Abstract 8910: Clinical Use, Diagnostic Efficiency and Impact on Patient Management of Cardiovascular Magnetic Resonance
Objectives: To evaluate the clinical use, diagnostic efficiency and impact on patient management of cardiovascular magnetic resonance (CMR).
Methods: Data of the individual patient and procedural information of 2598 consecutive clinically indicated CMR exams were collected. For a representative subgroup of 250 exams, an external blinded reviewer evaluated the need for diagnostic tests and hospitalization before and after CMR and assessed the impact of CMR on patient management.
Results: Table 1 lists the subjects' characteristics and procedural information of all studies. CMR was used in a large variety of indications, with inflammatory (29.4 %) and ischemic (26.2 %) heart disease as the most frequent. All moderate adverse events (0.5 %) were associated with stress medication or contrast media. In the subgroup analysis, CMR ruled out a suspected disease in 63.1%, confirmed a suspected or known disease in 27.8% or detected an unexpected new pathology in 7.2 %. The clinical question was answered completely or partial in 88.4 % and 11.2 %, respectively. CMR reduced the amount of ordered diagnostic tests by 65.7 % and led to an altered diagnostic strategy in the individual patient in 92.4 %. Heart catheterization was cancelled in almost every third patient following CMR (11 / 36), and newly ordered after CMR in additional 6% (12 / 214). In 23.6 %, CMR led to a strategic change between in- or outpatient treatment.
Conclusions: CMR is safe, robust and versatile. It influences the indication for hospital admission, the choice and extent of individual downstream diagnostic testing, and the determination of the final diagnosis.
- © 2011 by American Heart Association, Inc.