-
摘要: 结节病是一类多系统受累的肉芽肿性疾病,心脏结节病是结节病的心脏表现,常表现为心脏传导阻滞、心律失常、心力衰竭及心脏猝死。心脏猝死是导致心脏结节病患者死亡的重要原因。认识该类疾病的机制和危险分层有助于早期诊断和预防心脏猝死。本文结合国内研究进展,阐述心脏结节病的流行病学、临床特征、辅助检查及心脏猝死的危险分层,为临床医生能够更好地认识心脏结节病而有效避免心脏猝死的发生提供参考。Abstract: Sarcoidosis is a granulomatous disease with multiple system involvement.Cardiac sarcoidosis,a kind of sarcoidosis involving the heart,may clinically manifest as cardiac conduction block,arrhythmia,heart failure, and sudden cardiac death.Sudden cardiac death,which is a significant cause of death in cardiac sarcoidosis,can be prevented by previously diagnosis and treatment of cardiac sarcoidosis,so it's necessary to figure out the underlying mechanisms and risk stratification of sudden cardiac death in cardiac sarcoidosis.Combined with domestic research,this article reviews the epidemiology,clinical characteristics,auxiliary examination of cardiac sarcoidosis as well as the risk stratification and assessment of sudden cardiac death,aiming at helping doctors to better understand cardiac sarcoidosis and effectively manage the occurrence of sudden cardiac death in cardiac sarcoidosis.
-
Key words:
- cardiac sarcoidosis /
- sudden cardiac death
-
[1] Valeyre D,Prasse A,Nunes H,et al.Sarcoidosis[J].Lancet,2014,383(9923):1155-1167.
[2] 汪小鹏,赵妍妍,黎春艳,等.1303例肺结节病临床荟萃分析[J].现代中西医结合杂志,2013,22(18):2009-2011.
[3] Muchtar E,Blauwet LA,Gertz MA.Restrictive cardiomyopathy:genetics,pathogenesis,clinical manifestations,diagnosis,and therapy[J].Circ Res,2017,121(7):819-837.
[4] Webb M,Conway KS,Ishikawa M,et al.Cardiac involvement in sarcoidosis deaths in wayne county,michigan:a 20-year retrospective study[J].Acad Forensic Pathol,2018,8(3):718-728.
[5] Kandolin R,Lehtonen J,Airaksinen J,et al.Cardiac sarcoidosis:epidemiology,characteristics,and outcome over 25 years in a nationwide study[J].Circulation,2015,131(7):624-632.
[6] Ekstrom K,Lehtonen J,Nordenswan HK,et al.Sudden death in cardiac sarcoidosis:an analysis of nationwide clinical and cause-of-death registries[J].Eur Heart J,2019,40(37):3121-3128.
[7] 崔会娣,郭立琳,刘永太.35例心脏结节病患者临床分析[J].北京医学,2011,33(1):18-20.
[8] 杨德彦,陈太波,方全.结节病心脏损害80例临床分析[J].临床内科杂志,2009,26(8):530-532.
[9] 王翔飞,吴鸿谊,王齐兵,等.表现为房室传导阻滞的心脏结节病一例[J].中华心血管病杂志,2010,38(3):274.
[10] Yazaki Y,Isobe M,Hiroe M,et al.Prognostic determinants of long-term survival in Japanese patients with cardiac sarcoidosis treated with prednisone[J].Am J Cardiol,2001,88(9):1006-1010.
[11] Iwai K,Tachibana T,Takemura T,et al.Pathological studies on sarcoidosis autopsy.I.Epidemiological features of 320 cases in Japan[J].Acta Pathol Jpn,1993,43(7-8):372-376.
[12] Birnie DH,Nery PB,Ha AC,et al.Cardiac Sarcoidosis[J].J Am Coll Cardiol,2016,68(4):411-421.
[13] Zipse MM,Sauer WH.Cardiac sarcoidosis and consequent arrhythmias[J].Card Electrophysiol Clin,2015,7(2):235-249.
[14] Viles-Gonzalez JF,Pastori L,Fischer A,et al.Supraventricular arrhythmias in patients with cardiac sarcoidosis prevalence,predictors,and clinical implications[J].Chest,2013,143(4):1085-1090.
[15] Sayah DM,Bradfield JS,Moriarty JM,et al.Cardiac involvement in sarcoidosis:evolving concepts in diagnosis and treatment[J].Semin Respir Crit Care Med,2017,38(4):477-498.
[16] Zipse MM,Sauer WH.Cardiac sarcoidosis[J].Curr Cardiol Rep,2014,16(8):514.
[17] Roberts WC,Mcallister HJ,Ferrans VJ.Sarcoidosis of the heart.A clinicopathologic study of 35 necropsy patients (group 1) and review of 78 previously described necropsy patients (group 11)[J].Am J Med,1977,63(1):86-108.
[18] Birnie DH,Sauer WH,Bogun F,et al.HRS expert consensus statement on the diagnosis and management of arrhythmias associated with cardiac sarcoidosis[J].Heart Rhythm,2014,11(7):1305-1323.
[19] Serei VD,Fyfe B.The many faces of cardiac sarcoidosis[J].Am J Clin Pathol,2020,153(3):294-302.
[20] Kron J,Sauer W,Schuller J,et al.Efficacy and safety of implantable cardiac defibrillators for treatment of ventricular arrhythmias in patients with cardiac sarcoidosis[J].Europace,2013,15(3):347-354.
[21] Coleman GC,Shaw PW,Balfour PJ,et al.Prognostic value of myocardial scarring on CMR in patients with cardiac sarcoidosis[J].JACC Cardiovasc Imaging,2017,10(4):411-420.
[22] Murtagh G,Laffin LJ,Beshai JF,et al.Prognosis of myocardial damage in sarcoidosis patients with preserved left ventricular ejection fraction:risk stratification using cardiovascular magnetic resonance[J].Circ Cardiovasc Imaging,2016,9(1):e3738.
[23] Blankstein R,Osborne M,Naya M,et al.Cardiac positron emission tomography enhances prognostic assessments of patients with suspected cardiac sarcoidosis[J].J Am Coll Cardiol,2014,63(4):329-336.
[24] Wicks EC,Menezes LJ,Barnes A,et al.Diagnostic accuracy and prognostic value of simultaneous hybrid 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging in cardiac sarcoidosis[J].Eur Heart J Cardiovasc Imaging,2018,19(7):757-767.
[25] Zipse MM,Tzou WS,Schuller JL,et al.Electrophysiologic testing for diagnostic evaluation and risk stratification in patients with suspected cardiac sarcoidosis with preserved left and right ventricular systolic function[J].J Cardiovasc Electrophysiol,2019,30(10):1939-1948.
计量
- 文章访问数: 91
- PDF下载数: 28
- 施引文献: 0