Role of cardiovascular magnetic resonance in the management of patients with stable coronary artery disease

Motwani, Manish; Swoboda, Peter; Plein, Sven; Greenwood, John P

doi:10.1136/heartjnl-2017-311658

Cited by 18 publications

(9 citation statements)

References 45 publications

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“…LGE MRI can identify undetected necrotic scars and viable myocardium. 939,1152,1153 Evaluation of cardiac function by cardiac CT is also useful. However, these 3 modalities mentioned are all more expensive than echocardiography.…”

Section: Assessment Of Resting Cardiac Functionmentioning

confidence: 99%

JCS 2018 Guideline on Diagnosis of Chronic Coronary Heart Diseases

Yamagishi¹,

Tamaki²,

Akasaka³

et al. 2021

Circ J

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ABI ankle-brachial index ACC American College of Cardiology ACS acute coronary syndrome AHA American Heart Association APV averaged peak velocity ARH autosomal recessive hypercholesterolemia AS Agatston score ASO arteriosclerosis obliterans ATP adenosine triphosphate BMIPP β-methyl-p-iodophenyl-pentadecanoic acid BNP B-type natriuretic peptide CABG coronary artery bypass grafting CACS coronary artery calcium score CAD coronary artery disease CANM Canadian Association of Nuclear Medicine CanSCMR Canadian Society of Cardiovascular Magnetic Resonance CAR Canadian Association of Radiologists CCS Canadian Cardiovascular Society CCTA coronary CT angiography CDC Centers for Disease Control and Prevention CFR coronary flow reserve CFVR coronary flow velocity reserve CI confidence interval CKD chronic kidney disease CNCS Canadian Nuclear Cardiology Society CPAP continuous positive airway pressure CT computed tomography CTA computed tomography angiography CTDIvol computed omography dose index volume ▋ 2.2.1 Selection of the Lead System and Recording Time Appropriate ECG recording is essential for making a diagnosis of coronary heart disease. Care should be exercised with regard to selection of the electrodes, leads, paste, and lead system to obtain stable recordings during daily activities. The leads that are most likely to reflect ischemic changes are V5-like leads. In particular, lead CM5 is less affected by body movements and has a good detection rate for ischemic changes. 50 A 2-lead system is commonly used, and the AHA guidelines recommend a combination of leads that approximates leads V1 and V5. 51 For capturing ST elevation in patients with variant angina, vertical leads (II, III, and aVF) and approximations to lead V2 or V3 provide a high diagnostic rate. 52 Both circadian and diurnal (dayto-day) variations may exist in relation to the incidence and duration of myocardial ischemia and the extent of ST changes. However, it is difficult to evaluate the influence of diurnal variation based on 24-hour recording, which means that 48-hour recording is desirable for detecting myocardial ischemia and determining the response to treatment. ▋ 2.2.2 Criteria for ST-Segment Changes The diagnostic significance of persistent ST depression on Holter ECG is not high. Rather, detection and evaluation of transient ST-segment changes is more important. The criteria for ST depression are as follows: (1) horizontal or sagging depression of the ST segment by ≥0.1 mV; (2) reaching maximum ST depression after 1 min; and (3) ST depression of ≥0.1 mV lasting for ≥30-60 s compared with the baseline in a controlled state. 49,53-55 ST depression is measured at 0.08 s after the S or J point, and J-type ST depression is not judged to be ischemic ST depression. 52 When counting the number of ischemic episodes, the definition adopted is that each ischemic interval should last for at least 1 min. 56 The criterion for ST elevation is elevation of the ST segment by ≥0.1 mV lasting for ≥30-60 s in leads without Q waves. 49 In patients with chest pain ...

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Section: Assessment Of Resting Cardiac Functionmentioning

confidence: 99%

JCS 2018 Guideline on Diagnosis of Chronic Coronary Heart Diseases

Yamagishi¹,

Tamaki²,

Akasaka³

et al. 2021

Circ J

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“…La fibrosis nefrogénica sistémica, la cual es una enfermedad rara irreversible que está relacionada con la administración de gadolinio en pacientes con enfermedad renal crónica en estadio terminal, nos obliga a que dentro del protocolo de preparación del paciente se evalúe la función renal previa a la administración del fármaco con la finalidad de evitar la ocurrencia de esta enfermedad. 15 Las contraindicaciones para el uso de los fármacos descritos y del medio de contraste, así como quienes no pueden realizarse el estudio se describen en la Tabla 2.…”

Section: Agentes Estresores Y Medios De Contrasteunclassified

Utilidad de la Resonancia Magnética Cardíaca con Estrés Farmacológico para valorar Isquemia Miocárdica

Ramírez¹,

Paucca²

2020

Arch Peru Cardiol Cir Cardiovasc

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La enfermedad cardiovascular es la causa principal de mortalidad y morbilidad en el mundo y se estima que su prevalencia irá en aumento debido al incremento en la prevalencia de los factores de riesgo según la Organización Mundial de la Salud (OMS). En el Perú, la enfermedad cardiovascular es la segunda causa de muerte, por ello la detección de isquemia es una parte importante de la estrategia diagnóstica en pacientes que tienen sospecha de enfermedad coronaria, puesto que es un fuerte predictor de eventos adversos como infarto de miocardio y muerte de origen cardiovascular.La resonancia magnética cardíaca con estrés farmacológico para evaluar isquemia es una herramienta diagnóstica no invasiva que ofrece muchas ventajas sobre otras técnicas diagnósticas ya que tiene una alta resolución espacial y ausencia de exposición a la radiación. Su precisión diagnóstica para detectar enfermedad coronaria es alta, así como su valor pronóstico en los pacientes con sospecha de esta enfermedad.En esta revisión se describirá cómo se realiza el estudio de resonancia magnética cardiaca con estrés farmacológico para detección de isquemia y también se discutirá el valor pronóstico y diagnóstico en pacientes con sospecha de enfermedad coronaria.

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“…With a single scan, high-resolution images providing an unrestricted view may be obtained. These are useful for global and regional functional assessment, particularly the determination of left ventricular ejection fraction (LVEF) and myocardium viability [1]. CMR is a versatile diagnostic tool that can be employed to distinguish ischemic and nonischemic cardiomyopathies (NICM).…”

Section: Introductionmentioning

confidence: 99%

The Spectrum of Non-ischemic Cardiac Magnetic Resonance Imaging Findings: A Retrospective Analysis

Almas¹,

Saleem

Ehtesham³

et al. 2020

Cureus

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Introduction Since cardiac pathologies remain ubiquitous, their prompt diagnosis through the means of innovative technologies, such as cardiac magnetic resonance imaging, remains pivotal. The spectrum of these pathologies varies widely, ranging from ischemic etiologies to rare cardiac malignancies. This study evaluates the prevalence of nonischemic cardiac pathologies, such as infiltrative heart diseases, that often warrant meticulous diagnostic evaluation through the means of cardiac magnetic resonance imaging. Methods We performed a retrospective study in order to analyse the cardiac magnetic resonance imaging records of 250 patients over a period of six months with previously remarkable cardiac histories. Patients with a prior history of ischemic cardiac disease, as determined from past medical and surgical records, were excluded from the study. The prevalence of various nonischemic findings was ascertained. The demographic characteristics and comorbidities of the patients were also tabulated. Results In the present study, 250 patients were included, of which 115 were females and 135 were males, with the mean age hovering at 48.21 ± 11.49 years. The top two most prevalent cardiac magnetic resonance imaging findings were concentric moderate-to-severe left ventricular hypertrophy and patchy subendocardial late gadolinium enhancement of the left ventricle; these were observed in 62.2% and 23.7% of the patients, respectively. Cardiac magnetic resonance imaging also divulged findings typical of rarer pathologies, including cardiac sarcoidosis and primary cardiac lymphoma. Conclusion Pathologies of the heart often mandate extensive diagnostic workup through the means of radiological modalities such as cardiac magnetic resonance imaging. In patients with indications of nonischemic cardiac pathologies, cardiac magnetic resonance imaging can be employed as part of the initial radiological armamentarium. Furthermore, cardiac magnetic resonance remains the imaging modality of choice for detecting infrequent cardiac pathologies, such as cardiac sarcoidosis.

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Role of cardiovascular magnetic resonance in the management of patients with stable coronary artery disease

Cited by 18 publications

References 45 publications

JCS 2018 Guideline on Diagnosis of Chronic Coronary Heart Diseases

JCS 2018 Guideline on Diagnosis of Chronic Coronary Heart Diseases

Utilidad de la Resonancia Magnética Cardíaca con Estrés Farmacológico para valorar Isquemia Miocárdica

The Spectrum of Non-ischemic Cardiac Magnetic Resonance Imaging Findings: A Retrospective Analysis

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