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两种罕见神经肌肉疾病的心脏受累:LAMA2 相关肌营养不良症和 SELENON 相关肌病。

Cardiac involvement in two rare neuromuscular diseases: LAMA2-related muscular dystrophy and SELENON-related myopathy.

机构信息

Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, the Netherlands; Department of Pediatric Neurology, Donders Institute for Brain, Cognition and Behaviour, Amalia Children's Hospital, Radboud university medical center, Nijmegen, the Netherlands.

Department of Cardiology, Radboud university medical center, Nijmegen, the Netherlands.

出版信息

Neuromuscul Disord. 2022 Aug;32(8):635-642. doi: 10.1016/j.nmd.2022.06.004. Epub 2022 Jun 23.

Abstract

LAMA2-related muscular dystrophy (LAMA2-MD) and SELENON(SEPN1)-related myopathy (SELENON-RM) are rare neuromuscular diseases caused by mutations in the LAMA2 and SELENON (SEPN1) gene, respectively. Systematic reviews on cardiac features in both neuromuscular diseases are lacking. This scoping review aims to elucidate the cardiac involvement in LAMA2-MD or SELENON-RM. Three electronic databases (PubMed, Embase and Cochrane) were searched. All studies, case reports and case series with information on cardiac features in LAMA2-MD or SELENON-RM patients were included. Study selection and data extraction were performed by two independent reviewers. 31 Articles on LAMA2-MD and 17 articles on SELENON-RM met the inclusion criteria, resulting in the inclusion of 131 LAMA2-MD and 192 SELENON-RM cases. In 41% of LAMA2-RM cases, a cardiac abnormality was present. Left ventricular systolic dysfunction and arrhythmia were most frequently described. In 15% of SELENON-RM cases, a cardiac abnormality was reported, of which pulmonary hypertension, including right ventricular dysfunction secondary to pulmonary failure, was most prevalent. We conclude that in LAMA2-MD primary left ventricular dysfunction and in SELENON-RM secondary right ventricular dysfunction are frequently reported. Optimal cardiorespiratory surveillance by screening of asymptomatic patients every two years with ECG, Holter and echocardiography is necessary for early detection and/or treatment of cardiac manifestations.

摘要

肌营养不良蛋白 2 相关肌病(LAMA2-MD)和硒蛋白 N 相关肌病(SELENON-RM)是由 LAMA2 和 SELENON(SEPN1)基因突变引起的罕见神经肌肉疾病。系统评价中缺乏这两种神经肌肉疾病的心脏特征。本范围综述旨在阐明 LAMA2-MD 或 SELENON-RM 的心脏受累情况。检索了三个电子数据库(PubMed、Embase 和 Cochrane)。纳入了所有关于 LAMA2-MD 或 SELENON-RM 患者心脏特征的研究报告、病例报告和病例系列。由两名独立的审查员进行研究选择和数据提取。符合 LAMA2-MD 纳入标准的文章有 31 篇,符合 SELENON-RM 纳入标准的文章有 17 篇,共纳入 131 例 LAMA2-MD 和 192 例 SELENON-RM 病例。在 41%的 LAMA2-MD 病例中存在心脏异常。左心室收缩功能障碍和心律失常最为常见。在 15%的 SELENON-RM 病例中报告了心脏异常,其中肺动脉高压,包括因肺衰竭引起的右心室功能障碍,最为常见。我们的结论是,在 LAMA2-MD 中,主要表现为左心室功能障碍,而在 SELENON-RM 中,主要表现为继发性右心室功能障碍。通过每两年对无症状患者进行心电图、动态心电图和超声心动图筛查,进行最佳的心肺监测,对于早期发现和/或治疗心脏表现是必要的。

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