免疫检查点抑制剂相关心肌炎的心血管磁共振研究进展

Research progress on cardiovascular magnetic resonance in immune checkpointinhibitor-associated myocarditis

  • 摘要: 免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)在提高机体对肿瘤细胞的杀伤能力时,也会导致多种心血管毒性的出现。其中,免疫检查点抑制剂相关心肌炎(ICI-associated myocarditis,ICI-M)的发病率及死亡率最高,这也是临床诊疗中的关键难题。心血管磁共振(cardiovascular magnetic resonance,CMR)是无创评估心脏结构、功能和组织特性的“金标准”,近年来国内外指南已将其作为评价ICI-M的重要工具。本文基于国内外近期指南和国内外研究成果,对ICI-M的病理学机制、诊断标准、CMR的相关研究进展及临床应用价值进行综述。

     

    Abstract: Although immune checkpoint inhibitors (ICIs) enhance the immune system’s capacity to destroy tumor cells, they can also induce a range of toxic responses that lead to cardiovascular damage. Among these adverse effects, ICI-associated myocarditis (ICI-M) has the highest morbidity and mortality rates, presenting a significant challenge in clinical practice. Cardiovascular magnetic resonance (CMR) is regarded as the "gold standard" for noninvasive assessment of cardiac structure, function, and tissue characteristics. While this imaging technique has advanced rapidly in recent years, with both domestic and international guidelines recognizing it as a crucial tool for evaluating ICI-M. This article provides a comprehensive overview of the pathological mechanisms underlying ICI-M, its diagnostic criteria, and the latest research developments in CMR and its clinical applications; it also discusses the most recent domestic and international guidelines and research findings.

     

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