Chapter

Heart failure imaged by cardiac magnetic resonance imaging

C. Parsai and S.K. Prasad

in Oxford Textbook of Heart Failure

Published on behalf of Oxford University Press

ISBN: 9780199577729
Published online July 2011 | e-ISBN: 9780199697809 | DOI: http://dx.doi.org/10.1093/med/9780199577729.003.0021

Series: Oxford Textbooks

Heart failure imaged by cardiac magnetic resonance imaging

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Heart failure (HF) is a growing clinical condition resulting from a variety of primary or systemic disorders that impair the ability of the heart to meet systemic demands. Coronary artery disease(CAD), hypertension, and dilated cardiomyopathy (DCM) represent the most common aetiologies in the Western world, with a genetic background found in up to 30% of DCM. Although HF is largely a clinical diagnosis, imaging has become an essential part of patients’ work-up complementing more invasive testing (e.g. coronary angiography, endomyocardial biopsy) and genetic testing. It is key to characterize myocardial and valvular structure and function; identify an underlying treatable substrate; risk-stratify patients; and guide decision-making for medical, surgical, or device therapies such as internal cardioverter-defibrillators (ICD) and cardiac resynchronization therapy (CRT). In addition, it provides measurements for assessing the effect of treatment, including percutaneous or surgical procedures. As the prognosis of HF remains poor, particular emphasis has been placed on detection of early disease in patients at risk and in those with asymptomatic evidence of left ventricular damage as well as screening of relatives. Although echocardiography remains the first imaging step, cardiac magnetic resonance imaging (CMR) is now widely available and appears as an ideal complementary technique with the potential to address in a single 45–60 min scan an exhaustive evaluation of three-dimensional cardiac anatomy, function, tissue characterization, coronary and microvascular perfusion, valve disease, and coronary angiography. The diagnostic and prognostic strengths of CMR as an integral part of the clinical workup of a HF patient are reviewed in a stepwise approach.

Chapter.  6060 words.  Illustrated.

Subjects: Cardiovascular Medicine

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