CMR在高血压心脏病中的应用进展

Progress in the application of cardiac magnetic resonance in hypertensive heart disease

高血压作为各种心血管疾病的最重要诱因,会引起心脏结构变化、冠脉微循环障碍等一系列适应性改变,因此,对高血压患者心脏结构和功能的评价显得格外重要。临床上常用于评价心脏结构和功能的工具为超声心动图,但心脏磁共振(cardiac magnetic resonance,CMR)较其具有更好的软组织分辨率及多功能、多参数成像的优点,可通过电影序列、T2WI、灌注成像序列、早期强化序列以及延迟强化序列(late gadolinium enhancement,LGE)、增强前后T1 mapping对高血压心脏病(hypertensiveheartdisease,HHD)进行全方位评估。本文通过总结这些技术对高血压引起的左室肥厚(leftventricular hypertrophy,LVH)、心肌纤维化、收缩舒张功能降低、冠脉微循环障碍等方面进行的定量、定性分析,对指导临床决策、改善患者预后有重要意义,并有望为将来的研究提供参考方向。

As the most important cause of various cardiovascular diseases,hypertension can cause a series of adaptive changes such as heart structure changes and coronary microcirculation disorders.Therefore,it is particularly important to evaluate the cardiac structure and function of hypertensive patients.Echocardiography is commonly used in clinical evaluation of cardiac structure and function,but cardiac magnetic resonance(CMR)has the advantages of better soft tissue resolution and multi-functional,multi-parameter imaging.CMR cine imaging,T2WI,perfusion imaging,early enhancement and late gadolinium enhancement(LGE)T1 mapping before and after enhancement sequences can be used to comprehensive assessment of hypertensive heart disease(HHD).By summarizing these techniques,this paper conductes quantitative and qualitative analysis on left ventricular hypertrophy(LVH),myocardial fibrosis,reduced systolic and diastolic function,and coronary microcirculation disturbance caused by hypertension,which is of great significance for guiding clinical decision-making and improving patient prognosis,and is expected to provide reference direction for future research.