Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research (OCMR), John Radcliffe Hospital, Level 0, University of Oxford, Oxford, OX3 9DU, UK.
Divison of Cardiology, Pulmonary Disease and Vascular Medicine, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Eur Heart J Cardiovasc Imaging. 2024 Oct 30;25(11):1491-1504. doi: 10.1093/ehjci/jeae224.
Despite remarkable progress in therapeutic drugs, morbidity, and mortality for heart failure (HF) remains high in developed countries. HF with preserved ejection fraction (HFpEF) now accounts for around half of all HF cases. It is a heterogeneous disease, with multiple aetiologies, and as such poses a significant diagnostic challenge. Cardiac magnetic resonance (CMR) has become a valuable non-invasive modality to assess cardiac morphology and function, but beyond that, the multi-parametric nature of CMR allows novel approaches to characterize haemodynamics and with magnetic resonance spectroscopy (MRS), the study of metabolism. Furthermore, exercise CMR, when combined with lung water imaging provides an in-depth understanding of the underlying pathophysiological and mechanistic processes in HFpEF. Thus, CMR provides a comprehensive phenotyping tool for HFpEF, which points towards a targeted and personalized therapy with improved diagnostics and prevention.
尽管在治疗药物方面取得了显著进展，但发达国家的心衰（HF）发病率和死亡率仍然很高。射血分数保留的心衰（HFpEF）现在约占所有 HF 病例的一半。它是一种异质性疾病，有多种病因，因此构成了重大的诊断挑战。心脏磁共振（CMR）已成为评估心脏形态和功能的一种有价值的非侵入性方式，但除此之外，CMR 的多参数性质还允许采用新方法来描述血液动力学，通过磁共振波谱（MRS）来研究代谢。此外，运动 CMR 与肺水成像相结合，可以深入了解 HFpEF 中的潜在病理生理和机械过程。因此，CMR 为 HFpEF 提供了一种全面的表型工具，可实现针对特定患者的靶向治疗，从而改善诊断和预防。
