文献速递心血管MR

心肌梗死后非梗死心肌的多参数心脏磁共振特征:定义、评估与临床意义

Multiparametric Cardiac Magnetic Resonance Characterization of the Noninfarcted Myocardium: Definition, Assessment, and Clinical Significance.
PubMed 文献 · JACC Cardiovasc Imaging · 2026-05-20

本文综述了急性心肌梗死后非梗死心肌(NIM)的功能、结构和炎症改变,指出CMR可检测NIM的炎症、间质扩张和心肌变形异常,强调NIM主动参与心梗后疾病进展,并可作为风险分层工具和潜在治疗靶点。

要点

  • CMR可评估NIM的炎症、间质扩张及心肌变形改变。
  • NIM并非被动受累,而是主动参与心梗后疾病进展。
  • NIM有望成为风险分层指标和抗炎抗纤维化治疗靶点。

核心结论

  • 急性心肌梗死后非梗死心肌存在功能、结构和炎症改变,CMR可检测这些改变并用于风险分层和靶向治疗评估。

研究设计与样本

  • 综述类文章,检索范围与纳入文献未在摘要中报告。

关键影像表现/征象

  • CMR可检测非梗死心肌的炎症、间质扩张和心肌变形改变。

临床应用与阅片要点

  • 在评估急性心肌梗死CMR时,除梗死灶和 peri-infarct 区域外,应关注非梗死心肌的炎症、间质扩张和变形异常。

局限性

  • 摘要未报告纳入文献的检索策略及证据等级,综述结论基于现有文献汇总。

以上解读依据论文摘要(全文未开放获取或许可不允许翻译转载)。

英文原文(摘要)· 点击展开

Acute myocardial infarction (AMI) remains a major cause of cardiovascular illness and death. Advanced imaging techniques, particularly cardiac magnetic resonance (CMR), have become essential in assessing tissue alterations within the infarcted zone. The CMR published reports focus primarily on evaluating infarct size and the peri-infarct region in the context of AMI. Recent evidence highlights that the noninfarcted myocardium (NIM) surrounding the infarct sustains functional, structural, and inflammatory changes due to ischemic injury. CMR can detect significant changes in the NIM, such as inflammation, interstitial expansion, and altered myocardial deformation. These findings indicate that the NIM is not merely passive but is actively involved in the progression of heart disease after AMI. Targeting the NIM with novel therapeutic strategies, such as anti-inflammatory and antifibrotic treatments, shows promise for improving patient outcomes. This review aims to define the role and imaging criteria for exploring the NIM after AMI and to highlight its emerging significance as a tool for risk stratification and a potential therapeutic target.

来源:JACC Cardiovasc Imaging,查看原文。版权归原作者所有。

引用

  1. Pavon AG, Bergamaschi L, Guglielmo M, et al. Multiparametric Cardiac Magnetic Resonance Characterization of the Noninfarcted Myocardium: Definition, Assessment, and Clinical Significance. JACC Cardiovasc Imaging. 2026. PMID: 42165778. doi:10.1016/j.jcmg.2026.03.015

供执业医师工作参考,不替代临床判断;数值与分级以指南原文为准。