Coronary heart disease MRI

CMR may be used for identifying coronary artery anomalies and aneurysms and for determining coronary artery patency. In specialized centers, CMR may be uniquely useful in identifying patients with multivessel coronary artery disease without exposure to ionizing radiation or iodinated contrast medium.

The combination of CMR stress perfusion, function, and LGE allows the use of CMR as a primary form of testing for

• identifying patients with ischemic heart disease when there are resting ECG abnormalities or an inability to exercise,
• defining patients with large vessel coronary artery disease and its distribution who are candidates for interventional procedures, or
• determining patients who are appropriate candidates for interventional procedures.

Assessment of LV wall motion after low-dose dobutamine in patients with resting akinetic LV wall segments is useful for identifying patients who will develop improvement in LV systolic function after coronary arterial revascularization. The writing committee recognizes the potential advantages of spectroscopic techniques for identifying early evidence of myocardial ischemia that may or may not be evident using existing non-CMR methods. Myocardial infarction/scar LGE-CMR may be used for identifying the extent and location of myocardial necrosis in individuals suspected of having or possessing chronic or acute ischemic heart disease.