CMR重新分类了大多数怀疑MINOCA和非MINOCA的患者
Kate Liang1,2, Giandomenico Bisaccia3,4, Isabella Leo3,5
1Bristol Medical School, Faculty of Health Sciences, University of Bristol, Senate House, Tyndall Avenue, Bristol, BS8 1TH, UK.
European heart journal. Cardiovascular Imaging
|August 1, 2023
概括
心脏MRI显著重新分类急性冠状动脉综合征和无阻塞冠状动脉的患者的诊断. 大多数患者被诊断为非心肌梗塞与非阻塞冠状动脉 (MINOCA) 疾病,突出显示CMR.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
背景情况:
- 没有阻塞的冠状动脉的急性冠状动脉综合征 (ACS) 是一个诊断挑战.
- 心脏磁共振 (CMR) 对于诊断 ACS 呈现有价值.
- 在这些患者中,CMR的诊断重新分类作用需要进一步澄清.
研究的目的:
- 确定疑似心肌梗塞的患者中,有非阻塞冠状动脉 (MINOCA) 或非MINOCA疾病的比例,其诊断通过CMR重新分类.
- 评估CMR对ACS和无阻塞冠状动脉患者的替代诊断的影响.
主要方法:
- 在888名患者的回顾性队列研究中,由于怀疑MINOCA,他们被转诊为CMR.
- 分析CMR前后诊断以确定诊断重新分类率.
- 替代诊断的分类,包括心肌炎,Takotsubo综合征,心肌病和正常的CMR发现.
主要成果:
- 在78%的患者中,CMR重新分类了诊断.
- 在只有27%的患者中确认了MINOCA.
- 在73%的患者中发现了替代性诊断,包括心肌炎 (24%),Takotsubo综合征 (13%),心肌病 (11%),正常/非特异性CMR (24%).
结论:
- 在没有阻塞冠心病的ACS患者中,非MINOCA诊断比MINOCA更常见.
- CMR显著重新分类诊断,证实其在识别潜在疾病方面的关键作用.
- 这项研究强调了将MINOCA与其他心脏病区分开来的诊断挑战.
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