The Role of Cardiac MR in New-Onset Heart Failure |
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Authors: | Yong-Jin Kim Raymond J Kim |
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Institution: | Cardiac MR Research Center, Seoul National University College of Medicine, Seoul, South Korea. |
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Abstract: | In patients with heart failure, cardiovascular magnetic resonance imaging (CMR) allows a multifaceted approach to cardiac
evaluation by enabling an assessment of morphology, function, perfusion, viability, tissue characterization, and blood flow
during a single comprehensive examination. Given its accuracy and reproducibility, many believe CMR is the reference standard
for the noninvasive assessment of ventricular volumes, mass, and function, and offers an ideal means for the serial assessment
of disease progression or treatment response in individual patients. Delayed-enhancement (DE)-CMR provides a direct assessment
of myopathic processes. This permits a fundamentally different approach than that traditionally taken to ascertaining the
etiology of cardiomyopathy, which is vital in patients with nonischemic cardiomyopathy and incidental coronary artery disease
and patients with mixed, ischemic and nonischemic cardiomyopathy. Precise tissue characterization with DE-CMR also improves
the diagnosis of left ventricular thrombus, for which it is the emerging clinical reference standard. There is a growing body
of literature on the utility of CMR for patient risk stratification, and its potential role in important management decisions
such as for cardiac resynchronization therapy and defibrillator placement. |
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