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Clonal haematopoiesis and cardiovascular diseases: A growing relationship.

克隆造血与心血管疾病: 日益增长的关系。

  • 影响因子:2.06
  • DOI:10.1016/j.acvd.2021.01.002
  • 作者列表:"Fawaz S","Mansier O","Pucheu Y","Marti S","Leroy H","Gaufroy A","Broitman J","James C","Couffinhal T
  • 发表时间:2021-03-10
Abstract

:Cardiovascular diseases, particularly atherothrombosis, are the leading cause of death worldwide, but their mechanisms are not yet fully understood. Traditional cardiovascular risk factors have been known for many years, but are not enough to predict individual risk. Clonal haematopoiesis of indeterminate potential (CHIP) has been described recently; it corresponds to the clonal expansion of a population of haematopoietic cells in response to the acquisition of a somatic mutation, without any clinical or biological sign of haematological malignancy. The prevalence of this condition increases with age, reaching 10-20% of the general population aged>70 years. Recent observational studies have shown a link between CHIP and cardiovascular diseases in humans, revealing that CHIP carriers have a higher risk of myocardial infarction, heart failure and severe aortic valve stenosis. The prognosis of these conditions also seems to be altered by the presence of CHIP. Experimental studies have identified that the immune system and inflammation - particularly interleukin-1β-secreting macrophages - play a critical role in enhancing the cardiovascular consequences of CHIP, through their action on the atherosclerotic plaque and myocardial tissues. We aimed to write an extensive review of what is currently known about CHIP and its cardiovascular consequences, the pathophysiological mechanisms leading to the increased cardiovascular risk and, finally, the expected influence on our daily practice and how we care for patients with CHIP.

摘要

: 心血管疾病,尤其是动脉粥样硬化,是世界范围内的主要死亡原因,但其机制尚未完全了解。传统的心血管危险因素已经知道很多年了,但还不足以预测个体风险。最近已经描述了不确定潜能的克隆造血 (CHIP); 它对应于造血细胞群体的克隆扩增,以响应获得体细胞突变,而没有任何血液学恶性肿瘤的临床或生物学迹象。这种疾病的患病率随着年龄的增长而增加,在> 70岁的普通人群中达到10-20%。最近的观察性研究显示了CHIP与人类心血管疾病之间的联系,揭示了CHIP携带者患心肌梗死、心力衰竭和严重主动脉瓣狭窄的风险更高。这些病症的预后似乎也因CHIP的存在而改变。实验研究已经确定,免疫系统和炎症-特别是分泌白细胞介素-1β 的巨噬细胞-通过它们对动脉粥样硬化斑块和心肌组织的作用在增强CHIP的心血管后果中起关键作用。我们的目的是写一篇关于CHIP及其心血管后果的广泛综述,导致心血管风险增加的病理生理机制,最后是对我们日常实践的预期影响以及我们如何护理CHIP患者。

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DOI:10.1080/14656566.2020.1814255
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发表时间:2021-03-24
DOI:10.1007/s11033-021-06299-9
作者列表:["Louvrier A","Terranova L","Meyer C","Meyer F","Euvrard E","Kroemer M","Rolin G"]

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