心血管磁共振作为SLE和胸痛患者的初始查工具
Isak Samuelsson1,2, Simon Thalén3,4, Giorgia Grosso5
1Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden isak.samuelsson@ki.se.
Lupus science & medicine
|November 10, 2025
概括
心血管磁共振 (CMR) 有助于识别心脏缺血,冠状动脉疾病 (CAD) 和冠状动脉微血管功能障碍 (CMD) 在有系统性红斑狼 (SLE) 患者胸部症状. 这种成像技术在三分之一的病例中改变了管理.
科学领域:
- 心脏病学 心脏病学
- 类风湿病学 类风湿病学
- 医疗成像医学成像
背景情况:
- 系统性红斑狼 (SLE) 患者经常经历胸痛.
- 区分心脏原因,如冠状动脉疾病 (CAD),冠状动脉微血管功能障碍 (CMD),心周炎和心肌炎至关重要.
研究的目的:
- 利用心血管磁共振 (CMR) 来诊断患有胸部症状的SLE患者的心脏病.
- 评估CMR在指导治疗决策中的临床实用性.
主要方法:
- 患有心脏暗示性胸部症状的成人SLE患者在2018-2023年期间接受了CMR.
- 进行了定量心肌 perfusion 映射,并在适当时进行腺应激成像.
- 医疗记录被审查,以确定CMR发现是否改变了患者管理或导致干预.
主要成果:
- 在有症状的SLE患者中,CMR在21%的患者中诊断出CAD,在14%的患者中诊断出CMD;在16%的患者中发现心膜炎.
- 在任何参与者中都没有诊断出心肌炎.
- 在63%的患者中,CMR没有发现症状的原因,但在32%的患者中改变了医疗管理.
结论:
- 心脏缺血,包括CAD和CMD,是SLE胸部症状的重要原因,比心周炎或心肌炎更为普遍.
- CMR显示了早期检测和改善症状SLE患者心脏病的管理的潜力.
- 需要对更大的队列进行进一步研究,以验证研究结果并评估早期CMR的长期预后价值.
更多相关视频
相关概念视频
Imaging Studies for Cardiovascular System IV: CMRI
304
Cardiovascular magnetic resonance imaging, or CMRI, is a non-invasive diagnostic test that employs a magnetic field and radiofrequency waves to create precise images of the heart and arteries. It provides comprehensive information about cardiac anatomy, function, perfusion, and tissue characterization without ionizing radiation.IndicationsCMRI diagnoses various heart conditions, including tissue damage from heart attacks, ischemic heart disease, myocarditis, aortic issues (tears, aneurysms,...
304
Imaging Studies for Cardiovascular System I:Echocardiography
710
Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
710
Acute Coronary Syndrome III: Diagnostic Studies
200
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
200
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
470
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
470
Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
377
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
377
Angina III: Clinical Manifestations and Assessment
195
Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
195


