Muscle Matters: CMR Tissue Characterization for Mechanistically Tailored Risk Stratification of Functional Mitral Regurgitation.
Muscle Matters: CMR Tissue Characterization for Mechanistically Tailored Risk Stratification of Functional Mitral Regurgitation.
复制标题
肌肉很重要：CMR 组织表征，用于功能性二尖瓣反流的机械定制风险分层。
DOI：
10.1161/circimaging.123.015808
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Weinsaft,JonathanW
中科院分区：
文献类型：
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作者：
Kim,Jiwon;VillarCalle,Pablo;Weinsaft,JonathanW
功能性二尖瓣返流（FMR）是瓣膜性心脏病的主要原因，可显著增加心力衰竭、心律失常和死亡的风险。1，2 FMR源于适应不良的左心室（LV）重塑，导致固有正常二尖瓣瓣叶的对合不良。虽然FMR广义上指的是由不良LV重构引起的二尖瓣关闭不全，但其机制各不相同。在缺血性心肌病（ICM）中，二尖瓣下方区域的局部心肌损伤（缺血或梗死）可导致二尖瓣栓系和关闭不全。3，4在非ICM（NICM）中，弥漫性心肌纤维化增加了LV刚度，这可能增加二尖瓣后负荷并导致FMR。FMR的肌病因素也可以是混合的，梗死和非缺血性纤维化共存。鉴于机制的差异和临床评估的不精确性，心肌组织定征成像非常适合于改善FMR患者的临床决策和预后结果。
Functional mitral regurgitation (FMR) is a lead-ing cause of valvular heart disease that markedly increases the risk of heart failure, arrhythmia, and death. 1, 2 FMR stems from maladaptive left ventricular (LV) remodeling that leads to malcoaptation of intrinsically normal mitral leaflets. While FMR broadly refers to mitral incompetence stemming from adverse LV remodeling, mechanism for this varies. In ischemic cardiomyopathy (ICM), localized myocardial injury (ischemia or infarction) in regions underlying the mitral valve can result in mitral valve tethering and insufficiency. 3, 4 In non-ICM (NICM), diffuse myocardial fibrosis augments LV stiffness, which can increase mitral afterload and contribute to FMR. Myopathic contributors to FMR can also be mixed, with both infarction and nonischemic fibrosis coexisting. Given the differences in mechanism and imprecision of clinical assessment, myocardial tissue characterization imaging is well suited to improve clinical decision-making and prognostic outcomes for patients with FMR.