Reclasificar algunas canalopatías: Cambios tras una larga espera

Margarita Dorantes Sánchez; Marleny Cruz Cardentey; Jesús A. Castro Hevia; Osmín Castañeda Chirino

Autores/as

Margarita Dorantes Sánchez
Marleny Cruz Cardentey
Jesús A. Castro Hevia
Osmín Castañeda Chirino

Resumen

Desde hace tiempo la muerte súbita cardíaca y las arritmias ventriculares malignas, en sujetos sin cardiopatía estructural demostrable por métodos convencionales, ha sido tema sometido de controversia. Las enfermedades eléctricas primarias se hicieron equivalentes a enfermedades puramente eléctricas y el término de canalopatía ha sufrido modificaciones porque a las mutaciones genéticas se añaden alteraciones en algunas proteínas interactuantes y porque existen anomalías estructurales tales como inflamación, fibrosis, adiposis, miocarditis, microaneurismas, aumento del colágeno, disfunción mecánica y otros, evidenciadas por procedimientos diagnósticos más finos: el corazón es normal en apariencia pero los miocitos no lo son. A la base genética (disfunción iónica) y a la clínica, se integran alteraciones estructurales y se consideran los síndromes de Brugada, de QT largo y de QT corto, como enfermedades orgánico-funcionales, electroanatómicas, con la necesidad de su reclasificación, lo cual es trascendente para estratificar riesgo y adoptar la conducta terapéutica más apropiada.

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Citas

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