for further diagnostic measures. As different forms of amyloidosis may have different clinical presentations, suspicion of amyloidosis is often difficult. As not only the diagnostic possibilities have become broader but also new therapeutic possibilities have been tested in clinical studies, the working group on myocardial and pericardial diseases of the European Society of Cardiology (ESC) has set up a working group of experts to compile the current data on the clinical presentation, diagnostics and treatment of patients with cardiac amyloidosis, in order to subsequently develop diagnostic criteria and treatment options for patients with different forms of cardiac amyloidosis by consensus. The aim was to formulate a uniform Europe-wide acceptable concept for essential diagnostics and treatment for this group of patients. Only this will create the foundation for national and international registers and double-blind randomized treatment studies.

摘要

心脏淀粉样变性仍被认为是一种罕见疾病,尽管最近的数据显示,它导致心脏功能障碍的频率比预期更高。心脏淀粉样变性的诊断基于检测心肌中错误折叠蛋白的细胞外沉积物。这种检测可以通过侵入性或非侵入性方式进行,并且基于初步诊断,该初步诊断构成进一步诊断措施的基础。由于不同形式的淀粉样变性可能有不同的临床表现,因此对淀粉样变性的怀疑往往很困难。不仅诊断可能性变得更广泛,而且新的治疗可能性也已在临床研究中得到检验,欧洲心脏病学会(ESC)心肌和心包疾病工作组已成立一个专家工作组,以汇编有关心脏淀粉样变性患者临床表现、诊断和治疗的当前数据,以便随后通过共识制定针对不同形式心脏淀粉样变性患者的诊断标准和治疗方案。目的是为这组患者制定一个全欧洲范围内可接受的基本诊断和治疗统一概念。只有这样才能为国家和国际登记册以及双盲随机治疗研究奠定基础。

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