Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, Queen Mary, University of London, Barts, UK.
Prog Cardiovasc Dis. 2011 Nov-Dec;54(3):215-29. doi: 10.1016/j.pcad.2011.07.003.
Cardiovascular magnetic resonance (CMR) has a recognized role in diagnosing and monitoring coronary artery disease (CAD). Multiple studies have shown that CMR can predict adverse outcomes. We reviewed contemporary available literature to establish the role of CMR with late gadolinium enhancement (LGE) in predicting mortality and major adverse cardiac events (MACEs) in patients with CAD. Meta-analysis of available prospective studies showed that the presence of LGE increases the hazards of death by more than 4 times and of MACE by almost 4 times. The size of LGE (per gram or percent) increases the hazards of death and MACE by 4% and 5%, respectively. The presence and size of LGE predict mortality and MACE in CAD. Various parameters derived from LGE images enhance the predictive value. Large randomized controlled trials are needed to establish the actual value of LGE and other derived parameters in the wider population.
心血管磁共振（CMR）在诊断和监测冠状动脉疾病（CAD）方面具有公认的作用。多项研究表明，CMR 可以预测不良结局。我们回顾了现有的当代文献，以确定在 CAD 患者中，晚期钆增强（LGE）CMR 在预测死亡率和主要不良心脏事件（MACE）中的作用。对现有前瞻性研究的荟萃分析表明，LGE 的存在使死亡风险增加了 4 倍以上，MACE 风险增加了近 4 倍。LGE 的大小（每克或百分比）使死亡和 MACE 的风险分别增加 4%和 5%。LGE 的存在和大小可预测 CAD 患者的死亡率和 MACE。源自 LGE 图像的各种参数可增强预测值。需要进行大型随机对照试验来确定 LGE 及其他衍生参数在更广泛人群中的实际价值。
