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扩展性心肌病的定义中的各种概念:理论和实践
Michael C Myers1, Boris Breznen2, Yue Zhong1
1Bristol Myers Squibb, Princeton, NJ, USA.
Cardiology research
|October 18, 2024
概括
扩展性心肌病 (DCM) 的定义正在不断发展,主要组织同意核心临床特征,但在分类上有所不同. 新的诊断工具有助于识别DCM的原因,并完善临床研究标准.
科学领域:
- 心脏病学 心脏病学
- 遗传学 是一个遗传学.
- 生物标志物 生物标志物
背景情况:
- 扩张性心肌病 (DCM) 的理解正随着新的病理生理学见解而不断进步.
- 专业组织正在改进DCM定义,以改善治疗.
- 本次审查重点关注已公布的DCM定义和诊断标准.
研究的目的:
- 总结有关扩张性心肌病定义和诊断标准的关键文献.
- 为了比较主要专业组织提出的定义和分类.
- 分析临床研究中的诊断工具和标准的使用情况.
主要方法:
- 从创立到2022年9月19日的Embase的文献搜索.
- 包括专业组织对DCM定义的出版物和临床研究.
- 对68个选定的记录进行分析.
主要成果:
- AHA和ESC的定义在DCM的临床表现上一致 (LV扩张,收缩功能障碍),但在心肌病的分类上有所不同.
- AHA将DCM分类为具有混合病因的初级疾病;ESC使用基于表型的分类学.
- 临床研究在很大程度上采用AHA/ESC定义,但有时使用更狭窄的标准.
- 先进的诊断工具,如心脏MRI和生物标志物,对于病因诊断至关重要.
结论:
- 关于DCM的定义正在集中在核心临床特征上,有助于诊断和研究.
- 分类中的差异凸显了不断努力改进心肌病分类的努力.
- 临床研究利用并有时改进已建立的DCM定义.
- 进一步的研究旨在进一步了解DCM病因学和自然史.
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