EuroCMR (European Cardiovascular Magnetic Resonance) Registry Results of the German Pilot Phase

被引:132
作者
Bruder, Oliver [1 ]
Schneider, Steffen [2 ]
Nothnagel, Detlef [3 ]
Dill, Thorsten [4 ]
Hombach, Vinzenz [5 ]
Schulz-Menger, Jeanette [6 ]
Nagel, Eike [7 ]
Lombardi, Massimo [8 ]
van Rossum, Albert C. [9 ]
Wagner, Anja [10 ]
Schwitter, Juerg [11 ]
Senges, Jochen [2 ]
Sabin, Georg V. [1 ]
Sechtem, Udo [12 ]
Mahrholdt, Heiko [12 ]
机构
[1] Elisabeth Hosp, Dept Cardiol & Angiol, D-45138 Essen, Germany
[2] Inst Herzinfarktforsch, Ludwigshafen, Germany
[3] Klinikum Ludwigsburg, Dept Cardiol, Ludwigsburg, Germany
[4] Kerckhoff Klin, Dept Cardiol, Bad Nauheim, Germany
[5] Univ Ulm, Dept Internal Med 2, D-7900 Ulm, Germany
[6] Charite, Franz Volhard Klin, Kardiol Klin, HELIOS Klinikum Berlin Buch, D-13353 Berlin, Germany
[7] Kings Coll London, BHF Ctr Excellence,St Thomas Hosp London, Div Imaging Sci,Rayne Inst, NIHR Biomed Res Ctr,Guys & St Thomas NHS Trust Fd, London WC2R 2LS, England
[8] G Monasterio Fdn, Inst Clin Physiol, Pisa, Italy
[9] Vrije Univ Amsterdam Med Ctr, Dept Cardiol, Amsterdam, Netherlands
[10] Drexel Univ, Coll Med, Hahnemann Univ Hosp, Philadelphia, PA 19104 USA
[11] Univ Lausanne Hosp, Cardiac MR Ctr, Lausanne, Switzerland
[12] Robert Bosch Med Ctr, Dept Cardiol, Stuttgart, Germany
关键词
cardiovascular magnetic resonance; registry; patient management; therapeutic implications; CORONARY-ARTERY-DISEASE; EMISSION-COMPUTED-TOMOGRAPHY; HYPERTROPHIC CARDIOMYOPATHY; MYOCARDIAL-PERFUSION; DELAYED ENHANCEMENT; DIAGNOSTIC PERFORMANCE; STRESS PERFUSION; ANGIOGRAPHY; SOCIETY; ECHOCARDIOGRAPHY;
D O I
10.1016/j.jacc.2009.07.003
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives During its German pilot phase, the EuroCMR (European Cardiovascular Magnetic Resonance) registry sought to evaluate indications, image quality, safety, and impact on patient management of routine CMR. Background CMR has a broad range of applications and is increasingly used in clinical practice. Methods This was a multicenter registry with consecutive enrollment of patients in 20 German centers. Results A total of 11,040 consecutive patients were enrolled. Eighty-eight percent of patients received gadolinium-based contrast agents. Twenty-one percent underwent adenosine perfusion, and 11% high-dose dobutamine-stress CMR. The most important indications were workup of myocarditis/cardiomyopathies (32%), risk stratification in suspected coronary artery disease/ischemia (31%), as well as assessment of viability (15%). Image quality was good in 90.1%, moderate in 8.1%, and inadequate in 1.8% of cases. Severe complications occurred in 0.05%, and were all associated with stress testing. No patient died during or due to CMR. In nearly two-thirds of patients, CMR findings impacted patient management. Importantly, in 16% of cases the final diagnosis based on CMR was different from the diagnosis before CMR, leading to a complete change in management. In more than 86% of cases, CMR was capable of satisfying all imaging needs so that no further imaging was required. Conclusions CMR is frequently performed in clinical practice in many participating centers. The most important indications are workup of myocarditis/cardiomyopathies, risk stratification in suspected coronary artery disease/ischemia, and assessment of viability. CMR imaging as used in the centers of the pilot registry is a safe procedure, has diagnostic image quality in 98% of cases, and its results have strong impact on patient management. (J Am Coll Cardiol 2009;54:1457-66) (C) 2009 by the American College of Cardiology Foundation
引用
收藏
页码:1457 / 1466
页数:10
相关论文
共 40 条
[21]   Improved detection of coronary artery disease by stress perfusion cardiovascular magnetic resonance with the use of delayed enhancement infarction imaging [J].
Klem, I ;
Heitner, JF ;
Shah, DJ ;
Sketch, MH ;
Behar, V ;
Weinsaft, J ;
Cawley, P ;
Parker, M ;
Elliott, M ;
Judd, RM ;
Kim, RJ .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2006, 47 (08) :1630-1638
[22]   Standardized cardiovascular magnetic resonance imaging (CMR) protocols, society for cardiovascular magnetic resonance: board of trustees task force on standardized protocols [J].
Kramer, Christopher M. ;
Barkhausen, Jorg ;
Flamm, Scott D. ;
Kim, Raymond J. ;
Nagel, Eike .
JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE, 2008, 10 (1)
[23]   Impact of unrecognized myocardial scar detected by cardiac magnetic resonance imaging on event-free survival in patients presenting with signs or symptoms of coronary artery disease [J].
Kwong, Raymond Y. ;
Chan, Anna K. ;
Brown, Kenneth A. ;
Chan, Carmen W. ;
Reynolds, H. Glenn ;
Tsang, Sui ;
Davis, Roger B. .
CIRCULATION, 2006, 113 (23) :2733-2743
[24]   Noninvasive tests in patients with stable coronary artery disease [J].
Lee, TH ;
Boucher, CA .
NEW ENGLAND JOURNAL OF MEDICINE, 2001, 344 (24) :1840-1845
[25]   Heart Disease and Stroke Statistics-2009 Update A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee [J].
Lloyd-Jones, Donald ;
Adams, Robert ;
Carnethon, Mercedes ;
De Simone, Giovanni ;
Ferguson, T. Bruce ;
Flegal, Katherine ;
Ford, Earl ;
Furie, Karen ;
Go, Alan ;
Greenlund, Kurt ;
Haase, Nancy ;
Hailpern, Susan ;
Ho, Michael ;
Howard, Virginia ;
Kissela, Brett ;
Kittner, Steven ;
Lackland, Daniel ;
Lisabeth, Lynda ;
Marelli, Ariane ;
McDermott, Mary ;
Meigs, James ;
Mozaffarian, Dariush ;
Nichol, Graham ;
O'Donnell, Christopher ;
Roger, Veronique ;
Rosamond, Wayne ;
Sacco, Ralph ;
Sorlie, Paul ;
Stafford, Randall ;
Steinberger, Julia ;
Thom, Thomas ;
Wasserthiel-Smoller, Sylvia ;
Wong, Nathan ;
Wylie-Rosett, Judith ;
Hong, Yuling .
CIRCULATION, 2009, 119 (03) :E21-E181
[26]   Cardiovascular magnetic resonance assessment of human myocarditis - A comparison to histology and molecular pathology [J].
Mahrholdt, H ;
Goedecke, C ;
Wagner, A ;
Meinhardt, G ;
Athanasiadis, A ;
Vogelsberg, H ;
Fritz, P ;
Klingel, K ;
Kandolf, R ;
Sechtem, U .
CIRCULATION, 2004, 109 (10) :1250-1258
[27]   Delayed enhancement cardiovascular magnetic resonance assessment of non-ischaemic cardiomyopathies [J].
Mahrholdt, H ;
Wagner, A ;
Judd, RM ;
Sechtem, U ;
Kim, RJ .
EUROPEAN HEART JOURNAL, 2005, 26 (15) :1461-1474
[28]   Presentation, patterns of myocardial damage, and clinical course of viral myocarditis [J].
Mahrholdt, Heiko ;
Wagner, Anja ;
Deluigi, Claudia C. ;
Kispert, Eva ;
Hager, Stefan ;
Meinhardt, Gabriel ;
Vogelsberg, Holger ;
Fritz, Peter ;
Dippon, Juergen ;
Bock, C. -Thomas ;
Klingel, Karin ;
Kandolf, Reinhard ;
Sechtem, Udo .
CIRCULATION, 2006, 114 (15) :1581-1590
[29]   Differentiation of heart failure related to dilated cardiomyopathy and coronary artery disease using gadolinium-enhanced cardiovascular magnetic resonance [J].
McCrohon, A ;
Moon, JCC ;
Prasad, SK ;
McKenna, WJ ;
Lorenz, CH ;
Coats, AJS ;
Pennell, DJ .
CIRCULATION, 2003, 108 (01) :54-59
[30]   Diagnostic Performance of Coronary Angiography by 64-Row CT [J].
Miller, Julie M. ;
Rochitte, Carlos E. ;
Dewey, Marc ;
Arbab-Zadeh, Armin ;
Niinuma, Hiroyuki ;
Gottlieb, Ilan ;
Paul, Narinder ;
Clouse, Melvin E. ;
Shapiro, Edward P. ;
Hoe, John ;
Lardo, Albert C. ;
Bush, David E. ;
de Roos, Albert ;
Cox, Christopher ;
Brinker, Jeffery ;
Lima, Joao A. C. .
NEW ENGLAND JOURNAL OF MEDICINE, 2008, 359 (22) :2324-2336