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Peter M Spooner, Silvia G Priori, Robert J Myerburg, Spotlight on sudden cardiac death, Cardiovascular Research, Volume 50, Issue 2, May 2001, Pages 173–176, https://doi.org/10.1016/S0008-6363(01)00270-X
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Sudden cardiac death (SCD) is a very common mechanism for cardiac mortality in all developed nations, yet means to identify individuals at increased risk for this condition and effective strategies for its prevention remain elusive. For many years the focus of SCD research has concentrated on averting those conditions that are its primary antecedents, such as athero-thrombotic coronary artery disease, hypertension and heart failure. Recently however, major advances have occurred in understanding those more immediate cellular and molecular influences that contribute to the overall prevalence of SCD and the mechanisms responsible for its initiation in both apparently healthy individuals and those with established cardiac diseases. This “Spotlight” issue of the Journal has been designed to highlight many of these new discoveries and the remarkable progress and challenges that characterize this field today.
A number of factors have contributed to the difficulties that characterize the historically slow pace of progress in SCD research. Rather than being associated with specific, identifiable symptoms, the pathophysiology of SCD, in most cases, is diffuse in presentation, unpredictable in time, and its major cause, initiation of lethal ventricular arrhythmias, appears highly varied in different individuals. As suggested by the most commonly used definition of SCD, “…any near instantaneous, electrically-based, cessation of cardiac output in individuals with otherwise uncompromised circulatory function,” the forms of cardiac disease from which it arises are broad, and include a full spectrum of conditions from structural malformations, to progressive acquired pathologies, as well as terminal manifestations of otherwise silent genetic susceptibilities that may express at any life stage. Recent discoveries concerning several of these latter conditions (e.g. the Long QT Syndromes) have, however, over the past five years, catapulted SCD research to the forefront of investigations on the molecular causes of cardiovascular disease; and continuing population and laboratory discoveries on the heritable origins of mechanisms of SCD have finally begun to provide the clues essential to developing more effective strategies for their prevention.
