Cardiovascular magnetic resonance in women with cardiovascular disease: position statement from the Society for Cardiovascular Magnetic Resonance (SCMR)

Abstract

This document is a position statement from the Society for Cardiovascular Magnetic Resonance (SCMR) on recommendations for clinical utilization of cardiovascular magnetic resonance (CMR) in women with cardiovascular disease. The document was prepared by the SCMR Consensus Group on CMR Imaging for Female Patients with Cardiovascular Disease and endorsed by the SCMR Publications Committee and SCMR Executive Committee. The goals of this document are to (1) guide the informed selection of cardiovascular imaging methods, (2) inform clinical decision-making, (3) educate stakeholders on the advantages of CMR in specific clinical scenarios, and (4) empower patients with clinical evidence to participate in their clinical care. The statements of clinical utility presented in the current document pertain to the following clinical scenarios: acute coronary syndrome, stable ischemic heart disease, peripartum cardiomyopathy, cancer therapy-related cardiac dysfunction, aortic syndrome and congenital heart disease in pregnancy, bicuspid aortic valve and aortopathies, systemic rheumatic diseases and collagen vascular disorders, and cardiomyopathy-causing mutations. The authors cite published evidence when available and provide expert consensus otherwise. Most of the evidence available pertains to translational studies involving subjects of both sexes. However, the authors have prioritized review of data obtained from female patients, and direct comparison of CMR between women and men. This position statement does not consider CMR accessibility or availability of local expertise, but instead highlights the optimal utilization of CMR in women with known or suspected cardiovascular disease. Finally, the ultimate goal of this position statement is to improve the health of female patients with cardiovascular disease by providing specific recommendations on the use of CMR.

Posicionamento sobre a Saúde Cardiovascular nas Mulheres – 2022

“…Em relação ao rastreamento de cardiotoxicidade, é sabido que cerca de 25% das pacientes com fração de ejeção ventricular < 50% na RNM não apresenta alterações ao ecocardiograma quando em propedêutica para cardiotoxicidade. 144 Na avaliação funcional da DIC, é conhecido o impacto das mamas e da menor massa miocárdica em estudos de imagem em mulheres. Tal limitação não se aplica à RMC, que demonstrou semelhante grau de acurácia em homens e mulheres.…”

Imaging of heart disease in women: review and case presentation

“…CMR is particularly interesting in women with suspected CAD because it is devoid of ionizing radiation exposure [ 69 ]. In women with stable CAD, CMR has a higher sensitivity than SPECT as demonstrated by the CE-MARC [ 70 ] and MR-IMPACT II studies [ 71 ].…”

Imaging in Women with Heart Failure: Sex-specific Characteristics and Current Challenges

“…Moreover, myocardial oedema, hyperaemia and fibrosis could also be detected by a T1-based method, such as T1-mapping, ECV and/or T1-weighted LGE. [ 90 ] Of note, several patterns of LGE – diffuse subendocardial, subepicardial and even transmural – have been described even in patients with normal echocardiography. [ 91 ] Moreover, stress perfusion CMR with qualitative and quantitative MPR assessment using CMR to help differentiate underlying macro and microvascular complications in women often unable to exercise due to musculoskeletal compromise.…”