扩张型心肌病定义中的不同概念:理论与实践》。

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Cardiology Research Pub Date : 2024-10-01 Epub Date: 2024-09-16 DOI:10.14740/cr1679
Michael C Myers, Boris Breznen, Yue Zhong, Sonomi Maruyama, Cindy Bueno, Arnaud Bastien, Mir Sohail Fazeli, Negar Golchin
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引用次数: 0

摘要

随着人们对扩张型心肌病(DCM)的病理生理学有了新的认识,我们对它的理解也在不断发展。专业组织和临床专家正在改进 DCM 的定义,以便提出更准确的治疗建议。本综述总结了已发表的描述 DCM 定义和/或诊断标准的主要文献。从数据库建立之初到 2022 年 9 月 19 日,对 Embase 进行了检索,检索内容包括:1)主要专业组织报告 DCM 定义的出版物和相关意见书;2)DCM 和射血分数降低型心力衰竭的临床研究。本次研究共纳入 68 条记录。两大专业组织(美国心脏协会 (AHA) 和欧洲心脏病学会 (ESC))对 DCM 的定义就 DCM 的临床表现达成了一致;但是,它们在心肌病分类标准的大背景下对 DCM 的分类存在分歧。两个组织都认为,DCM 的临床定义是:在没有异常负荷条件和严重冠状动脉疾病的情况下,左心室扩张和收缩功能障碍。AHA 指南根据主要受累器官将心肌病分为两大类(原发性和继发性)。DCM 被归类为混合(遗传和/或获得性)病因的原发性心肌病。与此相反,ESC 出版了以临床为导向的分类法,将心肌病分为特定的形态和功能表型;每种表型又分为家族性和非家族性两种。评论文章进一步阐述了遗传与环境在 DCM 病因学中的复杂相互作用。多篇文章总结了新的和更新的诊断工具(如心脏磁共振成像、心电图和其他生物标记物)在正确确定 DCM 病因方面的重要性。在临床研究中,大多数纳入标准都采用了主要专业协会(AHA 和 ESC)提出的标准定义。临床研究人员有时会使用左心室射血分数阈值和左心室扩张的附加标准来缩小 DCM 的定义范围。目前心脏病学研究的重点是对 DCM 的病因和自然病史有更深入的了解。临床研究中发现的 DCM 定义主要依赖于已发布的指南,一些研究增加了特异性纳入标准,对 DCM 的广泛定义进行了细化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diverse Concepts in Definitions of Dilated Cardiomyopathy: Theory and Practice.

Our understanding of dilated cardiomyopathy (DCM) is evolving as new insights into the underlying pathophysiology become available. Professional organizations and clinical experts are improving definitions of DCM, allowing for more accurate treatment recommendations. This review summarized key published literature describing definitions and/or diagnostic criteria for DCM. Embase was searched from database inception to September 19, 2022 for 1) publications reporting definitions of DCM by major professional organizations and related opinion papers, and 2) clinical studies in DCM and heart failure with reduced ejection fraction. Sixty-eight records were included in this review. Definitions of DCM provided by two major professional organizations (American Heart Association (AHA) and European Society of Cardiology (ESC)) agreed on the clinical presentation of DCM; however, they differed in the classification of DCM within the larger context of cardiomyopathy taxonomies. Both organizations agreed that DCM could be clinically defined by the presence of left ventricular dilation and contractile dysfunction in the absence of abnormal loading conditions and severe coronary artery disease. AHA guidelines divided cardiomyopathies into two major groups (primary and secondary) based on predominant organ involvement. DCM was classified as primary cardiomyopathy with mixed (genetic and/or acquired) etiology. Conversely, ESC published a clinically oriented taxonomy in which cardiomyopathies were grouped into specific morphological and functional phenotypes; each was subclassified into familial or non-familial forms. Opinion papers further elaborated on the complex interplay between genetics and environment in the etiology of DCM. Several articles summarized the importance of the new and updated diagnostic tools, such as cardiac magnetic resonance imaging, electrocardiogram, and other biomarkers, in correctly identifying the etiology of DCM. Within clinical studies, most inclusion criteria used standard definitions proposed by leading professional associations (AHA and ESC). Clinical study investigators sometimes used a narrower definition of DCM using additional criteria for the left ventricular ejection fraction threshold value and left ventricular dilatation. Current efforts in cardiology research are focused on a more granular understanding of DCM etiology and the natural history of the disease. Definitions of DCM found in clinical studies mainly rely on published guidelines, with some studies adding idiosyncratic inclusion criteria refining the broad definitions of DCM.

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来源期刊
Cardiology Research
Cardiology Research CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.50
自引率
0.00%
发文量
42
期刊介绍: Cardiology Research is an open access, peer-reviewed, international journal. All submissions relating to basic research and clinical practice of cardiology and cardiovascular medicine are in this journal''s scope. This journal focuses on publishing original research and observations in all cardiovascular medicine aspects. Manuscript types include original article, review, case report, short communication, book review, letter to the editor.
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