Multimodality imaging in the assessment of myocardial viability.

Multimodality imaging in the assessment of myocardial viability.
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DOI:
10.1007/s10741-010-9201-7
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发表时间:
2011-07
影响因子:
4.6
通讯作者:
Dorbala, Sharmila
Dorbala, Sharmila
中科院分区:
医学2区
文献类型:
--
作者:
Partington, Sara L.;Kwong, Raymond Y.;Dorbala, Sharmila

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冠状动脉疾病导致的心力衰竭的患病率持续增加,并且它预示着比非缺血性心肌病更差的预后。血运重建改善了这些有存活证据的高危患者的预后;因此,对心肌存活性的最佳评估仍然至关重要。在收缩功能障碍的区域中,存在多种成像方式用于区分存活心肌和瘢痕。考虑到多种可用的模式,为特定患者选择最佳模式可能是一项艰巨的任务。本文就心肌冬眠和顿抑的生理机制进行综述。本文将回顾目前所有可用于评估生存能力的方法,包括超声心动图、心脏磁共振成像、单光子发射断层成像和正电子发射断层成像的核成像以及心脏计算机断层成像。各种技术的有效性将进行比较,并讨论目前文献的局限性。
The prevalence of heart failure due to coronary artery disease continues to increase, and it portends a worse prognosis than non-ischemic cardiomyopathy. Revascularization improves prognosis in these high-risk patients who have evidence of viability; therefore, optimal assessment of myocardial viability remains essential. Multiple imaging modalities exist for differentiating viable myocardium from scar in territories with contractile dysfunction. Given the multiple modalities available, choosing the best modality for a specific patient can be a daunting task. In this review, the physiology of myocardial hibernation and stunning will be reviewed. All the current methods available for assessing viability including echocardiography, cardiac magnetic resonance imaging, nuclear imaging with single photon emission tomography and positron emission tomography imaging and cardiac computed tomography will be reviewed. The effectiveness of the various techniques will be compared, and the limitations of the current literature will be discussed.
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