风湿

心脏核磁可用于风湿免疫疾病的诊治

作者:Sophie IM, et al 翻译:北医三院魏慧 来源:中国风湿病公众论坛 日期:2018-04-25
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         心脏核磁可用于风湿免疫疾病的诊治

关键字:  心脏核磁 

        靶向治疗已使结缔组织病(CTDs)的预后得到改善,但由于新出现的合并症,特别是心血管事件,患者的预期寿命仍短于一般人群。心脏核磁(CMR)是一种的无创的成像技术,可以提供多种心血管疾病的详细信息,同时患者不用受到电离辐射。CMR被仍为是可以定量评价左、右心室容积、质量、功能和心脏组织特征和评价胸腔血管的参考标准;它还可用于高分辨率心肌血流的定量评估以及冠状动脉的评估。这些技术的应用对于评估CTDs病情,因为心血管系统可能在CTDs的病理生理变化中有潜在或严重的病变。风湿病CMR国际共识小组成立于2012年1月,目的是在CMR和风湿病专家之间达成共识,就当前在CTDs中使用CMR的现状提出初步建议。本报告概述了CMR和风湿病专家达成共识的几个方面:(a)在类风湿关节炎、脊柱关节病、系统性红斑狼疮、小/中/大血管血管炎、肌炎、结节病(SRC)和硬皮病(SSc)中使用CMR的适应证;(b)CMR方案、CMR报告术语和CMR诊断标砖,以评估和量化心血管病变在CTDs中的情况;(c)进一步发展这一领域的研究。

        附原文:Targeted therapies in connective tissue diseases (CTDs) have led to improvement of disease-associated outcomes, but life expectancy remains lower compared to general population due to emerging co-morbidities, particularly due to excess cardiovascular risk.Cardiovascular magnetic resonance (CMR) is a noninvasive imaging technique which can provide detailed information about multiple cardiovascular pathologies without using ionizing radiation. CMR is considered the reference standard for quantitative evaluation of left and right ventricular volumes, mass and function, cardiac tissue characterization and assessment of thoracic vessels; it may also be used for the quantitative assessment of myocardial blood flow with high spatial resolution and for the evaluation of the proximal coronary arteries. These applications are of particular interest in CTDs, because of the potential of serious and variable involvement of the cardiovascular system during their course. The International Consensus Group on CMR in Rheumatology was formed in January 2012 aiming to achieve consensus among CMR and rheumatology experts in developing initial recommendations on the current state-of-the-art use of CMR in CTDs. The present report outlines the recommendations of the participating CMR and rheumatology experts with regards to: (a) indications for use of CMR in rheumatoid arthritis, the spondyloarthropathies, systemic lupus erythematosus, vasculitis of small, medium and large vessels, myositis, sarcoidosis (SRC), and scleroderma (SSc); (b) CMR protocols, terminology for reporting CMR and diagnostic CMR criteria for assessment and quantification of cardiovascular involvement in CTDs; and (c) a research agenda for the further development of this evolving field.

        引自:Sophie IM, George DK, Theodoros D, et al. Cardiovascular magnetic resonance in rheumatology: current status and recommendations for use. International Journal of Cardiology, 2016, 217: 135-148.

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