Rapid Cardiovascular Magnetic Resonance for Ischemic Heart Disease Investigation (RAPID-IHD)

Foley, James Rj; Richmond, Caroline; Fent, Graham; Bissell, Malenka M.; Levelt, Eylem; Dall’Armellina, Erica; Swoboda, Peter; Plein, Sven; Greenwood, John P

doi:10.1016/j.jcmg.2020.01.029

Cited by 18 publications

(10 citation statements)

References 5 publications

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“…perfusion) were out of scope, 13 even though recent data suggest these can also be done rapidly. 29 Latest techniques were not used (e.g. compressed sensing).…”

Section: Discussionmentioning

confidence: 99%

Improving cardiovascular magnetic resonance access in low- and middle-income countries for cardiomyopathy assessment: rapid cardiovascular magnetic resonance

Menacho

Ramírez²,

Pérez³

et al. 2022

European Heart Journal

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Aims To evaluate the impact of a simplified, rapid cardiovascular magnetic resonance (CMR) protocol embedded in care and supported by a partner education programme on the management of cardiomyopathy (CMP) in low- and middle-income countries (LMICs). Methods and results Rapid CMR focused particularly on CMP was implemented in 11 centres, 7 cities, 5 countries, and 3 continents linked to training courses for local professionals. Patients were followed up for 24 months to assess impact. The rate of subsequent adoption was tracked. Five CMR conferences were delivered (920 attendees—potential referrers, radiographers, reporting cardiologists, or radiologists) and five new centres starting CMR. Six hundred and one patients were scanned. Cardiovascular magnetic resonance indications were 24% non-contrast T2* scans [myocardial iron overload (MIO)] and 72% suspected/known cardiomyopathies (including ischaemic and viability). Ninety-eighty per cent of studies were of diagnostic quality. The average scan time was 22 ± 6 min (contrast) and 12 ± 4 min (non-contrast), a potential cost/throughput reduction of between 30 and 60%. Cardiovascular magnetic resonance findings impacted management in 62%, including a new diagnosis in 22% and MIO detected in 30% of non-contrast scans. Nine centres continued using rapid CMR 2 years later (typically 1–2 days per week, 30 min slots). Conclusions Rapid CMR of diagnostic quality can be delivered using available technology in LMICs. When embedded in care and a training programme, costs are lower, care is improved, and services can be sustained over time. Key question Key finding Take-home message

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“…perfusion) were out of scope, 13 even though recent data suggest these can also be done rapidly. 29 Latest techniques were not used (e.g. compressed sensing).…”

Section: Discussionmentioning

confidence: 99%

Improving cardiovascular magnetic resonance access in low- and middle-income countries for cardiomyopathy assessment: rapid cardiovascular magnetic resonance

Menacho

Ramírez²,

Pérez³

et al. 2022

European Heart Journal

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“…Additional strategies to consider include the implementation of rapid imaging protocols to reduce imaging times and improve throughput. Both the Impact of Noninvasive CMR Assessment (INCA) Peru study and the Rapid Cardiovascular Magnetic Resonance for Ischemic Heart Disease Investigation (RAPID-IHD) study have demonstrated the feasibility of acquiring localizer images, short and long axis segmented bSSFP cine images, and LGE with scan times averaging less than 20 min [16,17]. Additional sequences such as native T1 or T2 mapping could then be easily added to this protocol in appropriately selected patients.…”

Section: Determining Appropriate Cmr Indications During Reactivationmentioning

confidence: 99%

Society for Cardiovascular Magnetic Resonance (SCMR) guidance for re-activation of cardiovascular magnetic resonance practice after peak phase of the COVID-19 pandemic

Allen

Wong

Bucciarelli-Ducci

et al. 2020

Journal of Cardiovascular Magnetic Resonance

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During the peak phase of the COVID-19 pandemic, alterations of standard operating procedures were necessary for health systems to protect patients and healthcare workers and ensure access to vital hospital resources. As the peak phase passes, re-activation plans are required to safely manage increasing clinical volumes. In the context of cardiovascular magnetic resonance (CMR), re-activation objectives include continued performance of urgent CMR studies and resumption of CMR in patients with semi-urgent and elective indications in an environment that is safe for both patients and health care workers.

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“…After rest perfusion imaging, additional contrast is typically administered in order to perform LGE imaging to assess for ischaemic or non-ischaemic myocardial scarring and viability. A typical scan can take 30–45 min, but there are centres known to do rapid protocols in as little as 20 min, which if widely adopted could make stress CMR the fastest functional imaging test for ischaemia 6…”

Section: Introductionmentioning

confidence: 99%

“…In the future, research in AI aims to reduce the time taken for image acquisition and reconstruction, improving image quality (eg, spatial and temporal resolution), and improving image interpretation through the automated analysis of perfusion, parametric mapping and LGE images. Therefore, the implementation of rapid protocols (<20 min), AI, and efficient analysis workflows will mean that stress CMR can be a competitive imaging modality 6…”

Section: Introductionmentioning

confidence: 99%

Stress perfusion cardiovascular magnetic resonance imaging: a guide for the general cardiologist

Hamilton-Craig

Greenwood

Kozor

2022

Heart

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Stress cardiovascular magnetic resonance (CMR) is an emerging non-invasive imaging technique for the assessment of known or suspected ischaemic heart disease (IHD). Stress CMR provides information on myocardial perfusion, wall motion, ventricular dimensions and volumes, as well as late gadolinium enhancement (LGE) scar imaging in a single test without ionising radiation. Data from numerous multicentre randomised studies show high diagnostic and prognostic utility, its efficacy as a gatekeeper to invasive coronary angiography and use for guiding coronary revascularisation decisions. Stress CMR is cost-effective across multiple healthcare settings, yet its uptake and usage varies worldwide and is an underutilised technology. New developments include rapid acquisition protocols, automated quantification of perfusion and myocardial blood flow, and artificial intelligence-aided automated analysis and reporting. Stress CMR is becoming more accessible and standardised around the globe and is ready for ‘prime time’ use in the non-invasive assessment of patients with suspected IHD.

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Rapid Cardiovascular Magnetic Resonance for Ischemic Heart Disease Investigation (RAPID-IHD)

Cited by 18 publications

References 5 publications

Improving cardiovascular magnetic resonance access in low- and middle-income countries for cardiomyopathy assessment: rapid cardiovascular magnetic resonance

Improving cardiovascular magnetic resonance access in low- and middle-income countries for cardiomyopathy assessment: rapid cardiovascular magnetic resonance

Society for Cardiovascular Magnetic Resonance (SCMR) guidance for re-activation of cardiovascular magnetic resonance practice after peak phase of the COVID-19 pandemic

Stress perfusion cardiovascular magnetic resonance imaging: a guide for the general cardiologist

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