Cetta F, Michels V V
Section of Pediatric Cardiology, Mayo Clinic, Rochester, MN 55905, USA.
Ann Med. 1995 Apr;27(2):169-73. doi: 10.3109/07853899509031954.
Dilated cardiomyopathy is a form of heart disease characterized by ventricular dilatation and reduced systolic function. In most patients, dilated cardiomyopathy is a sporadic disease. However, 20% of dilated cardiomyopathy patients may have a familial form of the disease. The aetiologies of both the sporadic and familial forms of dilated cardiomyopathy are unknown in most cases. Dilated cardiomyopathy has a spectrum of clinical and subclinical presentations. During the last 10 years, there have been many investigations concerning the possible aetiologic role of immune factors in dilated cardiomyopathy. It is plausible that an antecedent viral infection initiates an immunological cascade which in turn leads to production of autoimmune antibodies resulting in dilated cardiomyopathy. However, in most dilated cardiomyopathy patients, an antecedent viral infection cannot be identified. Similarly, the trail of immunological research has diverged as different groups have identified distinct autoantibodies or other immune factors in heterogeneous subsets of dilated cardiomyopathy and control patients. In this manuscript, we review the studies which have contributed supportive and confounding evidence to the theoretical autoimmune basis of dilated cardiomyopathy.
扩张型心肌病是一种以心室扩张和收缩功能降低为特征的心脏病形式。在大多数患者中，扩张型心肌病是一种散发性疾病。然而，20%的扩张型心肌病患者可能患有家族性形式的该病。在大多数情况下，散发性和家族性扩张型心肌病的病因均不明。扩张型心肌病有一系列临床和亚临床症状。在过去10年中，有许多关于免疫因素在扩张型心肌病中可能的病因学作用的研究。一种先前的病毒感染引发免疫级联反应，进而导致自身免疫抗体产生，最终导致扩张型心肌病，这似乎是合理的。然而，在大多数扩张型心肌病患者中，无法确定先前的病毒感染情况。同样，由于不同的研究小组在扩张型心肌病和对照患者的异质子集中鉴定出不同的自身抗体或其他免疫因素，免疫学研究的线索也出现了分歧。在本手稿中，我们回顾了为扩张型心肌病的理论自身免疫基础提供支持性和混淆性证据的研究。
