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Brugada综合征拟表型与Brugada综合征:明确差异以实现最佳诊断与管理

Brugada phenocopy vs. Brugada syndrome: Delineating the differences for optimal diagnosis and management.

作者信息

Adytia Galih Januar, Sutanto Henry

机构信息

Internal Medicine Residency Program, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.

Internal Medicine Residency Program, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.

出版信息

Curr Probl Cardiol. 2024 Jun;49(6):102566. doi: 10.1016/j.cpcardiol.2024.102566. Epub 2024 Apr 8.

DOI:10.1016/j.cpcardiol.2024.102566
PMID:38599558
Abstract

Brugada syndrome (BrS) is a genetic disorder known for its characteristic electrocardiogram (ECG) patterns and increased risk of sudden cardiac death. Brugada phenocopy (BrP) presents similar ECG patterns but is distinguished by its reversible nature when the underlying conditions are resolved. This article delineates the intricacies of BrP, emphasizing its etiology, clinical presentation, diagnosis, treatment, and prognosis. The article categorizes BrP based on various underlying causes, including metabolic disturbances, myocardial infarction, and mechanical compression, among others. It also underscores the critical importance of differentiating BrP from BrS to avoid misdiagnosis and inappropriate treatment, such as unnecessary implantation of cardioverter-defibrillators. The reversible aspect of BrP underlines the necessity for an etiology-specific approach to treatment, which not only prevents cardiac death but also highlights the significance of understanding the dynamic nature of ECG patterns. Through an exploration of case studies and current research, this review advocates for increased awareness and further investigation into BrP. It aims to enhance the diagnostic accuracy and management strategies, thereby improving the prognosis for patients presenting with Brugada-like ECG patterns. The review culminates in a call for further research to close existing knowledge gaps and improve patient outcomes.

摘要

布加综合征(BrS)是一种遗传性疾病,以其特征性心电图(ECG)模式和心脏性猝死风险增加而闻名。布加综合征拟表型(BrP)呈现相似的心电图模式,但在潜在病因消除后具有可逆性,以此与布加综合征相区别。本文阐述了布加综合征拟表型的复杂性,重点介绍了其病因、临床表现、诊断、治疗和预后。本文根据各种潜在病因对布加综合征拟表型进行了分类,包括代谢紊乱、心肌梗死和机械压迫等。它还强调了区分布加综合征拟表型与布加综合征以避免误诊和不适当治疗(如不必要地植入心脏复律除颤器)的至关重要性。布加综合征拟表型的可逆性强调了针对病因进行特异性治疗的必要性,这不仅能预防心脏性猝死,还凸显了理解心电图模式动态性质的重要性。通过对病例研究和当前研究的探索,本综述倡导提高对布加综合征拟表型的认识并进一步开展研究。其目的是提高诊断准确性和管理策略,从而改善呈现布加综合征样心电图模式患者的预后。本综述最后呼吁进一步研究以填补现有知识空白并改善患者结局。

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