Cardiovascular Magnetic Resonance in Acute ST-Segment-Elevation Myocardial Infarction: Recent Advances, Controversies, and Future Directions.
Cardiovascular Magnetic Resonance in Acute ST-Segment-Elevation Myocardial Infarction: Recent Advances, Controversies, and Future Directions.
复制标题
急性 ST 段抬高型心肌梗死的心血管磁共振：最新进展、争议和未来方向。
DOI：
10.1161/circulationaha.117.030693
复制
发表时间：
2018-05-01
期刊：
影响因子：
37.8
通讯作者：
Hausenloy DJ
中科院分区：
文献类型：
--
作者：
Bulluck H;Dharmakumar R;Arai AE;Berry C;Hausenloy DJ
虽然ST段抬高心肌梗死(STEMI)后的死亡率在下降，但因既往心肌梗死(MI)而发生心力衰竭的患者数量却在上升。除了通过直接经皮冠状动脉介入治疗(PPCI)及时再通外，目前还没有确定的缩小MI大小的治疗方法。因此，需要新的心脏保护疗法来改善STEMI后的临床结果。心血管磁共振(CMR)已成为一种重要的影像检查手段，可用于评估缩小心肌梗死面积和预防随后的不良左室重构的新疗法的疗效。最近多参数标测CMR的出现为STEMI后心肌水肿、微血管阻塞、心肌内出血以及远端心肌间质间隙的改变提供了新的研究视角。在这篇文章中，我们提供了在STEMI再灌流患者中CMR成像的最新进展，讨论了围绕其使用的争议，并探讨了CMR在这方面的未来应用。
While mortality following ST-segment elevation myocardial infarction (STEMI) is on the decline, the number of patients developing heart failure due to prior myocardial infarction (MI) is on the rise. Apart from timely reperfusion by primary percutaneous coronary intervention (PPCI), there is currently no established therapy for reducing MI size. As such new cardioprotective therapies are required to improve clinical outcomes following STEMI. Cardiovascular magnetic resonance (CMR) has emerged as an important imaging modality for assessing the efficacy of novel therapies for reducing MI size and preventing subsequent adverse left ventricular remodeling. The recent availability of multi-parametric mapping CMR has provided new insights into the pathophysiology underlying myocardial edema, microvascular obstruction, intramyocardial hemorrhage, and changes in the remote myocardial interstitial space following STEMI. In this article, we provide an overview of the recent advances in CMR imaging in reperfused STEMI patients, discuss the controversies surrounding its use, and explore future applications of CMR in this setting.