Differenzierung struktureller Herzerkrankungen in der MRT

Strukturelle Herzerkrankungen umfassen erworbene oder angeborene Veränderungen, die mit einer Modifizierung der Herzklappen und des Herzmuskels einhergehen. Eine Verdickung des Herzmuskels gibt indirekte Hinweise für eine vergrößerte interstitielle Matrix, d. h., dass sich im Extrazellulärraum pathologische Stoffwechselabbauprodukte angesammelt haben und diese funktionelle Defizite in der Kontraktion des Herzmuskels verursachen können.

Abstract

Structural heart disease includes changes, which may be acquired or congenital, in the heart valves and heart muscle. The boundaries between congenital and acquired diseases are blurred and cannot be clearly defined. Thickening of the myocardium is an indirect indication of an enlarged interstitial matrix, which means that pathological metabolic degradation products such as fatty deposits (Fabry disease), amyloid proteins (amyloidosis), granulocytes (sarcoidosis) or fibrosis (CMP cardiomyopathy) accumulate in the extracellular space and can lead to functional deficits in the contraction of the myocardium.

Schlüsselwörter

Strukturelle Herzerkrankung - Herzmuskel - MRT - Morbus Fabry - Amyloidose

Key word

structural heart disease - myocardium - MRI - Fabry disease - amyloidosis

Publikationsverlauf

Artikel online veröffentlicht:
28. November 2023

• Literatur

• 1 Hombach V. Hrsg. Cardiovascular magnetic resonance imaging. Stuttgart: Schattauer;; 2012
• 2 Lütjen-Drecoll E, Rohen JW. Innenansichten des menschlichen Körpers. Stuttgart: Schattauer;; 2009
• 3 Harrison TR. Harrisons Innere Medizin. 15. Aufl.. Berlin: ABW Wissenschaftsverlag;; 2002
• 4 Gertz MA, Rajkumar SV. Amyloidosis. Diagnosis and Treatment. Contemporary Hematology. Berlin, Heidelberg: Springer; 2010
• 5 Hofmann NP, Giusca S, Klingel K. et al. Severe Left Ventricular Hypertrophy, Small Pericardial Effusion, and Diffuse Late Gadolinium Enhancement by Cardiac Magnetic Resonance Suspecting Cardiac Amyloidosis: Endomyocardial Biopsy Reveals an Unexpected Diagnosis. Case Rep Cardiol 2016; 2461502
• 6 Nam BD, Kim SM, Jung HN. et al. Comparison of quantitative imaging parameters using cardiovascular magnetic resonance between cardiac amyloidosis and hypertrophic cardiomyopathy: inversion time scout versus T1 mapping. Int J Cardiovasc Imaging 2018; 34: 1769-1777
• 7 Knight DS, Zumbo G, Barcella W. et al. (2018) Cardiac Structural and Functional Consequences of Amyloid Deposition by Cardiac Magnetic Resonance and Echocardiography and Their Prognostic Roles. JACC Cardiovasc Imaging 2018; 12: 823-833
• 8 Moore B, Semsarian C, Chan KH. et al. Sudden Cardiac Death and Ventricular Arrhythmias in Hypertrophic Cardiomyopathy. Heart Lung Circ 2019; 28: 146-154
• 9 Massalha S, Ruddy TD. Emerging role of echocardiography, cardiac magnetic resonance imaging and ^99mTc-labeled bone tracer scintigraphy for the diagnosis of cardiac amyloidosis. J Nucl Cardiol 2018; 25: 2080-2083
• 10 Messroghli DR, Moon JC, Ferreira VM. et al. Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: A consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI). J Cardiovasc Magn Reson 2017; 19: 75
• 11 Liu JM, Liu A, Leal J. et al. Measurement of myocardial native T1 in cardiovascular diseases and norm in 1291 subjects. J Cardiovasc Magn Reson 2017; 19: 74