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心脏离子通道病:临床诊断与前景广阔的治疗方法

Cardiac Channelopathies: Clinical Diagnosis and Promising Therapeutics.

作者信息

Nehme Ryan Dib, Sinno Lilas, Shouman Wael, Ziade Joanna A, Ammar Lama A, Amin Ghadir, Booz George W, Zouein Fouad A

机构信息

Department of Pharmacology and Toxicology American University of Beirut Faculty of Medicine Beirut Lebanon.

The Cardiovascular, Renal, and Metabolic Diseases Research Center of Excellence American University of Beirut Medical Center Beirut Lebanon.

出版信息

J Am Heart Assoc. 2025 May 6;14(9):e040072. doi: 10.1161/JAHA.124.040072. Epub 2025 Apr 25.

Abstract

Cardiac channelopathies, also known as primary electrical heart diseases, are inherited genetic abnormalities of cardiomyocyte electrical behavior. Notable for their absence of structural heart diseases, they include a diverse group of diseases such as long QT syndrome, short QT syndrome, Brugada syndrome, early repolarization syndrome, catecholaminergic polymorphic ventricular tachycardia, and idiopathic ventricular fibrillation, and carry the risk of malignant arrhythmias leading to sudden cardiac death. The genetic and molecular foundations of these diseases are diverse and complex, with evolving research highlighting the multifactorial nature of their pathophysiology and the intricate interplay of various genes in the manifestation of arrhythmias. While advances in diagnostic techniques, such as genetic testing and electrophysiological studies, have improved the identification and management of these conditions, the relationship between specific genetic mutations and sudden cardiac death remains incompletely understood. This review provides an overview of the molecular and genetic mechanisms underlying those inherited arrhythmias, exploring both well-established and emerging data. Additionally, it discusses current diagnostic approaches and management strategies, aiming to enhance the understanding of these conditions and contribute to better sudden cardiac death prevention.

摘要

心脏离子通道病,也被称为原发性心脏电疾病,是心肌细胞电活动的遗传性基因异常。其显著特点是没有结构性心脏病,包括多种疾病,如长QT综合征、短QT综合征、Brugada综合征、早期复极综合征、儿茶酚胺能多形性室性心动过速和特发性室颤,并伴有恶性心律失常导致心源性猝死的风险。这些疾病的遗传和分子基础多样且复杂,不断发展的研究突出了其病理生理学的多因素性质以及各种基因在心律失常表现中的复杂相互作用。虽然诊断技术的进步,如基因检测和电生理研究,改善了对这些疾病的识别和管理,但特定基因突变与心源性猝死之间的关系仍未完全理解。本综述概述了这些遗传性心律失常的分子和遗传机制,探讨了既定和新出现的数据。此外,还讨论了当前的诊断方法和管理策略,旨在增进对这些疾病的理解,并有助于更好地预防心源性猝死。

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