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从基因到临床管理:长QT综合征发病机制与治疗的全面综述

From genes to clinical management: A comprehensive review of long QT syndrome pathogenesis and treatment.

作者信息

Zhu Wenjing, Bian Xueyan, Lv Jianli

机构信息

Department of Pulmonary and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.

Department of Pediatrics, Lixia District People's Hospital, Jinan, Shandong, China.

出版信息

Heart Rhythm O2. 2024 Jul 15;5(8):573-586. doi: 10.1016/j.hroo.2024.07.006. eCollection 2024 Aug.

Abstract

BACKGROUND

Long QT syndrome (LQTS) is a rare cardiac disorder characterized by prolonged ventricular repolarization and increased risk of ventricular arrhythmias. This review summarizes current knowledge of LQTS pathogenesis and treatment strategies.

OBJECTIVES

The purpose of this study was to provide an in-depth understanding of LQTS genetic and molecular mechanisms, discuss clinical presentation and diagnosis, evaluate treatment options, and highlight future research directions.

METHODS

A systematic search of PubMed, Embase, and Cochrane Library databases was conducted to identify relevant studies published up to April 2024.

RESULTS

LQTS involves mutations in ion channel-related genes encoding cardiac ion channels, regulatory proteins, and other associated factors, leading to altered cellular electrophysiology. Acquired causes can also contribute. Diagnosis relies on clinical history, electrocardiographic findings, and genetic testing. Treatment strategies include lifestyle modifications, β-blockers, potassium channel openers, device therapy, and surgical interventions.

CONCLUSION

Advances in understanding LQTS have improved diagnosis and personalized treatment approaches. Challenges remain in risk stratification and management of certain patient subgroups. Future research should focus on developing novel pharmacological agents, refining device technologies, and conducting large-scale clinical trials. Increased awareness and education are crucial for early detection and appropriate management of LQTS.

摘要

背景

长QT综合征(LQTS)是一种罕见的心脏疾病,其特征为心室复极化延长以及室性心律失常风险增加。本综述总结了目前关于LQTS发病机制和治疗策略的知识。

目的

本研究的目的是深入了解LQTS的遗传和分子机制,讨论临床表现和诊断方法,评估治疗选择,并突出未来的研究方向。

方法

对PubMed、Embase和Cochrane图书馆数据库进行系统检索,以识别截至2024年4月发表的相关研究。

结果

LQTS涉及编码心脏离子通道、调节蛋白和其他相关因子的离子通道相关基因突变,导致细胞电生理改变。后天性原因也可能起作用。诊断依赖于临床病史、心电图检查结果和基因检测。治疗策略包括生活方式改变、β受体阻滞剂、钾通道开放剂、器械治疗和手术干预。

结论

对LQTS认识的进展改善了诊断和个性化治疗方法。在某些患者亚组的风险分层和管理方面仍存在挑战。未来的研究应侧重于开发新型药物、改进器械技术以及开展大规模临床试验。提高认识和教育对于LQTS的早期发现和恰当管理至关重要。

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本文引用的文献

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