Travin Mark I, Feng DaLi, Taub Cynthia C
From the Division of Nuclear Medicine, Department of Radiology (M.I.T.) and Division of Cardiology, Department of Medicine (C.C.T), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; and Metropolitan Heart and Vascular Institute, Minneapolis, MN (D.F.).
Circ Cardiovasc Imaging. 2015 Nov;8(11):e003019. doi: 10.1161/CIRCIMAGING.115.003019.
Determination of ventricular arrhythmic risk is crucial for guiding management of cardiac disease. Although for patients at increased risk an implantable cardioverter-defibrillator is recommended, it is widely acknowledged that current criteria for device use based predominantly on left ventricular ejection fraction are deficient. Genesis of ventricular arrhythmias involves a complex interaction of myocardial substrate abnormalities, precipitating triggers, and modulating factors. There are much data showing that by more directly assessing these factors, noninvasive imaging using echocardiography, radionuclide imaging, and cardiac magnetic resonance enhances arrhythmic risk stratification beyond ejection fraction and commonly used electrocardiographic and serum biomarkers. It is anticipated that further technological advancements studied in well-designed clinical trials will provide both more precise determination of risk and guide therapies to enhanced survival and patient well-being.
确定室性心律失常风险对于指导心脏病管理至关重要。尽管对于风险增加的患者推荐使用植入式心脏复律除颤器，但人们普遍认识到，目前主要基于左心室射血分数的器械使用标准存在缺陷。室性心律失常的发生涉及心肌基质异常、促发触发因素和调节因素之间的复杂相互作用。有大量数据表明，通过更直接地评估这些因素，使用超声心动图、放射性核素成像和心脏磁共振的非侵入性成像能够在射血分数以及常用的心电图和血清生物标志物之外，增强心律失常风险分层。预计在精心设计的临床试验中研究的进一步技术进步将提供更精确的风险测定，并指导治疗以提高生存率和患者福祉。
