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心肌病与心源性猝死:将临床实践与前沿研究相衔接

Cardiomyopathy and Sudden Cardiac Death: Bridging Clinical Practice with Cutting-Edge Research.

作者信息

Mistrulli Raffaella, Ferrera Armando, Salerno Luigi, Vannini Federico, Guida Leonardo, Corradetti Sara, Addeo Lucio, Valcher Stefano, Di Gioia Giuseppe, Spera Francesco Raffaele, Tocci Giuliano, Barbato Emanuele

机构信息

Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00189 Rome, Italy.

OLV Hospital Aalst, 9300 Aalst, Belgium.

出版信息

Biomedicines. 2024 Jul 18;12(7):1602. doi: 10.3390/biomedicines12071602.

Abstract

Sudden cardiac death (SCD) prevention in cardiomyopathies such as hypertrophic (HCM), dilated (DCM), non-dilated left ventricular (NDLCM), and arrhythmogenic right ventricular cardiomyopathy (ARVC) remains a crucial but complex clinical challenge, especially among younger populations. Accurate risk stratification is hampered by the variability in phenotypic expression and genetic heterogeneity inherent in these conditions. This article explores the multifaceted strategies for preventing SCD across a spectrum of cardiomyopathies and emphasizes the integration of clinical evaluations, genetic insights, and advanced imaging techniques such as cardiac magnetic resonance (CMR) in assessing SCD risks. Advanced imaging, particularly CMR, not only enhances our understanding of myocardial architecture but also serves as a cornerstone for identifying at-risk patients. The integration of new research findings with current practices is essential for advancing patient care and improving survival rates among those at the highest risk of SCD. This review calls for ongoing research to refine risk stratification models and enhance the predictive accuracy of both clinical and imaging techniques in the management of cardiomyopathies.

摘要

在肥厚型心肌病(HCM)、扩张型心肌病(DCM)、非扩张型左心室心肌病(NDLCM)和致心律失常性右心室心肌病(ARVC)等心肌病中预防心脏性猝死(SCD)仍然是一项关键但复杂的临床挑战,尤其是在年轻人群中。这些疾病固有的表型表达变异性和基因异质性阻碍了准确的风险分层。本文探讨了在一系列心肌病中预防SCD的多方面策略,并强调在评估SCD风险时将临床评估、基因见解和心脏磁共振成像(CMR)等先进成像技术相结合。先进成像技术,特别是CMR,不仅能增强我们对心肌结构的理解,还能作为识别高危患者的基石。将新的研究结果与当前实践相结合对于推进患者护理和提高SCD高危人群的生存率至关重要。本综述呼吁持续开展研究,以完善风险分层模型,并提高临床和成像技术在心肌病管理中的预测准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f15/11275154/42378b15b6d3/biomedicines-12-01602-g001.jpg

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