Andrzej Osiecki, Diana Wiligórska, Małgorzata Kołos, Agnieszka Pawlak
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引用次数: 0
摘要
病毒性心脏病包括由病毒感染引发的两种心血管疾病:急性病毒性心肌炎和病毒性心肌病。病毒性心肌炎可完全缓解,不留任何痕迹,也可引起持续炎症,继而发展为动力不足性扩张型/非扩张型心肌病。由于病毒性心肌炎有时无症状,因此其确切的流行病学仍不清楚,但根据《2019 年全球疾病负担研究》(Global Burden of Disease Study 2019),青壮年心肌炎的发病率估计为男性每 10 万人中有 6.1 人,女性每 10 万人中有 4.4 人,最常见的病因是病毒。根据文献记载,在特发性左心室功能障碍患者的心内膜活检标本中,病毒基因组可占相当大的比例(高达 67.4%),这表明心肌病的病因是病毒。在这篇综述中,我们将介绍最常见的心律失常和传导障碍类型及其在病毒性心脏病患者中的发病率。此外,本文还描述了病毒在急性病毒感染和慢性病毒性疾病中诱发心律失常和心脏传导系统疾病的可能病理机制。我们还希望强调在急性心肌炎过程中保护猝死的未决问题。
Arrhythmias and conduction disorders in patients with viral heart disease.
Viral heart disease comprises of two cardiovascular entities being evoked by viral infection: acute viral myocarditis and viral cardiomyopathy. Viral myocarditis may completely resolve leaving no traceable sign or cause ongoing inflammation with subsequent development of hypokinetic dilated/non-dilated cardiomyopathy. The exact epidemiology of viral myocarditis remains unknown due to its sometimes asymptomatic course, but according to the Global Burden of Disease Study 2019, the prevalence of myocarditis in young adults is estimated to range between 6.1 per 100,000 in men and 4.4 per 100,000 in women, with the most common viral etiology. According to the literature viral genome can be found in considerable percentage (up to 67,4%) of endomyocardial biopsy specimens obtained from patients with idiopathic left ventricular dysfunction- suggesting viral etiology of the cardiomyopathy. In this review we would like to enlighten most common types of arrhythmias and conduction disorders as well as their prevalence in patients with viral heart disease. Moreover, our paper depicts probable pathological mechanisms in which viruses induce arrhythmias and cardiac conduction system disease in both, acute viral infection and chronic viral disease. We would also like to highlight unresolved problem of sudden death protection in the course of acute myocarditis.