Vol 17, No 6 (2010)
Review Article
Submitted: 2013-01-14
Published online: 2010-12-08
Prognostic significance of cardiac magnetic resonance imaging: Update 2010
Vinzenz Hombach, Nico Merkle, Peter Bernhardt, Volker Rasche, Wolfgang Rottbauer
DOI: 10.5603/cj.21302
·
Cardiol J 2010;17(6):549-557.
Vol 17, No 6 (2010)
Review articles
Submitted: 2013-01-14
Published online: 2010-12-08
Abstract
Cardiac magnetic resonance imaging (CMR) has become an indispensible imaging technique
for the diagnosis and treatment of patients with cardiovascular diseases. Technical advances
in the past have rendered CMR unique in the evaluation of cardiovascular anatomy, physiology,
and pathophysiology due to its unique ability to produce high resolution tomographic
images of the human heart and vessels in any arbitrary orientation, with soft tissue contrast
that is superior to competing imaging modalities without the use of ionizing radiation. CMR
imaging is the gold standard for assessing left and right ventricular function and for detecting
myocardial tissue abnormalities like edema, infarction, or scars. For prognostic reasons abnormal
structure and dysfunction of the heart, and the detection of myocardial ischemia and/or myocardial scars are the main targets for CMR imaging. In this review we briefly describe
the prognostic significance of several CMR imaging techniques and special CMR parameters
in patients with coronary artery disease (CAD), with cardiomyopathies, and with chronic
heart failure. Myocardial ischemia proved to be a strong predictor of an adverse outcome in
patients with CAD. Microvascular obstruction in acute myocardial infarction is a new and
independent parameter of negative left ventricular remodeling and a worse prognosis. Myocardial
scars in patients with CAD and unrecognized myocardial infarction heralds a negative
outcome. Scar in patients with dilated or hypertrophic cardiomyopathy are a strong predictor of
both life-threatening ventricular tachyarrhythmias and prognosis. CMR imaging may improve
the assessment of inter- and intraventricular dyssynchrony and provide prognostic information
by detecting myocardial scars. (Cardiol J 2010; 17, 6: 549-557)
Abstract
Cardiac magnetic resonance imaging (CMR) has become an indispensible imaging technique
for the diagnosis and treatment of patients with cardiovascular diseases. Technical advances
in the past have rendered CMR unique in the evaluation of cardiovascular anatomy, physiology,
and pathophysiology due to its unique ability to produce high resolution tomographic
images of the human heart and vessels in any arbitrary orientation, with soft tissue contrast
that is superior to competing imaging modalities without the use of ionizing radiation. CMR
imaging is the gold standard for assessing left and right ventricular function and for detecting
myocardial tissue abnormalities like edema, infarction, or scars. For prognostic reasons abnormal
structure and dysfunction of the heart, and the detection of myocardial ischemia and/or myocardial scars are the main targets for CMR imaging. In this review we briefly describe
the prognostic significance of several CMR imaging techniques and special CMR parameters
in patients with coronary artery disease (CAD), with cardiomyopathies, and with chronic
heart failure. Myocardial ischemia proved to be a strong predictor of an adverse outcome in
patients with CAD. Microvascular obstruction in acute myocardial infarction is a new and
independent parameter of negative left ventricular remodeling and a worse prognosis. Myocardial
scars in patients with CAD and unrecognized myocardial infarction heralds a negative
outcome. Scar in patients with dilated or hypertrophic cardiomyopathy are a strong predictor of
both life-threatening ventricular tachyarrhythmias and prognosis. CMR imaging may improve
the assessment of inter- and intraventricular dyssynchrony and provide prognostic information
by detecting myocardial scars. (Cardiol J 2010; 17, 6: 549-557)
Keywords
cardiac magnetic resonance imaging; late gadolinium enhancement; prognosis; coronary artery disease; dilated cardiomyopathy; hypertrophic cardiomyopathy; chronic heart failure; cardiac resynchronization therapy
Title
Prognostic significance of cardiac magnetic resonance imaging: Update 2010
Journal
Cardiology Journal
Issue
Vol 17, No 6 (2010)
Article type
Review Article
Pages
549-557
Published online
2010-12-08
Page views
1154
Article views/downloads
2044
DOI
10.5603/cj.21302
Bibliographic record
Cardiol J 2010;17(6):549-557.
Keywords
cardiac magnetic resonance imaging
late gadolinium enhancement
prognosis
coronary artery disease
dilated cardiomyopathy
hypertrophic cardiomyopathy
chronic heart failure
cardiac resynchronization therapy
Authors
Vinzenz Hombach
Nico Merkle
Peter Bernhardt
Volker Rasche
Wolfgang Rottbauer