大辩论:心肌梗塞的普遍定义是有缺陷的,应该放弃
Christian Mueller1, Harvey D White2, Pedro Lopez-Ayala1
1Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
European heart journal
|September 9, 2025
概括
心肌梗塞 (MI) 的通用定义为使用临床和生物标志物证据诊断心脏病发作提供了一个框架. 尽管取得了进展,但关于其在临床实践中的应用和解释仍存在持续的争论.
科学领域:
- 心脏病学 心脏病学
- 生物标志物 生物标志物
- 病理生理学 病理生理学
背景情况:
- 心肌梗塞 (MI) 是由心肌细胞死因长期缺血而定义的.
- 临床诊断依赖于缺血的证据和心脏热素生物标志物.
- 心肌梗塞 (UDMI) 的通用定义旨在标准化诊断和分类.
研究的目的:
- 审查UDMI的发展和框架.
- 讨论MI类型的分类和与非缺血性损伤的区别.
- 突出现有的保留和围绕UDMI的持续辩论.
主要方法:
- 关于UDMI代的文献审查.
- 对急性心脏病发作的诊断标准的分析.
- 讨论区分MI与其他心肌损伤的因素.
主要成果:
- UDMI为MI分类提供了一个分层的,基于病理生理学的框架.
- 它为区分MI与非缺血性心肌损伤提供了指导.
- 有关利益相关者的重大保留需要进一步讨论.
结论:
- 在定义MI方面,UDMI已经取得了重大进展.
- 目前正在进行的辩论强调了需要继续改进和达成共识的必要性.
- UDMI的目的是定义MI,而不是管理MI.
相关概念视频
Myocarditis I: Introduction
374
Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
374
Acute Coronary Syndrome I: Introduction
835
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
835
Myocarditis II: Clinical Features and Diagnostic Tests
269
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
269
Cardiomyopathy I: Introduction and Classification
514
Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
514
Angina I: Introduction
472
Definition and Symptoms: Angina (angina pectoris) is chest pain or discomfort caused by myocardial ischemia, which occurs when the heart muscle receives insufficient oxygen-rich blood. It typically manifests as pressing, squeezing, or crushing sensations in the chest and may radiate to the shoulders, arms, neck, jaw, or back.Primary Cause: In a healthy state, the coronary arteries can dilate (widen) to increase blood flow and meet the increased oxygen demand during physical activity or...
472
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
364
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
364


