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Cardiac magnetic resonance imaging to detect ischemia in chronic coronary syndromes: state of the art


Sokolska, Justyna M; von Spiczak, Jochen; Gotschy, Alexander; Kozerke, Sebastian; Manka, Robert (2019). Cardiac magnetic resonance imaging to detect ischemia in chronic coronary syndromes: state of the art. Kardiologia Polska, 77(12):1123-1133.

Abstract

The new 2019 European Society of Cardiology guidelines for the diagnosis and management of chronic coronary syndromes emphasize the role of noninvasive functional imaging of myocardial ischemia in diagnosing coronary artery disease to guide decision making regarding revascularization. Cardiac magnetic resonance imaging (CMR) stands out relative to other imaging modalities given its high safety profile, absence of ionizing radiation, and its versatility in encoding various image contrasts. It also allows an assessment of myocardial function, ischemia, and viability as well as permits tissue characterization including detection of edema in a single examination. In recent years, a number of meta‑analyses and studies considering the role of CMR for detecting ischemia have been published. The recent multicenter randomized MR‑INFORM trial has demonstrated the clinical utility of CMR in patients with stable angina and cardiovascular risk factors. This landmark study has proved that a perfusion CMR‑based strategy leads to a lower number of revascularizations while being noninferior to an invasive coronary angiography with fractional flow reserve-guided therapy in terms of major adverse cardiac events at 1 year. In light of recent and future technical improvements, CMR will become increasingly important in the assessment of myocardial ischemia in patients with chronic coronary syndromes.

Abstract

The new 2019 European Society of Cardiology guidelines for the diagnosis and management of chronic coronary syndromes emphasize the role of noninvasive functional imaging of myocardial ischemia in diagnosing coronary artery disease to guide decision making regarding revascularization. Cardiac magnetic resonance imaging (CMR) stands out relative to other imaging modalities given its high safety profile, absence of ionizing radiation, and its versatility in encoding various image contrasts. It also allows an assessment of myocardial function, ischemia, and viability as well as permits tissue characterization including detection of edema in a single examination. In recent years, a number of meta‑analyses and studies considering the role of CMR for detecting ischemia have been published. The recent multicenter randomized MR‑INFORM trial has demonstrated the clinical utility of CMR in patients with stable angina and cardiovascular risk factors. This landmark study has proved that a perfusion CMR‑based strategy leads to a lower number of revascularizations while being noninferior to an invasive coronary angiography with fractional flow reserve-guided therapy in terms of major adverse cardiac events at 1 year. In light of recent and future technical improvements, CMR will become increasingly important in the assessment of myocardial ischemia in patients with chronic coronary syndromes.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Cardiology and Cardiovascular Medicine
Language:German
Date:19 December 2019
Deposited On:14 Feb 2020 14:58
Last Modified:22 Apr 2020 23:10
Publisher:Polskie Towarzystwo Kardiologiczne
ISSN:0022-9032
OA Status:Green
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.33963/KP.15057
PubMed ID:31719511

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