Precision medicine in cardiac electrophysiology: where we are and where we need to go

A. Correa, S. Haider, W. Aronow
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引用次数: 0

Abstract

ABSTRACT Introduction The treatment of arrhythmias is complex and there are many options including drug therapy, ablation techniques, and implantable devices. Selection of the right treatment strategy is complicated by the fact that patients with apparently the same clinical picture may respond differently to a given therapy, indicating some underlying molecular and cellular differences. We now know this is mediated in a large part by the genetics, and patients with similar phenotypes may have differing genotypes. Understanding this genotype–phenotype relationship is key in modern medicine. Areas covered We have conducted an exhaustive review of the literature surrounding the genetic basis of arrhythmias and have presented a comprehensive summary of the available information. We have demonstrated how understanding the underlying genetic and molecular derangements in arrhythmias has resulted in effective targeted treatments. We have further highlighted novel therapies in arrhythmia management based on emerging genomic research. Expert opinion The future of cardiac electrophysiology, and indeed all cardiovascular medicine, lies in the development of targeted therapies that can effectively treat the individual patient, based on their specific genetic attributes and variations. Future genetic research which drives the development of innovative therapies holds the promise of delivering such personalized therapies in cardiac electrophysiology.
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心脏电生理学中的精准医学:我们在哪里,我们需要去哪里
摘要简介心律失常的治疗很复杂,有很多选择,包括药物治疗、消融技术和植入式设备。选择正确的治疗策略是复杂的,因为具有明显相同临床特征的患者可能对给定的治疗有不同的反应,这表明了一些潜在的分子和细胞差异。我们现在知道,这在很大程度上是由遗传学介导的,具有相似表型的患者可能具有不同的基因型。了解这种基因型-表型关系是现代医学的关键。涵盖的领域我们对心律失常遗传基础的文献进行了详尽的综述,并对现有信息进行了全面总结。我们已经证明了了解心律失常潜在的遗传和分子紊乱是如何产生有效的靶向治疗的。基于新兴的基因组研究,我们进一步强调了心律失常治疗的新疗法。专家意见心脏电生理学的未来,甚至所有心血管医学的未来,都在于开发能够根据患者的特定遗传特征和变异有效治疗患者的靶向疗法。推动创新疗法发展的未来基因研究有望在心脏电生理学中提供这种个性化疗法。
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来源期刊
CiteScore
2.30
自引率
0.00%
发文量
9
期刊介绍: Expert Review of Precision Medicine and Drug Development publishes primarily review articles covering the development and clinical application of medicine to be used in a personalized therapy setting; in addition, the journal also publishes original research and commentary-style articles. In an era where medicine is recognizing that a one-size-fits-all approach is not always appropriate, it has become necessary to identify patients responsive to treatments and treat patient populations using a tailored approach. Areas covered include: Development and application of drugs targeted to specific genotypes and populations, as well as advanced diagnostic technologies and significant biomarkers that aid in this. Clinical trials and case studies within personalized therapy and drug development. Screening, prediction and prevention of disease, prediction of adverse events, treatment monitoring, effects of metabolomics and microbiomics on treatment. Secondary population research, genome-wide association studies, disease–gene association studies, personal genome technologies. Ethical and cost–benefit issues, the impact to healthcare and business infrastructure, and regulatory issues.
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