Di Bella Gianluca, Micari Antonino, Licordari Roberto, Crea Pasquale, Colarusso Luigi, Cusmà-Piccione Maurizio, Donato Rocco, D'Angelo Tommaso, Dattilo Giuseppe, Recupero Antonino, de Gregorio Cesare, Micari Antonio, Donato Aquaro Giovanni
Cardiology Unit, Department of Clinical and Experimental Medicine, University Hospital of Messina, 98124 Messina, Italy.
Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, 98124 Messina, Italy.
J Clin Med. 2025 Jul 11;14(14):4922. doi: 10.3390/jcm14144922.
Cardiac magnetic resonance imaging (CMRI) has become an indispensable tool in evaluating arrhythmic risk and guiding therapeutic decisions in patients with non-ischemic cardiomyopathies (NICMs), including dilated (DCM), hypertrophic (HCM), and arrhythmogenic cardiomyopathies (ACM). Both European and American guidelines have given an additive and different value of late gadolinium enhancement (LGE) in specific morpho-functional (hypertrophic, dilated, and arrhythmogenic) phenotypes. In particular, LGE plays a different weight in relation to different cardiomyopathies. In dilated cardiomyopathy, LGE is able to predict arrhythmic risk in relationship to the presence and localization (septal and/or ring like LGE). On the contrary, in HCM, LGE is related to increased risk of cardiac death according to the extent (LGE >15%), while in ACM, it has a greater role in the presence of fat infiltration associated with LGE. In this review, we aim to identify predictors of sudden cardiac death related to myocardial structural features seen in CMRI in cardiomyopathies, going beyond the sole assessment of left ventricular function and ejection fraction.
心脏磁共振成像（CMRI）已成为评估非缺血性心肌病（NICM）患者心律失常风险和指导治疗决策的不可或缺的工具，这些心肌病包括扩张型心肌病（DCM）、肥厚型心肌病（HCM）和致心律失常性心肌病（ACM）。欧洲和美国的指南都赋予了延迟钆增强（LGE）在特定形态功能（肥厚型、扩张型和致心律失常性）表型中的附加且不同的价值。特别是，LGE在不同的心肌病中具有不同的权重。在扩张型心肌病中，LGE能够根据其存在和定位（室间隔和/或环状LGE）预测心律失常风险。相反，在HCM中，根据LGE的范围（LGE>15%），LGE与心脏性死亡风险增加有关，而在ACM中，LGE在存在与LGE相关的脂肪浸润时发挥更大作用。在本综述中，我们旨在确定与心肌病CMRI中所见心肌结构特征相关的心脏性猝死预测因素，而不仅仅局限于对左心室功能和射血分数的评估。
