Towards risk stratification in systemic atherosclerosis: value of myocardial function and viability imaging as an adjunct to MR angiography.
OBJECTIVE
To longitudinally assess the value of cardiac functional and viability imaging as a supplement to MR angiography in patients with atherosclerotic disease.


METHODS
Cardiac MRI was performed in 195 consecutive patients with symptomatic peripheral arterial disease. Of these, 186 patients were followed for 22 +/- 5 months for the presence of cardiac events (cardiac death, acute coronary syndrome and hospitalisation as a result of congestive heart failure).


RESULTS
Myocardial viability imaging showed a high prevalence of known (n = 31) and occult myocardial infarctions (MI) (n = 26). Cardiac events occurred more often in patients with reduced ventricular function (ejection fraction (EF) less than 40%, cardiac event in 4/8 patients; EF 40-55%, cardiac event in 10/40 patients; EF greater than 55%, cardiac event in 15/138 patients) as well as in patients with occult MI (8/25 patients) and known MI (11/30 patients). In patients with normal function, the detection of a previous MI was of high relevance to prognosis.


CONCLUSIONS
Both reduced EF and the presence of MI influence patients' prognoses. Performing cardiac MRI in this patient population may influence further patient management including intensified risk factor intervention.
Seeger
Achim
A
Department of Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, Tuebingen, Germany. achim.seeger@med.uni-tuebingen.de
Fenchel
Michael
M
Kramer
Ulrich
U
Bretschneider
Christiane
C
Grimm
Florian
F
Klumpp
Bernhard
B
Scheule
Albertus
A
Balletshofer
Bernd
B
Claussen
Claus D
CD
Miller
Stephan
S
D000368:Aged; D050197:Atherosclerosis / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006331:Heart Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000706:statistics & numerical data*; D008297:Male; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014022:Tissue Survival