2023 ESC心肌病管理指南解读:非扩张型左室心肌病的分类革新  

The interpretation of 2023 ESC guidelines for the management of cardiomyopathies:classification innovation of non-dilated left ventricular cardiomyopathy

作　　者：凯赛尔江·艾斯开尔 撒芬 陈秀玉[1] 赵世华[1] KAISAIERJIANG Aisikaier;SA Fen;CHEN Xiuyu;ZHAO Shihua(Department of Magnetic Resonance Imaging,Fuwai Hospital,National Center for Cardiovascular Diseases of China,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院磁共振影像科,北京100037

出　　处：《磁共振成像》2025年第4期1-5,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：“十四五”国家重点研发项目(编号:2021YFF0501400、2021YFF0501404);国家自然科学基金重点项目(编号:82430066);云南省科技平台人才项目(编号:202305AF150033)。

摘　　要：《2023欧洲心脏病学会心肌病管理指南》对心肌病的分类、诊断、治疗和综合管理提供了全面的指导,创新性提出了非扩张型左室心肌病(non-dilated left ventricular cardiomyopathy,NDLVC)这一分型,强调了NDLVC表型、基因检测和心脏磁共振(cardiac magnetic resonance,CMR)成像在心肌病的早期诊断及风险评估中的重要价值,有助于更精准地识别心肌病的不同亚型,为心肌病的诊断、预后评估和风险分层提供了全新的思路,有望为NDLVC患者提供更早期、更精准的个体化风险分层和治疗策略。本文将围绕指南关于NDLVC新分类中CMR和基因在其疾病管理方面的应用进行核心解读,以期为临床和影像科医生提供参考。The 2023 European Society of Cardiology(ESC) Guidelines for the Management of Cardiomyopathies provide comprehensive guidance on the classification,diagnosis,treatment,and integrated management of cardiomyopathies.Innovatively,the guidelines introduce a new subtype,non-dilated left ventricular cardiomyopathy(NDLVC),emphasizing the critical role of NDLVC phenotypes,genetic testing,and cardiac magnetic resonance(CMR) imaging in the early diagnosis and risk assessment of cardiomyopathies.This approach facilitates more precise identification of cardiomyopathy subtypes and offers novel insights into diagnosis,prognosis evaluation,and risk stratification.It holds promise for delivering earlier and more accurate individualized risk stratification and treatment strategies for NDLVC patients.In this article,the author will focus on the core interpretation of the guidelines regarding the application of CMR and genetic testing in the management of NDLVC,aiming to provide valuable insights for clinicians and radiologists.

关 键 词：非扩张型左室心肌病 心脏磁共振 钆对比剂延迟强化 基因型 心源性猝死 

分 类 号：R445.2[医药卫生—影像医学与核医学] R542.2[医药卫生—诊断学]