节律失常的米特拉脱落和心脏突然死亡
Cristina Basso1, Martina Perazzolo Marra2, Stefania Rizzo2
1From Departments of Cardiac, Thoracic, and Vascular Sciences (C.B., M.P.M., S.R., M.D.L., A.C., A.C.F., I.R. F.M., K.P., E.B., L.C., B.B., D.C., G.T., S.I.) and Radiology (B.G.), Azienda Ospedaliera-University of Padua Medical School, Padua, Italy. cristina.basso@unipd.it.
Circulation
|July 11, 2015
概括
密特拉脱落 (MVP) 是年轻女性突然心脏死亡 (SCD) 的重要原因. 左心室的纤维化,特别是乳头肌肉,是与心室心律失常有关的关键结构异常.
科学领域:
- 心脏病学 心脏病学
- 心脏电生理学 心脏电生理学
- 病理学 病理学 病理学
背景情况:
- 密特拉脱落 (MVP) 可以导致心室节律失常和突然心脏死亡 (SCD),即使没有显著的血液动力学损害.
- 在MVP中这种电气不稳定的根本结构原因尚不清楚.
研究的目的:
- 调查MVP患者心室失律和SCD的结构基础.
- 为了确定MVP患者风险分层的成像生物标志物.
主要方法:
- 审查了650名患有SCD的年轻成年人的心脏病理学登记册,以确定MVP病例.
- 从MVP的SCD患者的心脏组织病理学分析.
- 对比增强心磁共振 (CE-CMR) 图像检测在活着的MVP患者中,有或没有复杂心室节律失常.
主要成果:
- 在7%的年轻人中,MVP是SCD的唯一原因,特别是女性 (13%).
- 组织学揭示了MVP的SCD患者的乳头肌肉和底壁的左心室纤维化.
- 与对照组 (14%),CE-CMR与对照组 (93%) 相比,MVP患者的晚期加多增强显著,纤维化模式重叠基因病理学.
结论:
- MVP是心律不整的SCD的一个未被认可的原因,特别是在年轻女性中.
- 左心室纤维化,特别是在乳头肌肉和底壁,是MVP的结构特征,与心室心律失常有关.
- CE-CMR可以识别这种隐藏的基质,以改善MVP患者的风险分层.
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