Pontone Gianluca, Carità Patrizia, Rabbat Mark G, Guglielmo Marco, Baggiano Andrea, Muscogiuri Giuseppe, Guaricci Andrea I
Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy.
Yonsei University Health System, Seoul, South Korea.
Curr Cardiol Rep. 2017 Aug 31;19(10):101. doi: 10.1007/s11886-017-0907-1.
The purpose of the present paper is to analytically review the diagnostic and prognostic role of CMR in ST-segment elevation myocardial infarction (STEMI) survivors. Percutaneous coronary intervention (PCI) is the treatment of choice in patients STEMI. However, risk of future events remains substantial. Assessment of the extent of myocardial infarction (MI), cardiac function and ventricular remodelling has become the focus of recent studies. Electrocardiography, angiography and echocardiography parameters, as well as risk scores, lack sensitivity and reproducibility in predicting future cardiovascular events. A major advantage of cardiac magnetic resonance imaging (CMR) is that it provides myocardial tissue characterization.
CMR is able to quantify both reversible and irreversible myocardial injury and correlates with future events. This review will illustrate how microvascular function indices (myocardial salvage index, presence and amount of microvascular obstruction and intramyocardial haemorrhage) detectable by CMR add prognostic information and could impact on future strategies to improve outcomes in revascularized patients.
本文旨在分析性回顾心脏磁共振成像（CMR）在ST段抬高型心肌梗死（STEMI）幸存者中的诊断和预后作用。经皮冠状动脉介入治疗（PCI）是STEMI患者的首选治疗方法。然而，未来发生事件的风险仍然很大。评估心肌梗死（MI）范围、心脏功能和心室重构已成为近期研究的重点。心电图、血管造影和超声心动图参数以及风险评分在预测未来心血管事件方面缺乏敏感性和可重复性。心脏磁共振成像（CMR）的一个主要优点是它能提供心肌组织特征。
CMR能够量化可逆性和不可逆性心肌损伤，并与未来事件相关。本综述将阐述CMR可检测到的微血管功能指标（心肌挽救指数、微血管阻塞的存在和程度以及心肌内出血）如何增加预后信息，并可能影响改善血运重建患者预后的未来策略。
