耳前巨细胞心肌炎:一个独特的临床病理学实体
Brandon T Larsen1, Joseph J Maleszewski, William D Edwards
1Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
Circulation
|November 28, 2012
概括
巨细胞心肌炎 (GCM) 可以影响心房,呈现与典型的腹腔心肌炎不同. 这种心房变异显示出更有利的预后和明显的临床特征.
科学领域:
- 心脏病学 心脏病学
- 病理学 病理学 病理学
- 免疫学 免疫学 免疫学
背景情况:
- 巨细胞心肌炎 (GCM) 通常呈现为爆发性心力衰竭,需要积极治疗.
- 已经确定了一种新的GCM变体,主要影响着心房.
- 这种心房GCM变体表现出明显的临床特征和更良性的临床过程.
研究的目的:
- 描述一种新型巨细胞心肌炎 (GCM) 的临床病理特征,主要影响着心房.
- 根据临床表现,成像和组织学来区分这种心房GCM与经典的心室GCM.
- 评估被诊断为心房GCM的患者的临床过程和结果.
主要方法:
- 在2010年至2012年期间,对6名被诊断患有心房GCM的患者进行了回顾性审查.
- 从手术切除的心房组织中分析临床病史,心声学和组织病理学发现.
- 对治疗策略和患者随访数据的评估.
主要成果:
- 患者出现心房动,心力衰竭,或在尸检中偶然发现.
- 心声扫描显示了严重的心房扩张,心交/三腹吐和心房壁异常,心室功能得到保护.
- 组织学显示巨细胞和淋巴细胞透,心肌细胞缩/过度缩,纤维化和颗粒瘤.
结论:
- 心房GCM是一个独特的临床病理学实体,预后比心室GCM更有利.
- 这种情况应在心房扩张的差异诊断中考虑,特别是伴随着心房壁加厚的情况.
- 对心房GCM免疫调节疗法的疗效需要进一步研究.
相关概念视频
Myocarditis I: Introduction
647
Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
647
Myocarditis II: Clinical Features and Diagnostic Tests
496
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
496
Cardiomyopathy I: Introduction and Classification
828
Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
828
Cardiomyopathy II: Dilated Cardiomyopathy
798
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
798
Cardiomyopathy III: Hypertrophic Cardiomyopathy
810
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
810
Cardiomyopathy IV: Restrictive Cardiomyopathy
957
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
957


