Zhu Leyi, Wang Yining, Zhao Shihua, Lu Minjie
State Key Laboratory of Cardiovascular Disease, Department of Magnetic Resonance Imaging, National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China.
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Cardiovasc Med. 2022 Sep 29;9:926378. doi: 10.3389/fcvm.2022.926378. eCollection 2022.
Myocardial fibrosis, resulting from the disturbance of extracellular matrix homeostasis in response to different insults, is a common and important pathological remodeling process that is associated with adverse clinical outcomes, including arrhythmia, heart failure, or even sudden cardiac death. Over the past decades, multiple non-invasive detection methods have been developed. Laboratory biomarkers can aid in both detection and risk stratification by reflecting cellular and even molecular changes in fibrotic processes, yet more evidence that validates their detection accuracy is still warranted. Different non-invasive imaging techniques have been demonstrated to not only detect myocardial fibrosis but also provide information on prognosis and management. Cardiovascular magnetic resonance (CMR) is considered as the gold standard imaging technique to non-invasively identify and quantify myocardial fibrosis with its natural ability for tissue characterization. This review summarizes the current understanding of the non-invasive detection methods of myocardial fibrosis, with the focus on different techniques and clinical applications of CMR.
心肌纤维化是一种常见且重要的病理重塑过程，它是由于细胞外基质稳态受到不同损伤的干扰而产生的，与不良临床结局相关，包括心律失常、心力衰竭，甚至心源性猝死。在过去几十年中，已经开发出多种非侵入性检测方法。实验室生物标志物可以通过反映纤维化过程中的细胞甚至分子变化来辅助检测和风险分层，但仍需要更多证据来验证其检测准确性。不同的非侵入性成像技术已被证明不仅可以检测心肌纤维化，还能提供有关预后和治疗的信息。心血管磁共振（CMR）因其具有组织特征的天然能力，被认为是用于非侵入性识别和量化心肌纤维化的金标准成像技术。本综述总结了目前对心肌纤维化非侵入性检测方法的理解，重点关注CMR的不同技术和临床应用。
