科普知识学英语 心肌病患者心肌受损易引发死亡.docVIP

Detection of midwall?fibrosis（纤维化）?(the presence of scar tissue in the middle of the heart muscle wall) via magnetic resonance imaging among patients with nonischemic dilatedcardiomyopathy（扩张型心肌病）?(a condition affecting the heart muscle) was associated with an increased likelihood of death, according to a study appearing in the March 6 issue of JAMA. Nonischemic dilated cardiomyopathy is associated with significant illness and death due to progressive heart failure (HF) and sudden cardiac death (SCD). Despite therapeutic advances, 5-year mortality remains as high as 20 percent. Risk stratification of patients with nonischemic dilated cardiomyopathy is primarily based on left ventricular ejection fraction [LVEF; a measure of how well the left ventricle of the heart pumps with each contraction]. Superiorprognostic（预兆的）?factors may improve patient selection for implantable cardioverter-defibrillators (ICDs) and other management decisions, according to background information in the article. Attention has recently focused on whether detection of?myocardial（心肌的）replacement fibrosis (scarring of the heart muscle) may assist with risk?stratification（层理）in dilated cardiomyopathy. Fibrosis is associated with contractile impairment. ? Ankur Gulati, M.D., of Royal Brompton Hospital, London, and colleagues evaluated whether midwall fibrosis (detected by late gadolinium enhancement cardiovascular magnetic resonance [LGE-CMR] imaging) predicts risk of death, independently of LVEF and other established prognostic factors in dilated cardiomyopathy. The study included 472 patients with dilated cardiomyopathy referred to a U.K. center for CMR imaging between November 2000 and December 2008 after presence and extent of midwall replacement fibrosis (scarring of the heart muscle present in the middle of the heart muscle wall) were determined. Patients were followed up through December 2011. ? During a median (midpoint) follow-up of 5.3 years, there were 73 deaths. Overall, 38 of 142 p