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肥厚型心肌病。

Hypertrophic Cardiomyopathy.

机构信息

Essex Cardiothoracic Centre, Nethermayne, Basildon, Essex SS16 5NL, UK.

Anglia Ruskin University, Chelmsford, UK.

出版信息

Curr Heart Fail Rep. 2024 Aug;21(4):428-438. doi: 10.1007/s11897-024-00654-0. Epub 2024 Mar 15.

Abstract

PURPOSE OF REVIEW

Hypertrophic cardiomyopathy (HCM) is a common inherited cardiac condition with potential for severe complications including sudden cardiac death. Early diagnosis allows appropriate risk stratification and prompt intervention to minimise the potential for adverse outcomes. The implications of poorly coordinated screening are significant, either missing relatives at high-risk or burdening low-risk individuals with a diagnosis associated with reduced life expectancy. We aim to guide clinicians through the diagnostic pathway through to novel treatment options. Several conditions mimic the condition, and we discuss the phenocopies and how to differentiate from HCM.

RECENT FINDINGS

We summarise the latest developments informing clinical decision making in the modern era of myosin inhibitors and future gene editing therapies. Early identification will enable prompt referral to specialist centres. A diagnostic flowchart is included, to guide the general cardiology and heart failure clinician in important decision making regarding the care of the HCM patient and importantly their relatives at risk. We have highlighted the importance of screening because genotype-positive/phenotype-negative patients are likely to have the most to gain from novel therapies.

摘要

目的综述

肥厚型心肌病(HCM)是一种常见的遗传性心脏病,有发生严重并发症的可能,包括心源性猝死。早期诊断可以进行适当的风险分层,并及时进行干预,以最大限度地减少不良后果的发生。筛查工作协调不力的后果很严重,要么会漏掉高风险的亲属,要么会给低风险的个体带来与预期寿命缩短相关的诊断负担。我们旨在为临床医生提供从诊断途径到新型治疗选择的指导。有几种情况会模仿这种情况,我们讨论了类同表现,并探讨了如何将其与 HCM 区分开来。

最新发现

我们总结了最新的研究进展,为肌球蛋白抑制剂和未来基因编辑治疗的现代时代的临床决策提供信息。早期发现将能够促使患者及时转至专科中心。本文还包括一个诊断流程图,以指导一般心内科和心力衰竭临床医生在管理 HCM 患者及其高危亲属的重要决策中做出正确决策。我们强调了筛查的重要性,因为基因型阳性/表型阴性的患者可能从新型疗法中获益最大。

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