Department of Pulmonary Medicine, VU University Medical Center, Amsterdam, Netherlands.
Am J Cardiol. 2012 Sep 15;110(6 Suppl):25S-31S. doi: 10.1016/j.amjcard.2012.06.013.
Pulmonary arterial hypertension (PAH) is a disease of the pulmonary vasculature characterized by vasoconstriction and vascular remodeling leading to a progressive increase in pulmonary vascular resistance (PVR). It is becoming increasingly recognized that it is the response of the right ventricle (RV) to the increased afterload resulting from this increase in PVR that is the most important determinant of patient outcome. A range of hemodynamic, structural, and functional measures associated with the RV have been found to have prognostic importance in PAH and, therefore, have potential value as parameters for the evaluation and follow-up of patients. If such measures are to be used clinically, there is a need for simple, reproducible, accurate, easy-to-use, and noninvasive methods to assess them. Cardiac magnetic resonance imaging (CMRI) is regarded as the "gold standard" method for assessment of the RV, the complex structure of which makes accurate assessment by 2-dimensional methods, such as echocardiography, challenging. However, the majority of data concerning the use of CMRI in PAH have come from studies evaluating a variety of different measures and using different techniques and protocols, and there is a clear need for the development of standardized methodology if CMRI is to be established in the routine assessment of patients with PAH. Should such standards be developed, it seems likely that CMRI will become an important method for the noninvasive assessment and monitoring of patients with PAH.
肺动脉高压（PAH）是一种肺血管疾病，其特征为血管收缩和血管重构，导致肺血管阻力（PVR）逐渐增加。越来越多的人认识到，正是右心室（RV）对 PVR 增加导致的后负荷增加的反应，是决定患者预后的最重要因素。已经发现与 RV 相关的一系列血流动力学、结构和功能指标在 PAH 中具有预后意义，因此具有作为评估和随访患者的参数的潜在价值。如果要在临床上使用这些措施，就需要简单、可重复、准确、易于使用且非侵入性的方法来评估它们。心脏磁共振成像（CMRI）被认为是评估 RV 的“金标准”方法，由于 RV 的复杂结构，二维方法（如超声心动图）对其进行准确评估具有挑战性。然而，关于 CMRI 在 PAH 中的应用的大多数数据来自评估各种不同指标的研究，并使用不同的技术和方案，因此，如果要在 PAH 患者的常规评估中确立 CMRI，就需要制定标准化方法。如果制定了这些标准，CMRI 似乎很可能成为 PAH 患者非侵入性评估和监测的重要方法。
