Topic Highlight
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Nov 26, 2014; 6(11): 1166-1174
Published online Nov 26, 2014. doi: 10.4330/wjc.v6.i11.1166
Diagnosis and management of ischemic cardiomyopathy: Role of cardiovascular magnetic resonance imaging
Christina Doesch, Theano Papavassiliu
Christina Doesch, Theano Papavassiliu, 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany
Christina Doesch, Theano Papavassiliu, DZHK (German Centre for Cardiovascular Research) partner site Mannheim, 69117 Heidelberg, Germany
Author contributions: Doesch C reviewed the literature, organized and wrote the manuscript; Papavassiliu T reviewed the literature, critically reviewed and edited the final version of the manuscript.
Correspondence to: Theano Papavassiliu, MD, 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. theano.papavassiliu@umm.de
Telephone: +49-621-3832204 Fax: +49-621-3833821
Received: May 23, 2014
Revised: July 2, 2014
Accepted: September 6, 2014
Published online: November 26, 2014
Processing time: 191 Days and 14.8 Hours
Abstract

Coronary artery disease (CAD) represents an important cause of mortality. Cardiovascular magnetic resonance (CMR) imaging evolved as an imaging modality that allows the assessment of myocardial function, perfusion, contractile reserve and extent of fibrosis in a single comprehensive exam. This review highlights the role of CMR in the differential diagnosis of acute chest pain by detecting the location of obstructive CAD or necrosis and identifying other conditions like stress cardiomyopathy or myocarditis that can present with acute chest pain. Besides, it underlines the prognostic implication of perfusion abnormalities in the setting of acute chest pain. Furthermore, the review addresses the role of CMR to detect significant CAD in patients with stable CAD. It elucidates the accuracy and clinical utility of CMR with respect to other imaging modalities like single-photon emission computed tomography and positron emission tomography. Besides, the prognostic value of CMR stress testing is discussed. Additionally, it summarizes the available CMR techniques to assess myocardial viability and describes algorithm to identify those patient who might profit from revascularization those who should be treated medically. Finally, future promising imaging techniques that will provide further insights into the fundamental disease processes in ischemic cardiomyopathy are discussed.

Keywords: Coronary artery disease, Cardiovascular magnetic resonance imaging, Prognostic value, Stress testing, Viability

Core tip: Coronary artery disease (CAD) represents an important cause of mortality. This review highlights the role of cardiovascular magnetic resonance (CMR) in the differential diagnosis of acute chest pain. It underlines the prognostic implication of perfusion abnormalities in the setting of acute chest pain and addresses the role of CMR to detect significant CAD in patients with stable CAD. Besides, the prognostic value of CMR stress testing is discussed. Additionally, it summarizes the available CMR techniques to assess myocardial viability. This review describes a treatment algorithm and presents new imaging techniques that might give further insights into the fundamental disease processes in ischemic cardiomyopathy.