慢性缺血性左心室功能障碍：从病理生理学到影像学及其在临床实践中的整合
Chronic ischemic left ventricular dysfunction: from pathophysiology to imaging and its integration into clinical practice.
作者信息
Rahimtoola Shahbudin H, Dilsizian Vasken, Kramer Christopher M, Marwick Thomas H, Vanoverschelde Jean-Louis J
机构信息
Griffith Center, Division of Cardiovascular Medicine, Department of Medicine, LAC+USC Medical Center, University of Southern California, Los Angeles, California 90033, USA.
出版信息
JACC Cardiovasc Imaging. 2008 Jul;1(4):536-55. doi: 10.1016/j.jcmg.2008.05.009.
Abstract
Chronic ischemic left ventricular dysfunction is present in a number of clinical syndromes in which myocardial revascularization results in an improvement of left ventricular function, patients' functional class, and their survival. Early diagnosis of and treatment of viability is essential. Coronary arteriography is of limited value in diagnosis of viability. Noninvasive testing is essential for diagnosis, which can be matched to the pathophysiologic changes that occur in hibernating myocardium. However, no single test has a perfect, or near perfect, sensitivity and specificity, and thus, a combination of tests are usually needed. Algorithms are developed to integrate these tests in clinical decision making.
摘要
慢性缺血性左心室功能障碍存在于多种临床综合征中，在这些综合征中，心肌血运重建可改善左心室功能、患者的心功能分级及其生存率。早期诊断和治疗存活心肌至关重要。冠状动脉造影在存活心肌诊断中的价值有限。非侵入性检测对于诊断必不可少，它可以与冬眠心肌中发生的病理生理变化相匹配。然而，没有单一的检测方法具有完美或近乎完美的敏感性和特异性，因此通常需要联合多种检测方法。已开发出算法以将这些检测方法整合到临床决策中。
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