Villuendas Roger, Kadish Alan H
Division of Cardiology and Department of Medicine, Northwestern University-Feinberg School of Medicine, Chicago, IL 60611, USA.
Prog Cardiovasc Dis. 2008 Sep-Oct;51(2):128-34. doi: 10.1016/j.pcad.2007.12.002.
Risk stratification of patients with structural heart disease remains problematic. While patients with low ejection fractions have been shown to be at significant risk for sudden cardiac death, a risk that can be decreased by ICD implantation, the sensitivity and specificity of ejection fraction for predicting sudden death are sub-optimal. Contrast enhanced magnetic resonance imaging (CMRI) has been shown to carefully delineate the extent and morphology of myocardial scar. Recent studies have suggested that the extent of myocardial scar and potentially its heterogeneity can help risk stratify patient with coronary artery disease. Ongoing clinical studies will help determine the utility of incorporating CMRI into a risk prediction algorithm.
结构性心脏病患者的风险分层仍然存在问题。虽然射血分数低的患者已被证明有显著的心脏性猝死风险，植入植入式心脏复律除颤器（ICD）可降低这种风险，但射血分数预测猝死的敏感性和特异性并不理想。对比增强磁共振成像（CMRI）已被证明能精确描绘心肌瘢痕的范围和形态。最近的研究表明，心肌瘢痕的范围及其潜在的异质性有助于对冠心病患者进行风险分层。正在进行的临床研究将有助于确定将CMRI纳入风险预测算法的实用性。
