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围生期心肌病:病理生理学、诊断方法、治疗和结局的最新认识。

Peripartum Cardiomyopathy: Current Understanding of Pathophysiology, Diagnostic Workup, Management, and Outcomes.

机构信息

School of Medicine, New York Medical College, Valhalla, New York, NY.

School of Medicine, New York Medical College, Valhalla, New York, NY; Department of Cardiology, Westchester Medical Center, Valhalla, New York, NY.

出版信息

Curr Probl Cardiol. 2023 Aug;48(8):101716. doi: 10.1016/j.cpcardiol.2023.101716. Epub 2023 Mar 25.

Abstract

Peripartum cardiomyopathy (PPCM) is a relatively rare, potentially life-threatening, idiopathic form of cardiomyopathy that affects previously healthy young women during late pregnancy or in the early postpartum period and is characterized by left ventricular systolic dysfunction in the absence of any other identifiable cardiac causes. Morbidity and mortality with PPCM are remarkably high and it continues to be one of the leading causes of maternal death. Although remarkable advances have been made in our understanding of PPCM in the last few decades, unanswered questions remain regarding its pathophysiology, diagnostic workup, and management options. In this article, we will complete an updated, comprehensive review of PPCM, including the epidemiology and risk factors, proposed etiology, presentation and complications, management, prognostic indicators and outcomes. In addition, we will identify current challenges and gaps in knowledge.

摘要

围生期心肌病(PPCM)是一种相对罕见的、可能危及生命的、特发性扩张型心肌病,发生于妊娠晚期或产后早期,既往健康的年轻女性,以左心室收缩功能障碍为特征,且无其他可识别的心脏病因。PPCM 的发病率和死亡率都很高,它仍然是导致产妇死亡的主要原因之一。尽管在过去几十年中,我们对 PPCM 的认识取得了显著进展,但在其病理生理学、诊断检查和治疗选择方面仍存在一些尚未解决的问题。在本文中,我们将对 PPCM 进行全面、更新的综述,包括流行病学和危险因素、提出的病因、临床表现和并发症、治疗、预后指标和结局。此外,我们还将确定目前知识的挑战和差距。

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