Experience with cardiac magnetic resonance imaging in patient management at the Markusovszky Hospital, County Vas, Hungary

Abstract

At the Markusovszky Hospital, Vas County, Hungary, cardiac magnetic resonance imaging has been routinely used since July, 2009. In the majority of cases this method has been applied for the assessment of myocardial viability in patients with chronic ischemic heart disease and, in a smaller number of cases, for the evaluation of patients with myocarditis, cardiomyopathy and syncope with uncertain etiology in young athletes. The aim of the study was to analyze the clinical value of cardiac magnetic resonance imaging in assessing the viability of affected myocardial regions due to chronic occlusion of major coronary arteries. Delayed-enhancement cardiac magnetic resonance examination was performed in 88 patients who had 103 myocardial regions affected with chronic occlusion of the coronary arteries. The number of affected myocardial regions which proved to be treatable with coronary artery intervention and the number of regions where revascularization strategy was based on cardiac magnetic resonance imaging findings were analyzed. Based on findings from cardiac magnetic resonance imaging, revascularization strategy was set up in 88 myocardial regions corresponding to 83.5% of all affected myocardial regions included in this study. Delayed-enhancement cardiac magnetic resonance imaging appears to be a powerful tool to choose the optimal reperfusion strategy in patients with chronic coronary occlusion. Although this diagnostic method is relatively expensive, its accuracy regarding the features of myocardial viability such as transmural extension of the lesion within the affected region is higher than that of other methods (e.g. myocardium scintigraphy or stress echocardiography).