心律失常和猝死:肥厚性心肌病有什么新发现?

IF 4.2 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Cardiac Failure Review Pub Date : 2025-04-01 eCollection Date: 2025-01-01 DOI:10.15420/cfr.2024.38
Deepthi Rajan, Christopher Ryan Zörner, Morten Lock Hansen, Jacob Tfelt-Hansen
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引用次数: 0

摘要

肥厚性心肌病(HCM)是一种复杂的遗传性疾病,由于其多种表现,包括心律失常和心源性猝死的高风险,引起了人们的广泛关注。精确诊断的进步,如基因检测和晚期钆增强心脏成像,已经改进了HCM的诊断,使有针对性的治疗和风险分层方法成为可能。房颤在HCM中普遍存在,加剧了症状和卒中风险,而室性心律失常则对生存构成直接威胁。导管消融可以缓解房颤合并HCM患者的症状,但由于独特的心肌改变,复发率仍然很高,因此需要精细的患者选择和长期监测。HCM的心源性猝死风险,特别是在年轻人中,强调了精确的风险分层工具的重要性,如欧洲心脏病学会HCM - scd模型。icd和包括肌球蛋白抑制剂在内的新兴药理学药物作用的扩大,标志着HCM向更个性化管理的转变。这篇综述整合了心律失常管理、靶向治疗和风险评估的最新进展,提供了一个全面的视角来定制HCM,通过精确医学透镜来改善临床结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Arrhythmias and Sudden Death: What is New in Hypertrophic Cardiomyopathy?

Hypertrophic cardiomyopathy (HCM) is a complex genetic disorder that has garnered significant attention because of its diverse manifestations, including arrhythmias and heightened risk of sudden cardiac death. Advances in precision diagnostics, such as genetic testing and cardiac imaging with late gadolinium enhancement, have refined HCM diagnosis, enabling targeted therapeutic and risk stratification approaches. AF, prevalent in HCM, exacerbates symptoms and stroke risk, while ventricular arrhythmias pose a direct threat to survival. Catheter ablation offers symptom relief in AF patients with HCM, yet recurrence remains high because of unique myocardial changes, highlighting the need for refined patient selection and long-term monitoring. The risk of sudden cardiac death in HCM, particularly in younger individuals, underscores the importance of precise risk stratification tools such as the European Society of Cardiology HCM Risk-SCD model. The expanding role of ICDs and emerging pharmacological agents, including myosin inhibitors, marks a shift toward more individualised management of HCM. This review integrates recent developments in arrhythmia management, targeted therapies and risk assessment, offering a comprehensive perspective on HCM tailored to improve clinical outcomes through a precision-medicine lens.

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来源期刊
CiteScore
5.60
自引率
0.00%
发文量
31
审稿时长
9 weeks
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