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Miocardiopatía dilatada
Robert G Weintraub1, Christopher Semsarian2, Peter Macdonald3
1Department of Cardiology, Royal Children's Hospital, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
Lancet (London, England)
|February 14, 2017
Resumen
La miocardiopatía dilatada implica el agrandamiento de los ventrículos izquierdos y una mala función de bombeo, a menudo causada por factores genéticos o adquiridos. El tratamiento se centra en controlar los síntomas de la insuficiencia cardíaca y prevenir la muerte súbita.
Área de la Ciencia:
- Cardiología
- La genética
- Médico interno
Sus antecedentes:
- La miocardiopatía dilatada (DCM) se caracteriza por el agrandamiento del ventrículo izquierdo y el deterioro de la contractilidad.
- Las mutaciones genéticas (citoesqueléticas, sarcomeras, proteínas de la envoltura nuclear) causan hasta el 35% de los casos de DCM.
- Las causas adquiridas incluyen miocarditis, toxinas y problemas metabólicos / endocrinos.
Objetivo del estudio:
- Definir la miocardiopatía dilatada y describir sus causas, síntomas y estrategias de tratamiento actuales.
- Resaltar los factores de pronóstico y las investigaciones terapéuticas emergentes en DCM.
Principales métodos:
- Revisión de la literatura existente sobre la miocardiopatía dilatada.
- Análisis de las etiologías genéticas y adquiridas
- Resumen de la presentación clínica, los indicadores de diagnóstico y las intervenciones terapéuticas.
Principales resultados:
- La DCM presenta síntomas de insuficiencia cardíaca congestiva, arritmias o colapso circulatorio.
- El pronóstico está relacionado con la fracción de eyección y la gravedad de la disfunción diastólica.
- Los tratamientos estándar incluyen inhibidores de la ECA y bloqueadores beta para la insuficiencia cardíaca crónica.
Conclusiones:
- El tratamiento eficaz de la miocardiopatía dilatada implica abordar la insuficiencia cardíaca, las arritmias y el riesgo de muerte súbita.
- La atención multidisciplinaria, la terapia de dispositivos y los tratamientos avanzados como el apoyo mecánico o el trasplante son cruciales para los casos refractarios.
- La investigación en curso explora el tratamiento preclínico de la enfermedad y el papel potencial de la terapia con células madre.
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