Delgado Victoria, Bax Jeroen J
Heart and Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
J Nucl Cardiol. 2015 Jun;22(3):408-18. doi: 10.1007/s12350-014-0054-7. Epub 2014 Dec 30.
Non-invasive cardiac imaging plays a central role in the diagnosis and management of patients with hypertrophic cardiomyopathy. Transthoracic echocardiography is the imaging technique of first choice to evaluate wall thickness, left ventricular systolic and diastolic function, presence of left ventricular outflow tract obstruction, and abnormal mitral anatomy, whereas cardiac magnetic resonance provides additional information on tissue characterization (replacement fibrosis) using late gadolinium enhancement. Nuclear imaging techniques permit also the assessment of left ventricular systolic and diastolic function in patients with hypertrophic cardiomyopathy but are more frequently used to evaluate myocardial ischemia (particularly assessment of microvascular dysfunction using positron emission tomography) and abnormal sympathetic myocardial innervation. This review article provides an overview of the use of nuclear imaging techniques to refine the phenotyping and risk stratification of patients with hypertrophic cardiomyopathy with particular focus on prediction of progression to overt heart failure, detection of myocardial ischemia, and evaluation of the arrhythmogenic substrate and risk of sudden cardiac death.
非侵入性心脏成像在肥厚型心肌病患者的诊断和管理中起着核心作用。经胸超声心动图是评估室壁厚度、左心室收缩和舒张功能、左心室流出道梗阻的存在以及二尖瓣解剖结构异常的首选成像技术，而心脏磁共振成像利用钆延迟增强提供有关组织特征（替代性纤维化）的额外信息。核成像技术也可用于评估肥厚型心肌病患者的左心室收缩和舒张功能，但更常用于评估心肌缺血（特别是使用正电子发射断层扫描评估微血管功能障碍）以及异常的交感神经心肌支配。这篇综述文章概述了核成像技术在细化肥厚型心肌病患者表型和风险分层方面的应用，特别关注向明显心力衰竭进展的预测、心肌缺血的检测以及致心律失常基质和心脏性猝死风险的评估。
