CMR Applications in Ischemic Heart Disease

Ischemic heart disease is the most frequent cause of cardiovascular morbidity and mortality. Early detection and accurate evaluation are essential to guide optimal patient treatment and assess the individual’s prognosis. Cardiovascular Magnetic Resonance (CMR) has proven accuracy and is an established technique for the assessment of myocardial function both at rest and during stress. CMR is widely used for structural heart disease and its use in ischemic cardiomyopathy evaluation is growing. It allows stress perfusion analysis with high spatial and temporal resolution and applies to differentiate tissue, such as distinguishing between reversibly and irreversibly injured myocardium. Evaluation of ischemic heart disease with CMR includes imaging of coronary arteries, assessment of ventricular morphology and function, myocardial perfusion and viability. Late Gadolinium Enhancement (LGE) CMR techniques can clearly differentiate necrotic to viable areas of the myocardium leading to proper patients’ revascularization management. CMR is considered to be a safe imaging modality with limited restrictions mainly to patients with implantable defibrillators and pacemakers. It is noninvasive and radiation-free and the burden of the high cost appears to diminish as it becomes more popular. CMR is considered to be a safe imaging modality with limited restrictions mainly to patients with implantable defibrillators and pacemakers. It is noninvasive and radiation-free and the burden of the high cost appears to diminish as it becomes more popular. CMR is an established imaging modality for both functional and structural ischemic heart disease.

Keywords: Cardiac imaging, coronary disease, gadolinium enhancement, ischemic cardiomyopathy, magnetic resonance, molecular imaging, myocardial viability, myocardial ischemia, perfusion imaging, stress imaging.