Author + information
- Siddique Abbasi,
- Andrew Ertel,
- Ravi Shah,
- Tomas Neilan,
- Bobby Heydari,
- Vineet Dandekar,
- Raymond Kwong and
- Afhsin Farzaneh-Far
Although CMR provides important information in patients with heart failure (HF), utilization of CMR remains limited in this population. We evaluated the impact of CMR on clinical decision-making in HF patients.
We prospectively studied 150 consecutive patients with LVEF≤50% referred for CMR. Definitions for “significant clinical impact” were predefined and collected from medical records and/or patients. Categories included: new diagnosis, medication change, hospital admission/discharge, and performance/avoidance of invasive procedures (angiography, revascularization, device therapy or biopsy).
Overall, CMR had a significant clinical impact on 65% of patients. This included an entirely new diagnosis in 30% and a change in medication management in 17%. CMR results led to angiography in 9% and to percutaneous coronary intervention in 7%. Gender (OR = 2.31, 95% CI 1.17-4.58, p=0.02), LVEF (OR 0.97; 95% CI 0.94-1.00, p=0.03) and LGE (OR 7.06, 95% CI 3.01-16.56, p<0.0001) predicted significant clinical impact in a univariable model. In a multivariable model that included clinical/imaging indices, presence of late gadolinium enhancement (LGE) was the only predictor of significant clinical impact (OR 7.06, 95% CI 3.01-16.56, p<0.0001).
CMR made a significant additive clinical impact on management, decision-making and diagnosis in 65% of selected heart failure patients. This study lends support to the growing use of CMR by heart failure programs.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Imaging: MRI I Prognostic Value of CMR
Abstract Category: 19. Imaging: MRI
Presentation Number: 1137-322
- 2013 American College of Cardiology Foundation