Eur J Heart Fail:肌营养不良蛋白相关扩张型心肌病的患病率和临床结局

2021-06-22 MedSci原创 MedSci原创

没有严重骨骼肌病的DMD相关的DCM患者特征是不完全外显但MACE风险高,包括进展为终末期心力衰竭和室性心律失常。无论是否伴有骨骼肌病,DCM发作是患者预后的主要决定因素,具有相似的生存率。

在患有轻度或无骨骼肌病的个体中,与肌营养不良蛋白基因 (DMD) 突变相关的扩张型心肌病 (DCM) 通常与其他DCM类型无法区分。

近日,血管领域权威杂志European Journal of Heart Failure上发表了一篇研究文章,研究人员试图描述没有严重骨骼肌病的DMD突变携带者中DMD相关的DCM表型和预后。

在26个欧洲中心,研究人员回顾性地收集了223名DMD突变携带者(83%为男性,33±15岁)的临床特征和结局。

生存率

中位随访96个月(四分位距为5-311个月),该研究共有112人(52%) 在第一次评估时患有DCM[n=85; 左心室射血分数 (LVEF)为34±11.2%]或发展为DCM(n=27;LVEF为41.3±7.5%)。40岁以上携带者的DCM外显率为45%。DCM在男性患者中出现较早,并且与突变类型、骨骼肌病的有无或血清肌酸激酶水平升高无关。22%的DCM患者发生了主要不良心脏事件(MACE),18%的患者发生了终末期心力衰竭,9%的患者发生了心源性猝死或类似事件。骨骼肌病与DCM患者的无MACE生存率无关。基线时LVEF降低和左心室舒张末期直径增加与MACE相关。没有DCM的个体在随访期间未发生MACE或死亡的情况下具有良好的预后。

由此可见,没有严重骨骼肌病的DMD相关的DCM患者特征是不完全外显但MACE风险高,包括进展为终末期心力衰竭和室性心律失常。无论是否伴有骨骼肌病,DCM发作是患者预后的主要决定因素,具有相似的生存率。

原始出处:

Maria A. Restrepo-Cordoba.et al.Prevalence and clinical outcomes of dystrophin-associated dilated cardiomyopathy without severe skeletal myopathy.European journal of heart failure.2021.https://onlinelibrary.wiley.com/doi/10.1002/ejhf.2250

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    2021-10-08 lsj637
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objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201203/23c7fab364194717836769d96a50cdde/783e78a2b4a4410c9dae7e959ba1c77c.jpg, createdBy=1efd2552192, createdName=福尔摩妮, createdTime=Tue Jun 22 17:49:52 CST 2021, time=2021-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=975757, encodeId=fed39e5757c3, content=好文章,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Tue Jun 22 11:00:03 CST 2021, time=2021-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=975733, encodeId=3e659e57330d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b995530949, createdName=ms8000001831385076, createdTime=Tue Jun 22 09:51:04 CST 2021, time=2021-06-22, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1737090, encodeId=b36b1e3709061, content=<a href='/topic/show?id=6ee1810e0ad' target=_blank style='color:#2F92EE;'>#肌营养不良#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81070, encryptionId=6ee1810e0ad, topicName=肌营养不良)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cd6034244098, createdName=751943081_32627960, createdTime=Tue Jul 06 11:04:25 CST 2021, time=2021-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1684871, encodeId=e8ac16848e1b1, content=<a href='/topic/show?id=794754e74f4' target=_blank style='color:#2F92EE;'>#扩张#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54774, encryptionId=794754e74f4, topicName=扩张)], attachment=null, authenticateStatus=null, createdAvatar=null, 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objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201203/23c7fab364194717836769d96a50cdde/783e78a2b4a4410c9dae7e959ba1c77c.jpg, createdBy=1efd2552192, createdName=福尔摩妮, createdTime=Tue Jun 22 17:49:52 CST 2021, time=2021-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=975757, encodeId=fed39e5757c3, content=好文章,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Tue Jun 22 11:00:03 CST 2021, time=2021-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=975733, encodeId=3e659e57330d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b995530949, createdName=ms8000001831385076, createdTime=Tue Jun 22 09:51:04 CST 2021, time=2021-06-22, status=1, ipAttribution=)]
    2021-06-23 zhaojie88
  6. [GetPortalCommentsPageByObjectIdResponse(id=1737090, encodeId=b36b1e3709061, content=<a href='/topic/show?id=6ee1810e0ad' target=_blank style='color:#2F92EE;'>#肌营养不良#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81070, encryptionId=6ee1810e0ad, topicName=肌营养不良)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cd6034244098, createdName=751943081_32627960, createdTime=Tue Jul 06 11:04:25 CST 2021, time=2021-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1684871, encodeId=e8ac16848e1b1, content=<a href='/topic/show?id=794754e74f4' target=_blank style='color:#2F92EE;'>#扩张#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54774, encryptionId=794754e74f4, topicName=扩张)], attachment=null, authenticateStatus=null, createdAvatar=null, 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objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201203/23c7fab364194717836769d96a50cdde/783e78a2b4a4410c9dae7e959ba1c77c.jpg, createdBy=1efd2552192, createdName=福尔摩妮, createdTime=Tue Jun 22 17:49:52 CST 2021, time=2021-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=975757, encodeId=fed39e5757c3, content=好文章,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Tue Jun 22 11:00:03 CST 2021, time=2021-06-22, status=1, ipAttribution=), 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    2021-06-23 slcumt
  7. 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objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201203/23c7fab364194717836769d96a50cdde/783e78a2b4a4410c9dae7e959ba1c77c.jpg, createdBy=1efd2552192, createdName=福尔摩妮, createdTime=Tue Jun 22 17:49:52 CST 2021, time=2021-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=975757, encodeId=fed39e5757c3, content=好文章,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Tue Jun 22 11:00:03 CST 2021, time=2021-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=975733, encodeId=3e659e57330d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b995530949, createdName=ms8000001831385076, createdTime=Tue Jun 22 09:51:04 CST 2021, time=2021-06-22, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1737090, encodeId=b36b1e3709061, content=<a href='/topic/show?id=6ee1810e0ad' target=_blank style='color:#2F92EE;'>#肌营养不良#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81070, encryptionId=6ee1810e0ad, topicName=肌营养不良)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cd6034244098, createdName=751943081_32627960, createdTime=Tue Jul 06 11:04:25 CST 2021, time=2021-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1684871, encodeId=e8ac16848e1b1, content=<a href='/topic/show?id=794754e74f4' target=_blank style='color:#2F92EE;'>#扩张#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54774, encryptionId=794754e74f4, topicName=扩张)], attachment=null, authenticateStatus=null, createdAvatar=null, 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objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201203/23c7fab364194717836769d96a50cdde/783e78a2b4a4410c9dae7e959ba1c77c.jpg, createdBy=1efd2552192, createdName=福尔摩妮, createdTime=Tue Jun 22 17:49:52 CST 2021, time=2021-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=975757, encodeId=fed39e5757c3, content=好文章,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Tue Jun 22 11:00:03 CST 2021, time=2021-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=975733, encodeId=3e659e57330d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b995530949, createdName=ms8000001831385076, createdTime=Tue Jun 22 09:51:04 CST 2021, time=2021-06-22, status=1, ipAttribution=)]
    2021-06-22 福尔摩妮

    学习了

    0

  9. 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objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201203/23c7fab364194717836769d96a50cdde/783e78a2b4a4410c9dae7e959ba1c77c.jpg, createdBy=1efd2552192, createdName=福尔摩妮, createdTime=Tue Jun 22 17:49:52 CST 2021, time=2021-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=975757, encodeId=fed39e5757c3, content=好文章,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Tue Jun 22 11:00:03 CST 2021, time=2021-06-22, status=1, ipAttribution=), 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    2021-06-22 yangchou

    好文章,谢谢分享。

    0

  10. 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    2021-06-22 ms8000001831385076

    学习

    0

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