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超越肌节性肥厚型心肌病:如何诊断和处理表型模拟。

Beyond Sarcomeric Hypertrophic Cardiomyopathy: How to Diagnose and Manage Phenocopies.

作者信息

Pieroni Maurizio, Ciabatti Michele, Saletti Elisa, Tavanti Valentina, Santangeli Pasquale, Martinese Lucia, Liistro Francesco, Olivotto Iacopo, Bolognese Leonardo

机构信息

Cardiovascular Department, San Donato Hospital, Via Pietro Nenni 22, 52100, Arezzo, Italy.

Radiology Department, San Donato Hospital, Arezzo, Italy.

出版信息

Curr Cardiol Rep. 2022 Nov;24(11):1567-1585. doi: 10.1007/s11886-022-01778-2. Epub 2022 Sep 2.

Abstract

PURPOSE OF REVIEW

We describe the most common phenocopies of hypertrophic cardiomyopathy, their pathogenesis, and clinical presentation highlighting similarities and differences. We also suggest a step-by-step diagnostic work-up that can guide in differential diagnosis and management.

RECENT FINDINGS

In the last years, a wider application of genetic testing and the advances in cardiac imaging have significantly changed the diagnostic approach to HCM phenocopies. Different prognosis and management, with an increasing availability of disease-specific therapies, make differential diagnosis mandatory. The HCM phenotype can be the cardiac manifestation of different inherited and acquired disorders presenting different etiology, prognosis, and treatment. Differential diagnosis requires a cardiomyopathic mindset allowing to recognize red flags throughout the diagnostic work-up starting from clinical and family history and ending with advanced imaging and genetic testing. Different prognosis and management, with an increasing availability of disease-specific therapies make differential diagnosis mandatory.

摘要

综述目的

我们描述肥厚型心肌病最常见的拟表型、其发病机制及临床表现,突出异同点。我们还提出了一个逐步的诊断检查方法,可用于指导鉴别诊断和管理。

最新发现

近年来,基因检测的更广泛应用以及心脏成像技术的进步显著改变了对肥厚型心肌病拟表型的诊断方法。不同的预后和管理,以及针对特定疾病疗法的日益增多,使得鉴别诊断成为必要。肥厚型心肌病表型可能是不同遗传和获得性疾病的心脏表现,这些疾病具有不同的病因、预后和治疗方法。鉴别诊断需要一种心肌病思维模式,以便在从临床和家族史开始到先进成像和基因检测结束的整个诊断检查过程中识别警示信号。不同的预后和管理,以及针对特定疾病疗法的日益增多,使得鉴别诊断成为必要。

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