在Transthyretin Amyloid心肌病症中脑血管参与
Lukas Haider1, Lore Schrutka2, Emanuele Tommasino1
1Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria.
Journal of clinical medicine
|August 10, 2024
概括
转氨基氨基酸心肌病 (ATTR-CM) 患者在MRI上表现出显著的沉默大脑小血管疾病和区域性缺血,即使没有神经症状. 这表明需要在ATTR-CM早期进行抗凝血和MRI查.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
背景情况:
- 心内血栓形成是常见的 transthyretin amyloid心肌病 (ATTR-CM),构成血栓栓塞事件的风险.
- 在ATTR-CM患者中,无声脑梗塞和脑小血管疾病的患病率在很大程度上是未知的.
- ATTR-CM是一种进展性疾病,影响心脏和潜在的其他器官,包括大脑.
研究的目的:
- 调查ATTR-CM患者中静音脑梗塞和脑小血管疾病的存在和程度.
- 为了比较ATTR-CM患者和匹配的对照组之间的脑磁共振成像 (cMRI) 发现.
- 评估ATTR-CM中CHA2DS2-VASc得分与大脑小血管疾病之间的关联.
主要方法:
- 使用cMRI对32名ATTR-CM患者和43名CHA2DS2-VASc匹配的对照进行前性研究.
- 使用标准cMRI序列来评估结构特征和脑血管参与.
- 神经辐射学家,对临床状态,量化心脏病发作,微型血流,维乔-罗宾空间和缺口病变的盲目.
主要成果:
- 与对照组相比,ATTR-CM患者的区域性心脏病发作 (4 vs. 0) 和大脑微型出血 (1.4 vs. 0.3) 的数量更高.
- 此外,ATTR-CM患者也显示出更多的Virchow-Robin空间 (43.8对20.6) 和更高的腔病变存在的趋势 (6对2).
- CHA2DS2-VASc评分,心房动或抗凝状态并没有显著影响区域或缺口病变的可能性.
结论:
- 在ATTR-CM患者中,大脑MRI揭示了显著的,以前未报告的小血管疾病和局部缺血,即使是没有明显神经症状的患者.
- 这些发现表明,ATTR-CM与较高的脑血管疾病负担有关.
- 这些结果支持在ATTR-CM患者中考虑较低的抗凝血值和cMRI查.
相关概念视频
Myocarditis I: Introduction
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...
Cardiomyopathy I: Introduction and Classification
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...
Cardiomyopathy II: Dilated Cardiomyopathy
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,...
Cardiomyopathy III: Hypertrophic Cardiomyopathy
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...
Cardiomyopathy IV: Restrictive Cardiomyopathy
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...
Cardiomyopathy V: Interprofessional Care
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...


