遗传因素与老年心源性猝死的相关性研究进展

Research progress on the correlation between genetic factors and sudden cardiac death in the elderly

老年人心源性猝死(SCD)定义为年龄65岁及以上患者,在出现症状后1 h内或无症状24 h内突然发生意外死亡,可能是由于心律失常或血流动力学突变所致。有发病急、进展快、死亡率高的特点。老年人心源性猝死是老年心脏疾病最严重的临床综合征,心源性猝死占整个猝死病例的80%以上,多数的老年猝死患者由于心源性猝死引起。临床对心源性猝死的检测手段主要是对家族史、个人史进行筛查,同时进行体格检查、心电图分析及超声心动图等检查,但存在针对性不强、检出率低、应用范围相对比较局限等缺点。心源性猝死也具有遗传易感性,遗传因素在心源性猝死的发生、发展中起着不可忽视的作用。现综述不同心血管疾病基础上猝死与遗传因素间的相关性,包括基因多态性在老年心源性猝死发生中的作用。

Sudden cardiac death(SCD)in the elderly is defined as a sudden accidental death in patients over 65 years of age within one hour of symptom onset or within 24 hours with no symptoms,possibly due to arrhythmia or abrupt hemodynamic changes.It is characterized by rapid onset,rapid progression,and high mortality.Sudden cardiac death in the elderly is the most serious clinical syndrome in elderly patients with heart disease.It accounts for more than 80%of all sudden death cases and is the cause of sudden death in the vast majority of elderly patients.Clinical methods for the detection of sudden cardiac death include mostly screening through family and personal history,physical examination,electrocardiogram analysis and echocardiography,but their drawbacks include lack specificity,low detection rates and relatively limited scenarios for their use.Genetic susceptibility is also responsible for sudden cardiac death.Genetic factors play an important role in the occurrence and development of sudden cardiac death.This review summarized the correlation between sudden death and genetic factors underlying different cardiovascular diseases,including the role of genetic polymorphisms in the occurrence of sudden cardiac death in older adults.