European cardiovascular magnetic resonance (EuroCMR) registry – multi national results from 57 centers in 15 countries

Abstract

BackgroundThe EuroCMR registry sought to evaluate indications, image quality, safety and impact on patient management of clinical routine CMR in a multi-national European setting. Furthermore, interim analysis of the specific protocols should underscore the prognostic potential of CMR.MethodsMulti-center registry with consecutive enrolment of patients in 57 centers in 15 countries. More than 27000 consecutive patients were enrolled.ResultsThe most important indications were risk stratification in suspected CAD/Ischemia (34.2%), workup of myocarditis/cardiomyopathies (32.2%), as well as assessment of viability (14.6%). Image quality was diagnostic in more than 98% of cases. Severe complications occurred in 0.026%, always associated with stress testing. No patient died during or due to CMR. In 61.8% CMR findings impacted on patient management. Importantly, in nearly 8.7% the final diagnosis based on CMR was different to the diagnosis before CMR, leading to a complete change in management. Interim analysis of suspected CAD and risk stratification in HCM specific protocols revealed a low rate of adverse events for suspected CAD patients with normal stress CMR (1.0% per year), and for HCM patients without LGE (2.7% per year).ConclusionThe most important indications in Europe are risk stratification in suspected CAD/Ischemia, work-up of myocarditis and cardiomyopathies, as well as assessment of viability. CMR imaging is a safe procedure, has diagnostic image quality in more than 98% of cases, and its results have strong impact on patient management. Interim analyses of the specific protocols underscore the prognostic value of clinical routine CMR in CAD and HCM.Condensed abstractThe EuroCMR registry sought to evaluate indications, image quality, safety and impact on patient management of clinical routine CMR in a multi-national European setting in a large number of cases (n > 27000). Based on our data CMR is frequently performed in European daily clinical routine. The most important indications in Europe are risk stratification in suspected CAD/Ischemia, work-up of myocarditis and cardiomyopathies, as well as assessment of viability. CMR imaging is a safe procedure, has diagnostic image quality in more than 98% of cases, and its results have strong impact on patient management. Interim analyses of the specific protocols underscore the prognostic value of clinical routine CMR in CAD and HCM.

Italian registry of cardiac magnetic resonance

“…These results are substantially in line with those of the Euro-CMR (0.5% of studies performed with 3 T machines) and confirm that both the higher scanners' costs and technical challenges (field homogeneity reduction with increased susceptibility artifacts and radiofrequency-induced power deposition) associated with high field systems are still perceived as major drawbacks by most centers limiting their diffusion and utilization in the territory only to few research sites regardless significant recent improvements and potential advantages of 3 T imaging in CMR [5,10,11].…”

“…The only available register is the EuroCMR, which was recently completed with 27,000 patients and was promoted and organized by the European Society of Cardiology Working Group of "Cardiovascular Magnetic Resonance", with obvious predominant involvement of CMR-dedicated cardiological centers [3][4][5] EuroCMR results convincingly showed that the exam has evolved from the status of "a niche modality" [6] with limited number of cases performed by few tertiary/academic referral into a routine imaging modality, homogeneously diffused and representing an extremely valuable diagnostic support to solve common clinical problems [3,4].…”

Potential for Rapid and Cost‐Effective Cardiac Magnetic Resonance in the Developing (and Developed) World

“…A new diagnosis was made in 19%, medication was changed or added in 23%, and other actions taken such as surgery, angiography, biopsy, hospital admission, etc in 13%. This impact on clinical decision making is in the same range as prior published results of large registries7 as well as pooled centers8 and single centers 9. The latter study by Abbasi et al9 was specifically targeted at patients with heart failure with reduced ejection fraction.…”

Phenotypic expression in hypertrophic cardiomyopathy and late gadolinium enhancement on cardiac magnetic resonance

“…28,29 The European Cardiovascular Magnetic Resonance registry, with a clinical follow-up of at least 12 months, observed only a trend towards better outcome in HCM patients without LGE. 30 …”