Cardiac MRI could help predict the risk of future cardiovascular events

Cardiac magnetic resonance imaging (MRI) can help predict the risk of future cardiovascular events in patients who have suffered heart attacks or are suspected to have cardiovascular disease, according to a study recently published online in the Journal of the American College of Cardiology.

Researchers--led by Hamza El Aidi, M.D., of the department of cardiology at the University Medical Center Utrecht in the Netherlands--performed an analysis of 56 studies (involving 25,497 patients) published before February 2013 in which they examined associations between cardiovascular events and MR imaging features such as left ventricular ejection fraction (LVEF), wall motion abnormalities, abnormal myocardial perfusion, microvascular obstruction, late gadolium enhancement, edema and inramyocardial hemorrhage. Patients were divided into two groups: those who had recently experienced heart attacks and those suspected of or known to have coronary artery disease.

The researchers then correlated the cardiac MR findings with hard events--such as cardiac death, cardiac transplantation and myocardial infarction--and major adverse cardiovascular events--including hard events and other cardiovascular events--as defined by the authors of the 56 studies.

While the authors were unable to establish associations between imaging findings and hard events for patients with recent myocardial infarctions, they found that LVEF was independently associated with major adverse cardiovascular events.

For patients with known or suspected coronary artery disease, the researchers determined that wall motion abnormalities, inducible perfusion defects, LVEF, and infarction were independently associated with hard events, and that the presence of inducible perfusion defects was associated with major adverse cardiovascular events.

"Among patients with suspected or known coronary artery disease, inducible wall motion abnormalities and inducible perfusion defects were the most important independent predictors of hard events," the authors said. "Other independent predictors were LVEF and infarct size."

The authors added that reporting guidelines should be developed for prognostic studies in cardiovascular imaging.

Researchers from the Johns Hopkins University School of Medicine recently developed a new MRI technique that enables prediction of prognosis for heart failure patients. In a study published in December in Science Translational Medicine, researchers, led by Robert Weiss, M.D., a cardiologist and professor of medicine at the Johns Hopkins, showed that energy metabolism within the heart, measured by MRI, is a significant predictor of clinical outcomes.

To learn more:
- see the study in the Journal of the American College of Cardiology