PMID- 24083836
OWN - NLM
STAT- MEDLINE
DCOM- 20140707
LR  - 20240117
IS  - 1532-429X (Electronic)
IS  - 1097-6647 (Print)
IS  - 1097-6647 (Linking)
VI  - 15
IP  - 1
DP  - 2013 Oct 1
TI  - Impact of cardiovascular magnetic resonance on management and clinical 
      decision-making in heart failure patients.
PG  - 89
LID - 10.1186/1532-429X-15-89 [doi]
AB  - BACKGROUND: Cardiovascular magnetic resonance (CMR) can provide important 
      diagnostic and prognostic information in patients with heart failure. However, in 
      the current health care environment, use of a new imaging modality like CMR 
      requires evidence for direct additive impact on clinical management. We sought to 
      evaluate the impact of CMR on clinical management and diagnosis in patients with 
      heart failure. METHODS: We prospectively studied 150 consecutive patients with 
      heart failure and an ejection fraction </= 50% referred for CMR. Definitions for 
      "significant clinical impact" of CMR were pre-defined and collected directly from 
      medical records and/or from patients. Categories of significant clinical impact 
      included: new diagnosis, medication change, hospital admission/discharge, as well 
      as performance or avoidance of invasive procedures (angiography, 
      revascularization, device therapy or biopsy). RESULTS: Overall, CMR had a 
      significant clinical impact in 65% of patients. This included an entirely new 
      diagnosis in 30% of cases and a change in management in 52%. CMR results directly 
      led to angiography in 9% and to the performance of percutaneous coronary 
      intervention in 7%. In a multivariable model that included clinical and imaging 
      parameters, presence of late gadolinium enhancement (LGE) was the only 
      independent predictor of "significant clinical impact" (OR 6.72, 95% CI 
      2.56-17.60, p=0.0001). CONCLUSIONS: CMR made a significant additive clinical 
      impact on management, decision-making and diagnosis in 65% of heart failure 
      patients. This additive impact was seen despite universal use of prior 
      echocardiography in this patient group. The presence of LGE was the best 
      independent predictor of significant clinical impact following CMR.
FAU - Abbasi, Siddique A
AU  - Abbasi SA
AD  - Section of Cardiology, Department of Medicine, University of Illinois at Chicago, 
      840 South Wood St, M/C 715, Suite 920 S, Chicago, IL 60612, USA. afshin@uic.edu.
FAU - Ertel, Andrew
AU  - Ertel A
FAU - Shah, Ravi V
AU  - Shah RV
FAU - Dandekar, Vineet
AU  - Dandekar V
FAU - Chung, Jaehoon
AU  - Chung J
FAU - Bhat, Geetha
AU  - Bhat G
FAU - Desai, Ankit A
AU  - Desai AA
FAU - Kwong, Raymond Y
AU  - Kwong RY
FAU - Farzaneh-Far, Afshin
AU  - Farzaneh-Far A
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20131001
PL  - England
TA  - J Cardiovasc Magn Reson
JT  - Journal of cardiovascular magnetic resonance : official journal of the Society 
      for Cardiovascular Magnetic Resonance
JID - 9815616
SB  - IM
EIN - J Cardiovasc Magn Reson. 2014;16:20
MH  - Adult
MH  - Aged
MH  - *Decision Support Techniques
MH  - Female
MH  - Heart Failure/*diagnosis/physiopathology/therapy
MH  - Humans
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Patient Selection
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Prospective Studies
MH  - Stroke Volume
MH  - Ventricular Function, Left
PMC - PMC3851265
EDAT- 2013/10/03 06:00
MHDA- 2014/07/08 06:00
PMCR- 2013/10/01
CRDT- 2013/10/03 06:00
PHST- 2013/06/17 00:00 [received]
PHST- 2013/09/20 00:00 [accepted]
PHST- 2013/10/03 06:00 [entrez]
PHST- 2013/10/03 06:00 [pubmed]
PHST- 2014/07/08 06:00 [medline]
PHST- 2013/10/01 00:00 [pmc-release]
AID - S1097-6647(23)00805-0 [pii]
AID - 1532-429X-15-89 [pii]
AID - 10.1186/1532-429X-15-89 [doi]
PST - epublish
SO  - J Cardiovasc Magn Reson. 2013 Oct 1;15(1):89. doi: 10.1186/1532-429X-15-89.