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弥合心脏质量诊断的差距:先进成像、基因关联和生物标志物。

Bridging the gap in cardiac mass diagnosis: Advanced imaging, genetic associations, and biomarkers.

作者信息

Loh Yi-Hao, Hong Xu-Lin

机构信息

School of Medicine, School of Medicine, Zhejiang University, China, Hangzhou 310000, Zhejiang Province, China.

Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310000, Zhejiang Province, China.

出版信息

World J Clin Cases. 2024 Aug 6;12(22):4859-4864. doi: 10.12998/wjcc.v12.i22.4859.

Abstract

In this editorial we comment on the article by Huffaker published in a recent issue of the . We focus on cardiac tumors linked to genetic syndromes and the differential diagnosis of cardiac masses. As cardiomyocytes lack the ability to actively divide, primary cardiac tumors are extremely rare across all ethnicities and age groups. Once they occur, these tumors are often associated with genetic mutations and, occasionally, genetic syndromes. This underscores the importance of considering genetic mutations and syndromes when encountering these cases. The more common growths in the heart are thrombi and vegetations, which can mimic tumors, further making the differential diagnosis challenging. Among the imaging techniques, contrast-enhanced cardiac magnetic resonance imaging has the highest sensitivity for differential diagnosis. To aid in the differential diagnosis of cardiac masses, especially thrombi, appropriate utilization of biomarkers ( D-dimer level) may provide pivotal clinical implications. Employing a multidisciplinary approach that integrates personal history, epidemiological insights, imaging findings, genetic markers, and biomarkers is therefore critical in the diagnostic process of cardiac masses.

摘要

在这篇社论中,我们对哈法克发表在最近一期《 》上的文章进行评论。我们聚焦于与遗传综合征相关的心脏肿瘤以及心脏肿块的鉴别诊断。由于心肌细胞缺乏主动分裂的能力,原发性心脏肿瘤在所有种族和年龄组中都极为罕见。一旦发生,这些肿瘤通常与基因突变相关,偶尔也与遗传综合征有关。这凸显了在遇到这些病例时考虑基因突变和综合征的重要性。心脏中较常见的病变是血栓和赘生物,它们可能会与肿瘤相似,这进一步增加了鉴别诊断的难度。在成像技术中,对比增强心脏磁共振成像在鉴别诊断方面具有最高的灵敏度。为了辅助心脏肿块的鉴别诊断,尤其是血栓,合理利用生物标志物(D - 二聚体水平)可能具有关键的临床意义。因此,采用一种综合个人病史、流行病学见解、成像结果、遗传标志物和生物标志物的多学科方法在心脏肿块的诊断过程中至关重要。

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本文引用的文献

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Genet Med. 2021 Jan;23(1):80-85. doi: 10.1038/s41436-020-00956-3. Epub 2020 Sep 7.
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Solitary neurofibroma of the heart.心脏孤立性神经纤维瘤。
J Int Med Res. 2020 Apr;48(4):300060520913170. doi: 10.1177/0300060520913170.

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