背景:Takotsubo综合征(TS)的特征是短暂性心肌功能障碍,其预后范围从有利到危及生命。心血管磁共振(CMR)已成为其诊断和管理的重要工具,目前的指南在诊断工作中一直推荐。然而,CMR对TS患者的预后价值尚不确定.这项研究的目的是评估CMR在管理TS患者中的预后价值。
方法:PubMed,MEDLINE通过Ovid,Scopus,并搜索Cochrane图书馆,以确定报告多参数CMR在随访≥12个月的TS患者中的预后作用的研究.主要终点是主要不良心脑血管事件(MACCE),定义为全因死亡率,心脏死亡,心力衰竭,心源性猝死,TS复发,和脑血管事件。
结果:纳入5项564例患者的研究,报告CMR参数与MACCE的相关性。主要终点发生在69例(12%)患者中。在评估的CMR参数中,心肌应变参数(包括左心房的测量,左心室和右心室),右心室受累,基于CMR的影像组学模型证明了与MACCE的相关性。此外,一项研究显示了CMR评分的预测能力.
结论:当前的系统评价表明,CMR可能为TS患者提供预后见解,强调其融入临床实践的潜在临床效用。然而,目前可用的数据很少;因此,需要进一步的研究。
BACKGROUND: Takotsubo syndrome (TS) is characterized by transient myocardial dysfunction with outcomes ranging from favorable to life-threatening. Cardiovascular magnetic resonance (CMR) has emerged as an essential tool in its diagnosis and management and is consistently recommended by current guidelines in the diagnostic work-up. However, the prognostic value of CMR in patients with TS remains undetermined. The aim of this study was to assess the prognostic value of CMR in managing patients with TS.
METHODS: PubMed, MEDLINE via Ovid, Scopus, and the Cochrane Library were searched to identify studies reporting the prognostic role of multiparameteric CMR in patients with TS with a follow-up ≥ 12 months. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), defined as all-cause mortality, cardiac death, heart failure, sudden cardiac death, recurrence of TS, and cerebrovascular events.
RESULTS: Five studies with 564 patients were included for reporting correlation of CMR parameters with MACCE. Primary endpoint occurred in 69 (12%) patients. Among the CMR parameters assessed, myocardial strain parameters (including measurements of the left atrium, left and right ventricle), right ventricle involvement, and a CMR-based radiomics model demonstrated correlations with MACCE. Additionally, one study showed the predictive ability of a CMR score.
CONCLUSIONS: The current systematic review suggests that CMR may offer prognostic insights in TS patients, underscoring its potential clinical utility for integration into clinical practice. However, scarce data are currently available; hence, further research is needed.