title: Towards risk stratification in systemic atherosclerosis: value of myocardial function and viability imaging as an adjunct to MR angiography.
abstract: 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.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, Tuebingen, Germany. achim.seeger@med.uni-tuebingen.de
authors.forename: Achim
authors.initials: A
authors.lastname: Seeger
authors.forename: Michael
authors.initials: M
authors.lastname: Fenchel
authors.forename: Ulrich
authors.initials: U
authors.lastname: Kramer
authors.forename: Christiane
authors.initials: C
authors.lastname: Bretschneider
authors.forename: Florian
authors.initials: F
authors.lastname: Grimm
authors.forename: Bernhard
authors.initials: B
authors.lastname: Klumpp
authors.forename: Albertus
authors.initials: A
authors.lastname: Scheule
authors.forename: Bernd
authors.initials: B
authors.lastname: Balletshofer
authors.forename: Claus D
authors.initials: CD
authors.lastname: Claussen
authors.forename: Stephan
authors.initials: S
authors.lastname: Miller
mesh_terms: 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