心源性猝死的高危人群及辨识

Identification of High Risk Population in Sudden Cardiac Death

心源性猝死(SCD)是由于心血管原因引起的预料外的迅速死亡或心跳停止。由于SCD的发病率不断增加且其具有较高的致命性,因此一直是世界范围的重大公共健康问题。来自SCD幸存者的流行病学研究表明,这种快速的死亡事件常常是由于在冠状动脉硬化性心脏病时出现的致命性的室性心律失常。除了冠状动脉硬化性心脏病外,其他原因引起的室性心律失常,特别是在一些特定的人群引起的SCD也越来越多地被发现。本文阐述了可能引起SCD的基础疾病(包括常见的和少见的),强调了危险因素的发现。根据部分临床研究总结的危险因素可以提供SCD的早期预防措施,减少SCD的病死率。

Sudden cardiac death（SCD）refers to an unexpected death or arrest from a cardiovascular cause that occurs rapidly.It has been a major public health problem due to its high prevalence and fatality rate worldwide.The presumption based on epidemiologic studies of SCD survivors is that such rapid deaths are often because of lethal ventricular arrhythmias in the setting of underlying coronary heart disease（CHD）.There may be a growing fraction of SCDs where the underlying cause is not CHD or ventricular arrhythmias,particularly among certain subsets of the population.In this article,we review the broad spectrum of underlying SCD,from common to rare forms,with an emphasis on risk factors.The summary of risk factors based on clinical multiple studies are imperative and may provide new insight on early prevention of SCD and reduce the incidence of SCD.