Chronic stable angina cardiac magnetic resonance imaging
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Smita Kohli, M.D.; Lakshmi Gopalakrishnan, M.B.B.S.
Overview
Cardiac magnetic resonance imaging (CMRI) is a non-invasive test that is useful in the evaluation of overall coronary anatomy and function, and also holds a potential for plaque characterization .
Indications for CMR based on Consensus Panel report [1]
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Class I1. Assessment of global ventricular (left and right) function and mass 2. Detection of coronary artery disease
3. Acute and chronic myocardial infarction
Class II1. Detection of coronary artery disease
2. Acute and chronic myocardial infarction
Class III1. Detection of coronary artery disease
2. Acute and chronic myocardial infarction
Class Inv1. Detection of coronary artery disease
2. Acute and chronic myocardial infarction |
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Note:
- Class I: provides clinically relevant information and is usually appropriate; may be used as first line imaging technique; usually supported by substantial literature.
- Class II: provides clinically relevant information and is frequently useful; other techniques may provide similar information; supported by limited literature.
- Class III: provides clinically relevant information but is infrequently used because information from other imaging techniques is usually adequate.
- Class Inv: potentially useful, but still investigational.
Detection of CAD
- Early detection of atherosclerosis and endothelial dysfunction using CMRI is possible with arterial wall imaging and assessing the reactivity of brachial artery.
- Alternative approaches include:
- Visualization of the effects of induced ischemia (wall motion, perfusion)
- Myocardial perfusion: In patients with CAD, CMR showed improvement in myocardial perfusion after coronary angioplasty [4] and in patients with cadiac syndrome X impaired sub-endocardial perfusion was observed [5].
- Direct visualization of coronary arteries (coronary angiography and flow)
References
- ↑ Pennell DJ, Sechtem UP, Higgins CB, Manning WJ, Pohost GM, Rademakers FE et al. (2004) Clinical indications for cardiovascular magnetic resonance (CMR): Consensus Panel report. Eur Heart J 25 (21):1940-65. DOI:10.1016/j.ehj.2004.06.040 PMID: 15522474
- ↑ Nagel E, Lorenz C, Baer F, Hundley WG, Wilke N, Neubauer S et al. (2001) Stress cardiovascular magnetic resonance: consensus panel report. J Cardiovasc Magn Reson 3 (3):267-81. PMID: 11816623
- ↑ Hundley WG, Hamilton CA, Thomas MS, Herrington DM, Salido TB, Kitzman DW et al. (1999) Utility of fast cine magnetic resonance imaging and display for the detection of myocardial ischemia in patients not well suited for second harmonic stress echocardiography. Circulation 100 (16):1697-702. PMID: 10525488
- ↑ Al-Saadi N, Nagel E, Gross M, Schnackenburg B, Paetsch I, Klein C et al. (2000) Improvement of myocardial perfusion reserve early after coronary intervention: assessment with cardiac magnetic resonance imaging. J Am Coll Cardiol 36 (5):1557-64. PMID: 11079658
- ↑ Panting JR, Gatehouse PD, Yang GZ, Grothues F, Firmin DN, Collins P et al. (2002) Abnormal subendocardial perfusion in cardiac syndrome X detected by cardiovascular magnetic resonance imaging. N Engl J Med 346 (25):1948-53. DOI:10.1056/NEJMoa012369 PMID: 12075055
- ↑ Hundley WG, Hamilton CA, Clarke GD, Hillis LD, Herrington DM, Lange RA et al. (1999) Visualization and functional assessment of proximal and middle left anterior descending coronary stenoses in humans with magnetic resonance imaging. Circulation 99 (25):3248-54. PMID: 10385498
- ↑ Nagel E, Thouet T, Klein C, Schalla S, Bornstedt A, Schnackenburg B et al. (2003) Noninvasive determination of coronary blood flow velocity with cardiovascular magnetic resonance in patients after stent deployment. Circulation 107 (13):1738-43. DOI:10.1161/01.CIR.0000060542.79482.81 PMID: 12665488
- ↑ Langerak SE, Kunz P, Vliegen HW, Jukema JW, Zwinderman AH, Steendijk P et al. (2002) MR flow mapping in coronary artery bypass grafts: a validation study with Doppler flow measurements. Radiology 222 (1):127-35. PMID: 11756716