心脏磁共振相关参数在AMI-PCI术后MACE 风险评估中的研究进展

Research Advances in Cardiac Magnetic Resonance Parameters for Risk Assessment of Major Adverse Cardiovascular Events Following Acute Myocardial Infarction Treated with Percutaneous Coronary Intervention

摘要: 急性心肌梗死(Acute Myocardial Infarction, AMI)是我国乃至全世界主要的致死性疾病，具有发病急、进展快、死亡率高等特点。急诊经皮冠状动脉介入治疗(Percutaneous Coronary Intervention, PCI)能及时恢复血运，但部分患者术后仍发生主要不良心血管事件(Major Adverse Cardiovascular Event, MACE)，精准的风险分层已成为临床管理的核心难题。心脏磁共振(Cardiac Magnetic Resonance, CMR)作为一种多参数、多序列的无创成像技术，在术后的风险分层中扮演着关键角色。除左心室射血分数等传统心脏结构与功能参数外，CMR的心肌组织特征、心肌应变、灌注及血流动力学等参数被逐步发现可通过反映微循环障碍、心肌损伤及组织重构等机制参与MACE的预测过程。本文重点总结CMR各参数在MACE风险评估中的研究进展，旨在为探索除传统射血分数之外的精准风险分层策略提供新的思路。

Abstract: Acute myocardial infarction (AMI) is a leading cause of death in China and worldwide, characterized by sudden onset, rapid progression, and high mortality. Emergency percutaneous coronary intervention (PCI) can promptly restore blood flow; however, some patients still experience major adverse cardiovascular events (MACE) post-procedure, making accurate risk stratification a core challenge in clinical management. Cardiac magnetic resonance (CMR), as a non-invasive imaging technique with multiple parameters and sequences, plays a pivotal role in post-procedural risk stratification. Beyond traditional cardiac structural and functional parameters such as left ventricular ejection fraction, CMR derived parameters including myocardial tissue characterization, myocardial strain, perfusion, and hemodynamics have been increasingly recognized for their role in predicting MACE. These parameters reflect underlying mechanisms such as microcirculatory dysfunction, myocardial injury, and tissue remodeling. This article focuses on summarizing the research progress regarding various CMR parameters in MACE risk assessment, aiming to provide new insights for exploring precise risk stratification strategies beyond traditional ejection fraction.