Direct comparison of the diagnostic capability of cardiac magnetic resonance and endomyocardial biopsy in patients with heart failure

Yoshida, Akemi; Ishibashi‐Ueda, Hatsue; Yamada, Naoaki; Kanzaki, Hideaki; Hasegawa, Takuya; Takahama, Hiroyuki; Amaki, Makoto; Asakura, Masanori; Kitakaze, Masafumi

doi:10.1093/eurjhf/hfs206

Cited by 69 publications

(54 citation statements)

References 36 publications

(37 reference statements)

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“…They found that MRI was superior for diagnosing cardiac sarcoid (75% versus 25%) and ARVC (100% versus 0%), but for myocarditis EMB was superior using a gold standard of both diagnostic techniques plus all available clinical information. 25 This study was limited by small numbers of patients with the various pathogeneses, and future studies should examine the diagnostic and clinical use of MRI compared with EMB in patients who underwent both procedures. Also, we rely solely on review of the medical record to determine both the rationale for EMB in each case and the effect of EMB on the subsequent clinical course.…”

Section: Limitationsmentioning

confidence: 98%

“…We did not collect any MRI data in this cohort, and it is possible that some patients might not have undergone biopsy if a diagnosis was determined by MRI. Yoshida et al 25 recently reported the results of a group of patients who had both a cardiac MRI and an EMB. They found that MRI was superior for diagnosing cardiac sarcoid (75% versus 25%) and ARVC (100% versus 0%), but for myocarditis EMB was superior using a gold standard of both diagnostic techniques plus all available clinical information.…”

Section: Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of the Role of Endomyocardial Biopsy in 851 Patients With Unexplained Heart Failure From 2000–2009

Bennett

Gilotra

Harrington

et al. 2013

Circ: Heart Failure

136

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Section: Limitationsmentioning

confidence: 98%

Section: Limitationsmentioning

confidence: 99%

Evaluation of the Role of Endomyocardial Biopsy in 851 Patients With Unexplained Heart Failure From 2000–2009

Bennett

Gilotra

Harrington

et al. 2013

Circ: Heart Failure

136

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“…Na przykład, CMR wraz z oceną LGE pozwala na obrazowanie blizn/włóknienia miokardium i różnicowanie między niedokrwiennym i nieniedokrwiennym tłem HF. Ponadto CMR pozwala na udokumentowanie specyficznego obrazu miokardium w przebiegu zapalenia mięśnia sercowego, amyloidozy, sarkoidozy, choroby Chagasa, choroby Fabry'ego, kardiomiopatii z niescalenia oraz hemochromatozy [91,101,103,104].…”

Section: Rezonans Magnetyczny Sercaunclassified

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

Ponikowski

Voors

Anker³

et al. 2016

Kardiol Pol

450

446

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“…In fact, CMR has shown diagnostic accuracy superior or comparable to that of endomyocardial biopsy (EMB) for the causal characterization of patients with heart failure. 51 Delayed enhancement-MR imaging is also superior to echocardiography in identifying such complications of heart failure as LV thrombus. 52 Perfusion imaging with use of dynamic contrast-enhanced (DCE)-MR can identify modifiable substrate, such as myocardial ischemia.…”

Section: A B Heart Failure and Heart Transplantationmentioning

confidence: 99%

Cardiac Magnetic Resonance Imaging for the Investigation of Cardiovascular Disorders. Part 2: Emerging Applications

Goenka¹,

Wang²,

Flamm³

2014

Texas Heart Institute Journal

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Cardiac magnetic resonance imaging has emerged as a robust noninvasive technique for the investigation of cardiovascular disorders. The coming-of-age of cardiac magnetic resonance-and especially its widening span of applications-has generated both excitement and uncertainty in regard to its potential clinical use and its role vis-à-vis conventional imagC ardiac magnetic resonance imaging (CMR) is unique in its ability to provide comprehensive evaluation of cardiovascular disorders in a single session. Part 1 of this review highlighted the mainstream applications of CMR that are now routinely used for diagnosis, risk stratification, and case management.1 In this section, we provide an overview of the principles and potential applications of emerging CMR techniques that seek to characterize the myocardial substrate in both health and disease. These techniques offer the ability to noninvasively delineate pathophysiologic processes in vivo and, therefore, to expand our understanding of cardiovascular disorders. We also present a synopsis of innovative applications of validated CMR techniques that have the potential to expand the usefulness of CMR as a clinically relevant, cost-effective tool for reliable investigation and accurate case management in a wide variety of clinical situations. T1 Mapping and Extracellular Volume QuantificationDetection of regional or replacement myocardial fibrosis on CMR arises from the visual evaluation of well-delineated areas of late gadolinium enhancement (LGE) on delayed-enhancement MR (DE-MR) imaging. As discussed in Part 1 of this review, 1 high contrast-to-noise ratio in DE-MR imaging is achieved by suppressing the signal from the normal, unaffected myocardium. However, in patients with diffuse interstitial fibrosis, defining the unaffected myocardium can be difficult, which limits the usefulness of DE-MR imaging for detecting diffuse myocardial processes and for quantifying the extent of extracellular matrix (ECM) expansion. Therefore, direct quantification of longitudinal relaxation time of tissue (T1) has been proposed as a novel alternative imaging biomarker of myocardial fibrosis.Depending on the composition of the tissue, T1 relaxation times vary across tissue types. Deviation from established ranges can therefore be used to quantify the effects of pathologic processes.2 The generation of parametric maps that encode T1 value in each pixel of an image is called T1 mapping (Fig. 1).Not only does T1 mapping provide quantitative estimation of diffuse myocardial disease processes and extracellular volume (ECV), but it has the advantage (when compared with DE-MR imaging) of circumventing the influences of windowing, of variations in signal enhancement, and of variability of observer input in characterizing the diseased myocardium.3 Recent robust developments in acquisition and postprocessing techniques have given T1 mapping significant traction.

show abstract

Direct comparison of the diagnostic capability of cardiac magnetic resonance and endomyocardial biopsy in patients with heart failure

Abstract: Non-invasive CMR demonstrated excellent diagnostic capability for patients with HF and was as effective as or superior to EMB. In particular, the use of CMR in combination with clinical data unrelated to EMB may provide excellent diagnostic accuracy for HF.

Cited by 69 publications

References 36 publications

Evaluation of the Role of Endomyocardial Biopsy in 851 Patients With Unexplained Heart Failure From 2000–2009

Evaluation of the Role of Endomyocardial Biopsy in 851 Patients With Unexplained Heart Failure From 2000–2009

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

Cardiac Magnetic Resonance Imaging for the Investigation of Cardiovascular Disorders. Part 2: Emerging Applications

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