Stress cardiac MRI can predict potentially fatal heart attack cases: JAMA

Written by Deepanjana Sarkar Published On 2019-02-10T19:30:10+05:30 | Updated On 18 Aug 2021 2:57 PM IST

A new multi-centre study at the Duke University Medical Center finds that Stress cardiac MRI can predict potentially fatal heart attack cases.Cardiac Magnetic Resonance (CMR) has emerged as a potent non-toxic and non-invasive identification tool for measuring the severity of coronary artery disease. The study has appeared in JAMA cardiology.

The use of MRI to determine heart function has been slow to catch on, but this new study shows that stress cardiac MRI not only diagnoses disease but can also predict which cases are potentially fatal. Results from a large, multi-centre study suggest that cardiac magnetic resonance, or CMR, can be an effective a non-invasive, non-toxic alternative to stress echocardiograms, catheterizations and stress nuclear exams in identifying the severity of coronary artery disease.

"We've known for some time that CMR is effective at diagnosing coronary artery disease, but it's still not commonly used and represents less than one percent of stress tests used in this country," said senior author Robert Judd, Ph.D., co-director of the Duke Cardiovascular Magnetic Resonance Center.

"One of the impediments to broader use has been a lack of data on its predictive value -- something competing technologies have," Judd said. "Our study provides some clarity, although direct comparisons between CMR and other technologies would be definitive."

Judd and colleagues analyzed data from more than 9,000 patients who underwent CMR at seven U.S. hospitals, encompassing up to 10 years of follow-up.

For patients without any history of heart disease and at low risk based on traditional clinical criteria, those with an abnormal CMR scan were 3.4 times more likely to die compared to patients with a normal CMR scan. For the entire patient population, the researchers found a strong association between abnormal stress CMR and mortality, even after adjusting for patient age, sex, and cardiac risk factors.

"Noninvasive cardiac stress testing is a cornerstone in the clinical management of patients with known or suspected coronary artery disease," Judd said, noting that CMR works as well or better than other exams at identifying heart wall motion, cell death and the presence of low blood flow. In addition, the technology does not require any radiation exposure, which is essential in nuclear stress tests that are by far the most commonly used in the U.S.

"There are a number of reasons for the limited use of stress CMR, including the availability of good quality laboratories, exclusion of patients who cannot undergo magnetization, and a lack of data on patient outcomes," Judd said. "With the findings from this study suggesting that stress CMR is effective in predicting mortality, we provide a strong basis for a head-to-head study between stress CMR and other modalities."

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Deepanjana Sarkar