Webb Jessica, Fovargue Lauren, Tøndel Kristin, Porter Bradley, Sieniewicz Benjamin, Gould Justin, Rinaldi Christopher Aldo, Ismail Tevfik, Chiribiri Amedeo, Carr-White Gerald
Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Division of Imaging Sciences and Biomedical Engineering, King's College London, London, SE1 7EH, UK.
Curr Heart Fail Rep. 2018 Feb;15(1):1-9. doi: 10.1007/s11897-018-0372-1.
To give an update on the emerging role of cardiac magnetic resonance imaging in the evaluation of patients with heart failure with preserved ejection fraction (HFpEF). This is important as the diagnosis of HFpEF remains challenging and cardiac imaging is pivotal in establishing the function of the heart and whether there is evidence of structural heart disease or diastolic dysfunction. Echocardiography is widely available, although the gold standard in quantifying heart function is cardiac magnetic resonance (CMR) imaging.
This review includes the recently updated 2016 European Society of Cardiology guidelines on diagnosing HFpEF that define the central role of imaging in identifying patients with HFpEF. Moreover, it includes the pathophysiology in HFpEF, how CMR works, and details current CMR techniques used to assess structural heart disease and diastolic function. Furthermore, it highlights promising research techniques that over the next few years may become more used in identifying these patients. CMR has an emerging role in establishing the diagnosis of HFpEF by measuring the left ventricular ejection fraction (LVEF) and evidence of structural heart disease and diastolic dysfunction.
更新心脏磁共振成像在射血分数保留的心力衰竭(HFpEF)患者评估中的新作用。这一点很重要,因为HFpEF的诊断仍然具有挑战性,而心脏成像对于确定心脏功能以及是否存在结构性心脏病或舒张功能障碍的证据至关重要。超声心动图应用广泛,尽管量化心脏功能的金标准是心脏磁共振(CMR)成像。
本综述包括2016年欧洲心脏病学会关于HFpEF诊断的最新指南,该指南明确了成像在识别HFpEF患者中的核心作用。此外,还包括HFpEF的病理生理学、CMR的工作原理,以及当前用于评估结构性心脏病和舒张功能的CMR技术细节。此外,还强调了未来几年可能在识别这些患者中更多使用的有前景的研究技术。CMR在通过测量左心室射血分数(LVEF)以及结构性心脏病和舒张功能障碍的证据来确立HFpEF诊断方面正发挥着新作用。