Multimodality imaging in ischaemic heart failure
Multimodality imaging in ischaemic heart failure
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DOI：
10.1016/s0140-6736(18)33207-0
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发表时间：
2019-03-09
期刊：
影响因子：
168.9
通讯作者：
Delgado, Victoria
中科院分区：
文献类型：
--
作者：
Bax, Jeroen J.;Di Carli, Marcelo;Delgado, Victoria
在心力衰竭中，需要使用现代非侵入性成像方式进行广泛评估，以评估病因、病理生理学和血流动力学，以确定预后并考虑治疗方案。该系统评估包括左心室大小和功能、冠状动脉疾病的存在和严重程度、二尖瓣反流、肺动脉高压、右心室扩张和功能障碍以及三尖瓣反流的逐步评估。基于这种成像衍生的信息，除了优化的药物治疗外，还可以确定对特定治疗的需求。血管重建的需要，植入式心脏除颤器的植入，二尖瓣或三尖瓣的修复或置换，可以（部分）由无创成像指导。重要的是，使用非侵入性成像来指导治疗的随机对照试验在该领域很少，大多数非药物治疗是基于专家共识的，但只要试验可用，它们将在本文中讨论。
In heart failure, extensive evaluation with modern non-invasive imaging modalities is needed to assess causes, pathophysiology, and haemodynamics, to determine prognosis and consider therapeutic options. This systematic evaluation includes a stepwise assessment of left ventricular size and function, the presence and severity of coronary artery disease, mitral regurgitation, pulmonary hypertension, right ventricular dilation and dysfunction, and tricuspid regurgitation. Based on this imaging-derived information, the need for specific therapies besides optimised medical therapy can be determined. The need for revascularisation, implantation of an implantable cardiac defibrillator, and mitral or tricuspid valve repair or replacement, can be (partially) guided by non-invasive imaging. Importantly, randomised controlled trials on the use of non-inasive imaging to guide therapy are scarce in this field and most non-pharmacological therapies are based on expert-consensus, but whenever trials are available, they will be addressed in this paper.