确定病因：采用延迟强化心血管磁共振成像的系统方法。
Identifying the etiology: a systematic approach using delayed-enhancement cardiovascular magnetic resonance.
作者信息
Senthilkumar Annamalai, Majmudar Maulik D, Shenoy Chetan, Kim Han W, Kim Raymond J
机构信息
Duke University Medical Center, Durham, NC 27710, USA.
出版信息
Heart Fail Clin. 2009 Jul;5(3):349-67, vi. doi: 10.1016/j.hfc.2009.02.009.
Abstract
In patients who have heart failure, treatment and survival are directly related to the cause. Clinically, as a practical first step, patients are classified as having either ischemic or non-ischemic cardiomyopathy, a delineation usually based on the presence or absence of epicardial coronary artery disease. However, this approach does not account for patients with non-ischemic cardiomyopathy who also have coronary artery disease, which may be either incidental or partly contributing to myocardial dysfunction (mixed cardiomyopathy). By allowing direct assessment of the myocardium, delayed-enhancement cardiovascular magnetic resonance (DE-CMR) may aid in addressing these conundrums. This article explores the use of DE-CMR in identifying ischemic and non-ischemic myopathic processes and details a systematic approach to determine the cause of cardiomyopathy.
摘要
在心力衰竭患者中，治疗和生存率与病因直接相关。临床上，作为实际的第一步，患者被分类为患有缺血性或非缺血性心肌病，这种划分通常基于是否存在心外膜冠状动脉疾病。然而，这种方法没有考虑到同时患有冠状动脉疾病的非缺血性心肌病患者，这些冠状动脉疾病可能是偶然的，也可能部分导致心肌功能障碍（混合性心肌病）。通过直接评估心肌，延迟强化心血管磁共振成像（DE-CMR）可能有助于解决这些难题。本文探讨了DE-CMR在识别缺血性和非缺血性肌病过程中的应用，并详细介绍了一种确定心肌病病因的系统方法。
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