Towards risk stratification in systemic atherosclerosis: value of myocardial function and viability imaging as an adjunct to MR angiography

Abstract

Both reduced EF and the presence of MI influence patients' prognoses. Performing cardiac MRI in this patient population may influence further patient management including intensified risk factor intervention.

Long-term prognosis of unrecognized myocardial infarction detected with cardiovascular magnetic resonance in an elderly population

“…In the present cohort the presence of a UMI entailed a more than double risk for MACE, also when adjusted for cardiovascular risk factors and sex. This observation confirms the results of other studies in selected [ 9 – 11 , 13 ] and unselected populations [ 5 ]. Those studies were performed mainly in populations with important risk factors such as manifest atherosclerotic disease or diabetes, whereas the present study population was representative of the general population.…”

“…The risk for MACE may also be influenced by the size of the MI scar, since. UMIs have been observed to be generally smaller than RMIs [ 2 , 13 ]. Thus, the presence of a smaller MI scar (i.e.…”

“…A number of studies have been conducted in selected risk populations establishing CMR detected UMIs as an important risk factor for major adverse cardiac events (MACE). This has been demonstrated in patients with confirmed [ 9 , 10 ] or suspected [ 9 – 11 ] coronary artery disease, in patients with peripheral arterial occlusive disease [ 13 ], and in diabetic [ 12 ] and prediabetic [ 14 ] patients.…”

Cardiac Troponin I Associated with the Development of Unrecognized Myocardial Infarctions Detected with MRI

“…The associations between cTnI concentration and sex, LVM, EF, NTproBNP, and FRS that were observed in the present study suggest that these parameters may be part of the same risk profile. Furthermore, NT-proBNP (40 ), sex, LVM, EF and atherosclerosis risk factors (10 ) are all individually associated with MRI-detected UMIs. Thus, considering cTnI concentrations in relation to these parameters might give additional information when estimating cardiovascular risk.…”

“…However, late enhancement MRI (LE-MRI) is a highly sensitive method to detect myocardial scars (7 ) that has revealed a higher prevalence of UMIs in the general population than previously expected (8,9 ). Like increased plasma concentrations of cardiac troponin, these MRI-detected UMIs have important prognostic value in patients (10 ) and in population-based samples (9 ), even if some of the UMIs are very small (11 ). However, no association has been established between the concentrations of cardiac troponin and MRI-detected UMIs (12 ).…”