突发心脏病死亡的未来全县监测和解剖特征:POST SCD研究
Zian H Tseng1, Jeffrey E Olgin2, Eric Vittinghoff3
1Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine (Z.H.T., J.E.O.) zhtseng@medicine.ucsf.edu.
Circulation
|June 20, 2018
概括
由于依赖于推断的原因,突然心脏死亡 (SCD) 的发生率尚不清楚. 尸体解剖显示,近一半的疑似SCD并非非心律失常,
科学领域:
- 心脏病学
- 法医病理学
- 公共卫生
背景情况:
- 由于依赖紧急医疗服务记录和死亡证明, 突然心脏死亡的发生率被低估.
- 超过90%的SCD发生在医院外,原因通常是由于尸检不频繁.
研究的目的:
- 确定大都市地区所有突发心脏病死亡的确切发病率和尸检确定的原因.
- 调查死后检查是否确实发现疑似SCD中的突然心律失常死亡.
主要方法:
- 在三年内在旧金山县对外心脏病发作死亡 (18-90岁) 的前性鉴定.
- 通过法医监测进行尸检,毒理学和组织学;应用世界卫生组织 (WHO) 的SCD标准.
- 对遗漏SCD的死亡证明进行审查,并由多学科委员会作出裁决.
主要成果:
- 在912例医院外心脏骤停中,541例 (59%) 符合世卫组织SCD标准,525例进行了尸检.
- 主要原因包括冠状动脉疾病 (32%),隐性过量服用 (13. 5%) 和心肌病 (10%).
- 尸检定义的突然心律失常死亡占世卫组织定义的SCD的55. 8%,其中98%显示结构性心脏病.
结论:
- 百分之四十的心脏病死亡不是突然发生的,也不是意想不到的.
- 这些发现挑战了世卫组织标准的准确性和SCD死亡率数据,临床试验和队列研究中的紧急医疗服务记录.
相关概念视频
Principles of Disease Surveillance
563
Disease surveillance is the systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice. This process integrates data dissemination to entities responsible for preventing and controlling disease, injury, and disability. Surveillance systems provide crucial information for action, helping public health authorities make informed decisions to manage and prevent outbreaks, ensure public safety, optimize...
563
Immune Surveillance by NK Cells and Phagocytes
8.8K
Immune surveillance is an integral part of the innate immune system, involving the continuous monitoring of peripheral tissues to detect and respond to pathogens, infected cells, or cancerous cells. This surveillance is conducted primarily by natural killer (NK) cells and phagocytes, which employ distinct but complementary mechanisms to identify and eliminate threats.
Natural Killer Cells: The Fast Responders
NK cells are large granular lymphocytes found in the blood and lymphatic system. These...
Natural Killer Cells: The Fast Responders
NK cells are large granular lymphocytes found in the blood and lymphatic system. These...
8.8K
Blood Studies for Cardiovascular System I: Cardiac Biomarkers
900
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
900
Autophagic Cell Death
4.6K
Christian de Duve discovered “autophagy,” a process in which cellular components are engulfed by membrane-bound organelles called autophagosomes. The autophagosomes then fuse with lysosomes to digest the enclosed contents. Autophagy is generally activated in cells to prevent cell death. However, cell death is triggered when the damage is beyond repair.
Autophagy and Apoptosis
Autophagy can activate apoptosis. In normal conditions, the autophagy activating protein Beclin-1 and...
Autophagy and Apoptosis
Autophagy can activate apoptosis. In normal conditions, the autophagy activating protein Beclin-1 and...
4.6K
Overview of Cell Death
10.2K
Cell death is an essential process where the body gets rid of old or damaged cells. Cell proliferation and death need to be balanced, as an imbalance between the two may lead to cancer or autoimmune diseases.
Cell death was observed in the early 19th century, but there was no experimental evidence to prove it. In 1842, Carl Vogt first discovered cell death in a metamorphic toad; however, it was not termed ‘cell death.’ Scientists discovered different cell death pathways only in the...
Cell death was observed in the early 19th century, but there was no experimental evidence to prove it. In 1842, Carl Vogt first discovered cell death in a metamorphic toad; however, it was not termed ‘cell death.’ Scientists discovered different cell death pathways only in the...
10.2K
Cardiac Output II: Effect of Stroke Volume on Cardiac Output
3.5K
Cardiac output (CO), the amount of blood the heart pumps per minute, is a parameter in cardiovascular physiology determined by stroke volume and heart rate. Stroke volume, the amount of blood pushed from one of the ventricles per heartbeat, is influenced by preload, afterload, and contractility.
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
3.5K


