中国循环杂志2024,Vol.39Issue(3) :294-300.DOI:10.3969/j.issn.1000-3614.2024.03.014

主动脉瓣狭窄患者左心室重构的过程、影像学特点与治疗决策

Progression,Imaging Characteristics of Left Ventricular Remodeling and the Clinical Value on Decision-making of Intervention in Patients With Aortic Stenosis

陈乔凡 叶蕴青 张而立 许海燕 吴永健
中国循环杂志2024,Vol.39Issue(3) :294-300.DOI:10.3969/j.issn.1000-3614.2024.03.014

主动脉瓣狭窄患者左心室重构的过程、影像学特点与治疗决策

Progression,Imaging Characteristics of Left Ventricular Remodeling and the Clinical Value on Decision-making of Intervention in Patients With Aortic Stenosis

陈乔凡 1叶蕴青 1张而立 1许海燕 1吴永健1
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作者信息

  • 1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 心内科,北京 100037
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摘要

主动脉瓣狭窄是一种以左心室结构和功能不断变化为特征的瓣膜性心脏病.其中,左心室心肌细胞和几何结构重构与患者的预后息息相关.主动脉瓣置换术是目前治疗重度主动脉瓣狭窄唯一有效的手段.现有指南针对该类患者的治疗建议主要基于症状和左心室射血分数.现代影像学技术可显示主动脉瓣狭窄患者左心室重构的不同表现,研究也进一步揭示了左心室重构与心功能之间的相.本文就主动脉瓣狭窄患者左心室重构的特点与潜在机制、影像学表现以及影像学手段在其诊治中的应用进行综述.

Abstract

Aortic stenosis is a valve disease characterized by dynamic and continuous changes in structure and function of left ventricle.Left ventricular remodeling,which embodies pathological changes in myocardial cellular and ventricular geometry,is an important prognostic factor of patients with aortic stenosis.Aortic valve replacement is the only effective treatment for severe aortic stenosis.Current guideline recommendations for interventions are based on symptoms and left ventricular ejection fraction.With the improvements of modern imaging technology,different patterns of remodeling,including hypertrophy and fibrosis,could be identified now.Studies also explored the close association between left ventricular remodeling and function in the setting of aortic stenosis.In this review,we aim to elucidate the characteristic imaging features and potential mechanisms of left ventricular remodeling,and further,we highlight the clinical value of specific imaging features and clinical application of modern imaging methods in the evaluation,risk stratification,and intervention decision-making for patients with aortic stenosis.

关键词

主动脉瓣狭窄/左心室重构/心肌肥厚/心肌纤维化/主动脉瓣置换术

Key words

aortic stenosis/left ventricular remodeling/myocardial hypertrophy/myocardial fibrosis/aortic valve replacement

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基金项目

国家重点研发计划(2020YFC2008100)

出版年

2024
中国循环杂志
中国医学科学院

中国循环杂志

CSTPCDCSCD北大核心
影响因子:2.803
ISSN:1000-3614
被引量1
参考文献量38
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