JCMR 2021; 23:17. Multiparametric exercise stress cardiovascular magnetic resonance in the diagnosis of coronary artery disease: the EMPIRE trial (CME)


This is the first study that demonstrates the feasibility of in-scanner multi-parametric exercise stress cardiovascular magnetic resonance imaging in diagnosing significant coronary artery disease. The accuracy of the test was validated against gold-standard invasive fractional flow reserve.


Exercise stress tests are more physiological in replicating the symptoms and haemodynamic changes compared to pharmacological-induced stress, with less adverse events and better tolerated. However, due to limited availability of CMR-conditional stress equipment that precludes physiological-induced stress, conventional stress CMR typically refers to pharmacological-induced stress perfusion CMR. Treadmill exercise CMR has recently been shown to be accurate and cost-effective in diagnosing CAD. In this article, we examined the feasibility and accuracy of exercise CMR using in-scanner supine ergometer, which could minimise delay in imaging at peak stress and is able to acquire images at various exercise intensities. The proposed multiparametric supine exercise CMR could potentially shift the paradigm of CAD assessment.


Learning Objective

To close the gap outlined above, learners will need to understand the availability and feasibility of exercise stress CMR using in-scanner supine ergometer to diagnose coronary artery disease, besides the conventional perfusion stress CMR.


Accreditation Statement
The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.


Credit Designation Statement
The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Instructions for Claiming CME

  • Read and fully comprehend the article
  • Complete the post-activity evaluation
  • A certificate of completion will be available once the evaluation is submitted


Financial Disclosures

The planners and faculty for this activity did not have any relationships to disclose unless listed below: None


Disclosure of Commercial Support

This activity received no commercial support.



Please see the bibliography at the end of the journal article.

Course Information
Course Date:
April 02, 2021
Accreditation Council For Continuing Medical Education
Total General Hours: 1.00
SCMR Member Price:$0.00
Non-Member Price:$10.00