Moura Brenda, Aimo Alberto, Al-Mohammad Abdallah, Keramida Kalliopi, Ben Gal Tuvia, Dorbala Sharmila, Todiere Giancarlo, Cameli Matteo, Barison Andrea, Bayes-Genis Antoni, von Bardeleben Ralph Stephan, Bucciarelli-Ducci Chiara, Delgado Victoria, Mordi Ify R, Seferovic Petar, Savarese Gianluigi, Čelutkienė Jelena, Rapezzi Claudio, Emdin Michele, Coats Andrew, Metra Marco, Rosano Giuseppe
Faculty of Medicine, University of Porto, Porto, Portugal.
Cardiology Department, Porto Armed Forces Hospital, Porto, Portugal.
Eur J Heart Fail. 2023 Sep;25(9):1493-1506. doi: 10.1002/ejhf.2997. Epub 2023 Sep 4.
Left ventricular (LV) hypertrophy consists in an increased LV wall thickness. LV hypertrophy can be either secondary, in response to pressure or volume overload, or primary, i.e. not explained solely by abnormal loading conditions. Primary LV hypertrophy may be due to gene mutations or to the deposition or storage of abnormal substances in the extracellular spaces or within the cardiomyocytes (more appropriately defined as pseudohypertrophy). LV hypertrophy is often a precursor to subsequent development of heart failure. Cardiovascular imaging plays a key role in the assessment of LV hypertrophy. Echocardiography, the first-line imaging technique, allows a comprehensive assessment of LV systolic and diastolic function. Cardiovascular magnetic resonance provides added value as it measures accurately LV and right ventricular volumes and mass and characterizes myocardial tissue properties, which may provide important clues to the final diagnosis. Additionally, scintigraphy with bone tracers is included in the diagnostic algorithm of cardiac amyloidosis. Once the diagnosis is established, imaging findings may help predict future disease evolution and inform therapy and follow-up. This consensus document by the Heart Failure Association of the European Society of Cardiology provides an overview of the role of different cardiac imaging techniques for the differential diagnosis and management of patients with LV hypertrophy.
左心室肥厚表现为左心室壁厚度增加。左心室肥厚可以是继发性的，由压力或容量负荷过重引起，也可以是原发性的，即不能仅由异常负荷情况来解释。原发性左心室肥厚可能是由于基因突变，或者是异常物质在细胞外间隙或心肌细胞内沉积或蓄积（更确切地定义为假性肥厚）。左心室肥厚往往是随后发生心力衰竭的先兆。心血管成像在左心室肥厚的评估中起着关键作用。超声心动图作为一线成像技术，可全面评估左心室的收缩和舒张功能。心血管磁共振成像具有额外价值，因为它能准确测量左心室和右心室的容积及质量，并对心肌组织特性进行表征，这可能为最终诊断提供重要线索。此外，使用骨显像剂的闪烁扫描法也被纳入心脏淀粉样变性的诊断流程中。一旦确诊，成像结果有助于预测未来疾病的发展，并为治疗和随访提供依据。欧洲心脏病学会心力衰竭协会的这份共识文件概述了不同心脏成像技术在左心室肥厚患者鉴别诊断和管理中的作用。
