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慢性缺血性心肌病中的存活心肌:不同诊断方法的相似性和差异性。

Myocardial viability in chronic ischemic cardiomyopathy: similarities and discordance of different diagnostic approaches.

机构信息

Washington Hospital Center, Washington, DC, USA.

出版信息

J Cardiovasc Transl Res. 2009 Mar;2(1):24-9. doi: 10.1007/s12265-008-9083-4. Epub 2008 Dec 31.

Abstract

The presence of myocardial viability in patients with chronic ischemic cardiomyopathy has significant predictive value for improvement of left ventricular function after revascularization. Myocardial viability also predicts improved survival for patients undergoing coronary revascularization as opposed to medical therapy. Evaluation of viability can be pursued by different imaging techniques. Dobutamine stress echocardiography [or magnetic resonance imaging (MRI)] evaluates contractile reserve, while nuclear tests and late contrast-enhancement MRI evaluate cellular and tissue integrity. The different targets of these tests are frequently reflected into discordant results of viability evaluation. We review the different techniques available and describe their concordance from a mechanistic perspective.

摘要

在慢性缺血性心肌病患者中,心肌存活具有显著的预测价值,可改善血运重建后的左心室功能。心肌存活也预示着接受冠状动脉血运重建治疗的患者比接受药物治疗的患者有更好的生存获益。心肌存活的评估可以通过不同的影像学技术来进行。多巴酚丁胺负荷超声心动图[或磁共振成像(MRI)]评估收缩储备,而核试验和晚期对比增强 MRI 评估细胞和组织完整性。这些试验的不同靶点常常反映出存活评估结果的不一致。我们回顾了现有的不同技术,并从机制的角度描述了它们的一致性。

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