心肌应变成像:理论、当前实践和未来。
Myocardial Strain Imaging: Theory, Current Practice, and the Future.
发表日期:2024 Aug 26
作者:
Otto A Smiseth, Oliver Rider, Marta Cvijic, Ladislav Valkovič, Espen W Remme, Jens-Uwe Voigt
来源:
JACC-Cardiovascular Imaging
摘要:
通过超声心动图或心脏磁共振 (CMR) 进行的心肌应变成像是诊断心脏病的有效方法。应变成像提供心肌缩短、增厚和延长的测量,并且可以应用于任何心室。通过斑点跟踪超声心动图测量的左心室 (LV) 整体纵向应变是最广泛使用的临床应变参数。几种基于 CMR 的模式已经可用,并已准备好在临床上实施。应变的临床应用包括整体纵向应变,作为诊断轻度收缩功能障碍比射血分数更敏感的方法。这适用于左心室射血分数正常的疑似心力衰竭患者、瓣膜疾病的早期收缩功能障碍以及癌症化疗期间监测心肌功能时。在评估左室不同步和缺血性功能障碍时,节段性左室应变图可为特定心肌病提供诊断线索。应变成像是一种有前景的量化右心室功能的方法。左心房应变可用于评估左心室舒张功能和充盈压。版权所有 © 2024 作者。由爱思唯尔公司出版。保留所有权利。
Myocardial strain imaging by echocardiography or cardiac magnetic resonance (CMR) is a powerful method to diagnose cardiac disease. Strain imaging provides measures of myocardial shortening, thickening, and lengthening and can be applied to any cardiac chamber. Left ventricular (LV) global longitudinal strain by speckle-tracking echocardiography is the most widely used clinical strain parameter. Several CMR-based modalities are available and are ready to be implemented clinically. Clinical applications of strain include global longitudinal strain as a more sensitive method than ejection fraction for diagnosing mild systolic dysfunction. This applies to patients suspected of having heart failure with normal LV ejection fraction, to early systolic dysfunction in valvular disease, and when monitoring myocardial function during cancer chemotherapy. Segmental LV strain maps provide diagnostic clues in specific cardiomyopathies, when evaluating LV dyssynchrony and ischemic dysfunction. Strain imaging is a promising modality to quantify right ventricular function. Left atrial strain may be used to evaluate LV diastolic function and filling pressure.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.