Purpose/ Objective
Cardiac MRI has been around for >2 decades, and yet its use is limited. This is due to knowledge gaps and available resources/expertise. By improving education, providers will understand the difference between the terms viability and functional recovery, and how cardiac MRI (late gadolinium enhancement imaging/low dose dobutamine testing) may help provide guidance in treatment of patients with obstructive coronary artery disease. Following this activity, learners will 1. Understand that CMR can define areas of scar, and thus non-viable myocardium 2. Understand that low dose dobutamine can help predict functional recovery of dysfunctional myocardial segments 3. Understand that revascularization or cardiac resynchronization therapy may not help patients who have large scar burden.
Speakers
Yiying Han, Ray Kim, Grigorios Korosolgou, Dipan Shah
Course Planner
Steve Leung
Bibliography
Kim RJ, Fieno DS, Parrish TB, Harris K, Chen EL, Simonetti O, Bundy J, Finn JP, Klocke FJ, Judd RM. Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function. Circulation. 1999 Nov 9;100(19):1992-2002. Kim RJ, Wu E, Rafael A, Chen EL, Parker MA, Simonetti O, Klocke FJ, Bonow RO, Judd RM. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med. 2000 Nov 16;343(20):1445-53. Glaveckaite S, Valeviciene N, Palionis D, Puronaite R, Serpytis P, Laucevicius A. Prediction of long-term segmental and global functional recovery of hibernating myocardium after revascularisation based on low dose dobutamine and late gadolinium enhancement cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2014 Oct 3;16:83. Kirschbaum SW, Baks T, van den Ent M, Sianos G, Krestin GP, Serruys PW, de Feyter PJ, van Geuns RJ. Evaluation of left ventricular function three years after percutaneous recanalization of chronic total coronary occlusions. Am J Cardiol. 2008 Jan 15;101(2):179-85 Bleeker GB, Kaandorp TA, Lamb HJ, Boersma E, Steendijk P, de Roos A, van der Wall EE, Schalij MJ, Bax JJ. Effect of posterolateral scar tissue on clinical and echocardiographic improvement after cardiac resynchronization therapy. Circulation. 2006 Feb 21;113(7):969-76.
- Understand that CMR can define areas of scar, and thus non-viable myocardium.
- Understand that revascularization or cardiac resynchronization therapy may not help patients who have large scar burden.
- Understand that low dose dobutamine can help predict functional recovery of dysfunctional myocardial segments.