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扩张型心肌病(dilated cardiomyopathy,DCM)是一种常见的原发性心肌疾病,以左心室扩大及泵功能衰竭为主要临床特征,其病死率高。其中心源性猝死(sudden cardiac death,SCD)占DCM总病死率的30%,心肌纤维化是其重要病理基质。延迟钆增强心脏磁共振成像(LGE-CMR)是目前公认的判断心肌纤维化的无创检查方法,多项研究揭示LGE-CMR阳性预示着DCM患者SCD风险增加,而LGE阴性发生SCD的概率大为降低,因此LGE-CMR结合经典指标LVEF有助于DCM患者发生SCD的预测,为临床决策尤其是植入自动心脏复律除颤器(implantable cardioverter defibrillator,ICD)的选择提供帮助。
Dilated cardiomyopathy (dilated cardiomyopathy, DCM) is a common primary myocardial disease, with left ventricular enlargement and pump failure as the main clinical features, the high mortality. Among them, sudden cardiac death (SCD) accounts for 30% of the total mortality of DCM, and myocardial fibrosis is an important pathological matrix. Delayed gadolinium-enhanced cardiac magnetic resonance imaging (LGE-CMR) is currently recognized as a noninvasive method for the diagnosis of myocardial fibrosis. A number of studies have revealed that LGE-CMR positivity predicts an increased risk of SCD in patients with DCM, Therefore, LGE-CMR combined with the classic LVEF is helpful for the prediction of SCD in patients with DCM, which may be helpful for clinical decision-making, especially implantable cardioverter defibrillator (ICD).