心脏受累在系统性硬化症:磁共振成像的作用。

IF 8.4 2区 医学 Q1 ALLERGY Clinical Reviews in Allergy & Immunology Pub Date : 2023-06-01 DOI:10.1007/s12016-022-08923-3
Giacomo De Luca, Sara Bombace, Lorenzo Monti
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引用次数: 4

摘要

系统性硬化症(SSc)是一种严重的结缔组织疾病,以弥漫性血管损伤和免疫系统异常激活为特征,导致皮肤和包括心脏在内的内脏器官的炎症和纤维化。心脏受累在SSc中很常见,尽管由于早期隐匿性和缺乏明确的诊断算法,通常无法识别。一旦临床表现明显,心脏受累与预后不良相关,是约三分之一SSc患者死亡的主要原因。因此,其早期识别和监测是至关重要的,允许及时的治疗干预和改善患者的结果。心脏磁共振(CMR)是一种无创、无辐射的成像技术,对心血管系统的评估具有重要意义,是心脏形态功能和结构表征的首选方式。在SSc中,CMR可以精确定义双心室和双心房的大小和功能,以及详细的组织表征。因此,在SSc中,CMR被广泛建议作为一种非侵入性诊断工具来表征心脏受累,特别是心肌受累。在这篇综述中,我们总结了支持在SSc中使用CMR作为识别和表征硬皮病心脏病的重要工具的最新证据。此外,本文还讨论了基于cmr的SSc心脏受累早期检测方法的未满足需求和未来前景。
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Heart Involvement in Systemic Sclerosis: the Role of Magnetic Resonance Imaging.

Systemic sclerosis (SSc) is a severe connective tissue disease characterized by diffuse vascular damage and aberrant activation of immune system, resulting in inflammation and fibrosis of skin and internal organs, including the heart. Cardiac involvement is frequent in SSc, even though often unrecognized due to the occult nature at early stages and to the lack of a defined diagnostic algorithm. Once clinically evident, heart involvement is associated with a poor prognosis, representing the leading cause of death in about one third of SSc patients. Thus, its early recognition and monitoring are of crucial importance to allow a prompt therapeutic intervention and to improve patients' outcomes. Cardiac Magnetic Resonance (CMR) is a non-invasive, non-radiating imaging technique of great importance for the assessment of cardiovascular system, and represents the modality of choice for the morpho-functional and structural characterization of the heart. In SSc, CMR allows a precise definition of biventricular and biatrial size and function, and a detailed tissue characterization. CMR has been therefore extensively proposed in SSc as a non-invasive diagnostic tool to characterize heart involvement, particularly myocardial involvement. In this review, we summarize the most recent evidences to support the use of CMR in SSc as an important tool to recognize and characterize scleroderma heart disease. Furthermore, the unmet needs and the future perspectives of a CMR-based approach for the early detection of SSc heart involvement are discussed.

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来源期刊
CiteScore
22.30
自引率
1.10%
发文量
58
审稿时长
6-12 weeks
期刊介绍: Clinical Reviews in Allergy & Immunology is a scholarly journal that focuses on the advancement of clinical management in allergic and immunologic diseases. The journal publishes both scholarly reviews and experimental papers that address the current state of managing these diseases, placing new data into perspective. Each issue of the journal is dedicated to a specific theme of critical importance to allergists and immunologists, aiming to provide a comprehensive understanding of the subject matter for a wide readership. The journal is particularly helpful in explaining how novel data impacts clinical management, along with advancements such as standardized protocols for allergy skin testing and challenge procedures, as well as improved understanding of cell biology. Ultimately, the journal aims to contribute to the improvement of care and management for patients with immune-mediated diseases.
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