门控心肌灌注成像评估心脏不同步并不改善患者管理。
Assessment of dyssynchrony by gated myocardial perfusion imaging does not improve patient management.
机构信息
Frankel Cardiovascular Center, Michigan Medicine, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109-5873, USA.
Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA.
出版信息
J Nucl Cardiol. 2018 Apr;25(2):526-531. doi: 10.1007/s12350-017-1022-9. Epub 2017 Aug 8.
Abstract
Clinical trials have demonstrated improved outcomes with cardiac resynchronization therapy in patients with heart failure and electrical evidence of dyssynchrony. There has been intense effort at developing imaging markers of dyssynchrony with the aim of improved risk stratification. However, these efforts have not been fruitful to date. This article discusses mechanisms of cardiac dyssynchrony, reviews clinical data supporting resynchronization therapy, and addresses the lack of convincing evidence to support the use of noninvasive imaging measures of dyssynchrony in improving patient management.
摘要
临床试验已经证明，在心力衰竭和电生理证据显示不同步的患者中，心脏再同步治疗可以改善预后。人们一直在努力开发不同步的影像学标志物，以实现更好的风险分层。然而，迄今为止，这些努力并没有取得成果。本文讨论了心脏不同步的机制，回顾了支持心脏再同步治疗的临床数据，并讨论了缺乏令人信服的证据支持使用非侵入性影像学方法来改善患者管理的问题。
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