应激性心肌病临床表现和诊断及发病机制研究进展

Advances in Clinical Manifestations,Diagnosis and Pathogenesis of Stress Cardiomyopathy

应激性心肌病(SCM)属于临床上较为常见的一种急性心血管病事件,其中心理因素、疾病因素、药物因素以及躯体应激因素等均可诱发该病。SCM患者的主要表现为胸痛,且伴有可逆性左心室功能障碍、心肌损伤标志物水平异常以及心电图异常等,与急性心肌梗死存在高度相似。SCM患者心室造影可见左室心尖部收缩力明显下降,心底部代偿性收缩增强,从而导致患者左室于收缩末期主要形态为圆底窄颈。由于SCM患者的收缩期左室造影形状和日本渔民用以捕捉章鱼的鱼篓相似,因此SCM又被称之为章鱼篓心肌病。本研究主要是通过患者的临床表现、诊断以及发病机制三个方面对SCM的研究进展进行综述,旨在为临床SCM的防治提供参考依据。

Stress cardiomyopathy(SCM)is a common clinical acute cardiovascular disease event,which can be induced by psychological factors,disease factors,drug factors and physical stress factors.The main manifestations of SCM patients are chest pain,reversible left ventricular dysfunction,abnormal levels of myocardial injury markers and abnormal electrocardiogram,which are highly similar to acute myocardial infarction.Ventricular angiography in SCM patients show that left ventricular apical systolic force decreased significantly and compensatory contraction increased at the bottom of the heart,which led to narrow neck at the end of the left ventricular systolic phase,which led to the main shape of the left ventricle at the end of contractile is round-bottomed and narrow-necked.Because shape of systolic left Ventricular Angiography in patients with SCM is similar to the fish basket used by Japanese fishermen to catch octopus,so it is called octopus basket cardiomyopathy.This study mainly reviews the research progress of SCM from three aspects:clinical manifestations,diagnosis and pathogenesis,so in order to provide reference for the prevention and treatment of clinical SCM.