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成人左心室心肌致密化不全诊断与管理的进展及挑战:一项文献综述

Advances and challenges in the diagnosis and management of left ventricular noncompaction in adults: A literature review.

作者信息

Llerena-Velastegui Jordan, Velastegui-Zurita Sebastian, Santander-Fuentes Carolina, Dominguez-Gavilanes Daniel, Roa-Guerra Alejandra, Jesus Ana Clara Fonseca Souza de, Coelho Pedro Moraes, Carrasco-Perez Paul, Calderon-Lopez Carlos, Benitez-Gutierrez Daniela

机构信息

Pontifical Catholic University of Ecuador, Medical School, Quito, Ecuador; Center for Health Research in Latin America (CISeAL), Research Center, Quito, Ecuador.

Pontifical Catholic University of Ecuador, Medical School, Quito, Ecuador.

出版信息

Curr Probl Cardiol. 2024 Jun;49(6):102571. doi: 10.1016/j.cpcardiol.2024.102571. Epub 2024 Apr 10.

Abstract

In the realm of cardiovascular health, isolated left ventricular noncompaction (LVNC) stands out for its distinct morphological features and the clinical challenges it presents, particularly in adults. This literature review explores the intricacies of LVNC, aiming to unravel its epidemiological spread, diagnostic hurdles, and therapeutic strategies. Despite technological advancements in cardiac imaging that have improved the recognition of LVNC, a significant gap persists alongside a fragmented understanding of its pathogenesis. The studies scrutinized reveal a broad spectrum of prevalence rates influenced by diverse diagnostic tools and demographic variables. This variation underscores the complexity of accurately identifying LVNC and the resultant implications for clinical management. The review succinctly addresses the need for precise guidelines to navigate the diagnosis of LVNC and outlines the imperative for tailored clinical management approaches that cater to the wide array of patient presentations, from asymptomatic cases to those with severe cardiac dysfunction. By highlighting the critical gaps in current literature-namely the absence of standardized diagnostic criteria and a comprehensive pathogenic model-the review sets the stage for future research directions. These endeavors are essential for enhancing diagnostic accuracy, refining management protocols, and ultimately improving patient outcomes in this complex subset of cardiomyopathy, thus contributing significantly to the advancement of cardiovascular medicine.

摘要

在心血管健康领域,孤立性左心室心肌致密化不全(LVNC)因其独特的形态特征以及所带来的临床挑战而备受关注,尤其是在成人患者中。这篇文献综述探讨了LVNC的复杂性,旨在阐明其流行病学分布、诊断障碍及治疗策略。尽管心脏成像技术的进步提高了对LVNC的识别能力,但在对其发病机制的理解上仍存在重大差距且认识碎片化。经仔细研究的各项研究显示,受不同诊断工具和人口统计学变量的影响,患病率范围广泛。这种差异凸显了准确识别LVNC的复杂性以及对临床管理的影响。该综述简要阐述了制定精确指南以指导LVNC诊断的必要性,并概述了针对从无症状病例到严重心功能不全患者等各种临床表现制定个性化临床管理方法的紧迫性。通过强调当前文献中的关键差距,即缺乏标准化诊断标准和全面的发病模型,该综述为未来的研究方向奠定了基础。这些努力对于提高诊断准确性、完善管理方案以及最终改善这一复杂心肌病亚组患者的预后至关重要,从而为心血管医学的发展做出重大贡献。

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