扩张型心肌病左心室几何学构型的磁共振评价  

Assessment of Left Ventricular Geometry in Dilated Cardiomyopathy by Cardiac Magnetic Resonance

作　　者：孙嘉莲 梁耀丹 张庆[1] SUN Chialien;LIANG Yaodan;ZHANG Qing(2.Department of Cardiology,Beijing Hospital,National Center of Gerontology,Beijing 100010,China)

机构地区：[1]四川大学华西医院心内科,四川成都610041 [2]北京医院心内科国家老年医学中心,北京100010

出　　处：《心血管病学进展》2019年第3期369-373,共5页Advances in Cardiovascular Diseases

摘　　要：左心室重构是扩张型心肌病重要的病理生理基础,是神经内分泌系统异常激活介导下发生的心肌组织特征以及心室形态结构改变。随着对左心室重构、治疗后逆转重构现象的关注和深入研究,过去曾被忽视的左心室几何学构型再次成为近年的研究热点之一,尤其是利用心脏磁共振成像技术,获取球形指数、相对室壁厚度、左心室质量/容积,以及新型的重构指数、长轴应变等分析指标。逐渐增多的磁共振研究显示左心室几何学构型对扩张型心肌病有明确的预后价值,可能优于单独使用射血分数来进行危险分层,并发现几何学构型的改变与心肌纤维化的程度有显著的相关性,其临床应用价值仍需进一步的验证与拓展。Left ventricular(LV) remodeling is the most important pathophysiologic mechanism of dilated cardiomyopathy(DCM) which is defined as the changes in myocardial tissue characteristics and ventricular morphology triggered by overactivated neuroendocrine system.With the attention on LV remodeling and reverse remodeling after therapy in DCM,LV geometry that used to be overlooked has become a clinical research hotspot recently.In particular,cardiac magnetic resonance(CMR) is a preferred imaging modality that used for the analysis of sphericity index,relative wall thickness,LV mass/volume,new remodeling index and long-axis strain as major parameters of LV geometry.Accumulated CMR studies revealed that LV geometry had an independent prognostic value in DCM,superior to using LV ejection fraction alone for risk stratification.In addition,it was found that there was a significant correlation between geometry change and myocardial fibrosis.However,further investigation is warranted for verification and expansion of its clinical application.

关 键 词：扩张型心肌病 左心室重构 几何学构型 心脏磁共振 

分 类 号：R542.2[医药卫生—心血管疾病] R445.2[医药卫生—内科学]