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长QT综合征的临床诊断与管理:2022年欧洲心脏病学会指南解读

The Clinical Diagnosis and Management of Long QT Syndrome: Insights from the 2022 ESC Guidelines.

作者信息

Wang Guangqiang, Chu Hongxia, Zhao Na

机构信息

Department of Cardiology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, 264000 Yantai, Shandong, China.

Department of Rheumatology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, 264000 Yantai, Shandong, China.

出版信息

Rev Cardiovasc Med. 2023 Jun 12;24(6):170. doi: 10.31083/j.rcm2406170. eCollection 2023 Jun.

DOI:10.31083/j.rcm2406170
PMID:39077522
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11264164/
Abstract

Long QT syndrome (LQTS) is an uncommon disorder that is characterized by QT prolongation and torsade de pointes leading to sudden cardiac death. It is mainly triggered by adrenergic activation. Since LQTS is rare, it is often underdiagnosed. The updated 2022 European Society of Cardiology (ESC) guidelines aim to define the diagnosis of LQTS and spread its management. However, some unknowns and uncertainties still exist regarding the treatment of LQTS. This commentary is geared to the expansion of clinical applications of drug therapies for different subtypes of LQTS based on the 2022 ESC guidelines.

摘要

长QT综合征(LQTS)是一种罕见的疾病,其特征是QT间期延长和尖端扭转型室速,可导致心源性猝死。它主要由肾上腺素能激活引发。由于LQTS较为罕见,常常诊断不足。2022年欧洲心脏病学会(ESC)更新的指南旨在明确LQTS的诊断并推广其管理方法。然而,关于LQTS的治疗仍存在一些未知和不确定因素。本述评旨在根据2022年ESC指南扩大针对不同亚型LQTS的药物治疗的临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dc3/11264164/518f1f03be51/2153-8174-24-6-170-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dc3/11264164/518f1f03be51/2153-8174-24-6-170-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dc3/11264164/518f1f03be51/2153-8174-24-6-170-g1.jpg

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引用本文的文献

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Front Pharmacol. 2025 Mar 21;16:1535259. doi: 10.3389/fphar.2025.1535259. eCollection 2025.
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Just as the girl communicating with her mother using sign language: an electrocardiogram can convey a lot through its signals.

本文引用的文献

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2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death.2022年欧洲心脏病学会室性心律失常患者管理和心脏性猝死预防指南
Eur Heart J. 2022 Oct 21;43(40):3997-4126. doi: 10.1093/eurheartj/ehac262.
2
Mexiletine effectively prevented refractory Torsades de Pointes and ventricular fibrillation in a patient with congenital type 2 long QT syndrome.美西律有效预防了一名先天性 2 型长 QT 综合征患者的难治性尖端扭转型室性心动过速和心室颤动。
J Cardiovasc Electrophysiol. 2022 Jul;33(7):1592-1595. doi: 10.1111/jce.15517. Epub 2022 May 8.
3
Ten-year-old boy with congenital long QT syndrome type 2 (LQTS2) and life-threatening electrical storm: a case report of successful treatment with mexiletine.
就像那个用手语与母亲交流的女孩一样:心电图可以通过其信号传达很多信息。
Eur Heart J Case Rep. 2024 Mar 15;8(4):ytae132. doi: 10.1093/ehjcr/ytae132. eCollection 2024 Apr.
10 岁先天性长 QT 综合征 2 型(LQTS2)伴危及生命的电风暴患儿:美西律治疗成功 1 例报告
Cardiol Young. 2022 Nov;32(11):1871-1872. doi: 10.1017/S1047951122000774. Epub 2022 Mar 30.
4
Sodium channel blockers in the management of long QT syndrome types 3 and 2: A system review and meta-analysis.钠通道阻滞剂在长 QT 综合征 3 型和 2 型治疗中的应用:系统评价和荟萃分析。
J Cardiovasc Electrophysiol. 2021 Nov;32(11):3057-3067. doi: 10.1111/jce.15223. Epub 2021 Sep 1.
5
Mexiletine Shortened QT Interval and Reduced Ventricular Arrhythmias in a Pedigree of Type 2 Long QT Syndrome Combined with Left Ventricular Non-Compaction.美西律缩短 QT 间期并减少 2 型长 QT 综合征合并左心室致密化不全患者的室性心律失常。
Int Heart J. 2021 Mar 30;62(2):427-431. doi: 10.1536/ihj.20-518. Epub 2021 Mar 17.
6
About the different faces of mexiletine.关于美西律的不同方面。
Heart Rhythm. 2020 Nov;17(11):1951-1952. doi: 10.1016/j.hrthm.2020.06.013. Epub 2020 Jun 13.
7
Mexiletine Shortens the QT Interval in Patients With Potassium Channel-Mediated Type 2 Long QT Syndrome.美西律缩短钾通道介导的 2 型长 QT 综合征患者的 QT 间期。
Circ Arrhythm Electrophysiol. 2019 May;12(5):e007280. doi: 10.1161/CIRCEP.118.007280.
8
The role of mexiletine in the management of long QT syndrome.美西律在长QT综合征管理中的作用。
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9
Mexiletine Prevents Recurrent Torsades de Pointes in Acquired Long QT Syndrome Refractory to Conventional Measures.美西律可预防常规治疗无效的获得性长QT综合征中的复发性尖端扭转型室速。
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J Electrocardiol. 2018 Jan-Feb;51(1):111-116. doi: 10.1016/j.jelectrocard.2017.08.022. Epub 2017 Aug 17.