Stress perfusion cardiovascular magnetic resonance imaging: a guide for the general cardiologist

• Published in: Heart Vol. 109; no. 6; pp. 428 - 433
• Main Authors: Hamilton-Craig, Christian, Ugander, Martin, Greenwood, John P, Kozor, Rebecca
• Format: Journal Article Book Review
• Language: English
• Published: England BMJ Publishing Group Ltd and British Cardiovascular Society 01.03.2023; BMJ Publishing Group LTD
• Subjects: Accuracy; Adenosine; Angina pectoris; Artificial Intelligence; Asymptomatic; Cardiac arrhythmia; Cardiologists; Cardiovascular disease; Clinical medicine; Clinical trials; Contraindications; Contrast agents; Contrast Media; coronary artery disease; Coronary Artery Disease - diagnosis; Coronary Circulation; Coronary vessels; diagnostic imaging; Electrocardiography; Gadolinium; Health economics; Heart rate; Humans; Ischemia; magnetic resonance angiography; Magnetic Resonance Imaging; Magnetic Resonance Imaging, Cine - methods; Magnetic Resonance Spectroscopy; Medical imaging; Medicin och hälsovetenskap; Myocardial Ischemia - diagnosis; Myocardial Perfusion Imaging - methods; Pain; Patients; Perfusion; Predictive Value of Tests; Radiation; Review; Tomography; Vein & artery diseases; United Kingdom > UK; coronary artery disease; magnetic resonance angiography; diagnostic imaging
• ISSN: 1355-6037; 1468-201X; 1468-201X
• DOI: 10.1136/heartjnl-2022-321630

Stress cardiovascular magnetic resonance (CMR) is an emerging non-invasive imaging technique for the assessment of known or suspected ischaemic heart disease (IHD). Stress CMR provides information on myocardial perfusion, wall motion, ventricular dimensions and volumes, as well as late gadolinium enhancement (LGE) scar imaging in a single test without ionising radiation. Data from numerous multicentre randomised studies show high diagnostic and prognostic utility, its efficacy as a gatekeeper to invasive coronary angiography and use for guiding coronary revascularisation decisions. Stress CMR is cost-effective across multiple healthcare settings, yet its uptake and usage varies worldwide and is an underutilised technology. New developments include rapid acquisition protocols, automated quantification of perfusion and myocardial blood flow, and artificial intelligence-aided automated analysis and reporting. Stress CMR is becoming more accessible and standardised around the globe and is ready for ‘prime time’ use in the non-invasive assessment of patients with suspected IHD.