Noninvasive assessment of left ventricular remodeling: Concepts, techniques, and implications for clinical trials
Noninvasive assessment of left ventricular remodeling: Concepts, techniques, and implications for clinical trials
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DOI：
10.1054/jcaf.2002.129286
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发表时间：
2002-12-01
影响因子：
6
通讯作者：
Udelson, JE
中科院分区：
文献类型：
--
作者：
Anand, IS;Florea, VG;Udelson, JE
背景：在过去的十年中，我们对心室形态和功能全球变化背后的细胞和生化机制的理解有了巨大的增长。然而，尽管导致心室明显变化的一系列事件始于细胞水平，但在活着的患者中，我们很少有机会评估这些现象的发生。因此，为了在实践和临床试验中研究重塑过程，我们依赖于来自心脏成像检查的评估和测量。方法和结果：自从最初基于血管造影的方法用于评估人类心室重构以来，各种各样的技术已经被开发出来，用于临床和研究中评估心室大小、形状和功能。由于二维超声心动图已成为临床评估左心室功能的主要无创诊断方法，这种方式已成为评估心室重构最广泛使用的技术。然而，核技术已经被证明是可靠的和高度可重复的，也被用于临床和研究环境，最近，心脏磁共振成像提供了获得高质量心脏图像的潜力，其分辨率比其他任何一种技术都高得多。结论：在个体患者和大规模临床试验的背景下，每一种技术都有其特定的优点和缺点。
Background: Over the past decade, our understanding of the cellular and biochemical mechanisms that underlie global changes in ventricular morphology and function has grown enormously. Nevertheless, although the sequence of events that lead to overt changes in the ventricle begin at the cellular level, in living patients we rarely have the opportunity to assess these phenomena as they occur. Thus, to study the process of remodeling in practice and in clinical trials, we have relied on assessments and measurements derived from cardiac imaging tests.Methods and Results: Since the initial angiographic based methods for assessing ventricular remodeling in humans, a variety of techniques has been developed that have been used for assessment of ventricular size, shape, and function for both clinical and research studies. As two-dimensional echocardiography has emerged as the predominant noninvasive diagnostic method for clinical use in evaluating left ventricular function, this modality has become the most widely used technique to assess ventricular remodeling. Nevertheless, nuclear techniques that have proven both reliable and highly reproducible have also been used in clinical and research setting and, more recently, cardiac magnetic resonance imaging has offered the potential to obtain extremely high-quality images of the heart at much higher resolution than either of the other techniques.Conclusions: Each of these techniques carries specific advantages and disadvantages for assessment of remodeling in individual patients and in the context of large-scale clinical trials.