Perfusion CMR to Guide Patient Management in Stable Angina

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Myocardial perfusion imaging with cardiovascular magnetic resonance (CMR) has demonstrated excellent accuracy and prognostic value versus invasive angiography with or without fractional flow reserve (FFR). Direct comparisons to nuclear medicine have shown superior performance. Perfusion CMR can reduce the number of unnecessary invasive angiographies. Recent studies have shown that perfusion CMR can guide patients with stable angina with similar safety and outcomes, rather than the current standard of care, i.e invasive angiogrpahy plus fractional flow reserve. This webinar will lead you through the evidence, describe how to perform and interpret perfusion CMR and provide guidance on various clinical scenarios.


Eike Nagel

Eike Nagel

Key Learning Objectives

  • the latest the evidence on perfusion CMR.
  • understanding its advantages and limitations.
  • how to refer the right patient to a perfusion CMR study and understand the resulting report.

Target Audience

  • Cardiac imaging specialists
  • Physicians treating/investigating stable angina and chest pain
  • Radiologists

Faculty Biographies

Eike Nagel

Eike Nagel

Eike Nagel, MD, is a Professor of Clinical Cardiovascular Imaging in the Division of Imaging Sciences at King’s College London. Prior to this, he was a Consultant in Cardiology at the German Heart Institute, and an Associate Professor of Medicine and Cardiology at Humboldt-University in Berlin. He has a long-standing interest in non-invasive imaging and his research has focused mainly on detecting and understanding ischemic heart disease with magnetic resonance techniques, in particular addressing myocardial ischaemia, coronary stenosis, and vessel wall alterations. Dr Nagel is engaged in developing new applications of magnetic resonance imaging for the characterization of coronary artery plaques.

E: eike.nagel@kcl.ac.uk

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Key References

1. Nagel E, Greenwood JP, McCann GP, Bettencourt N, Shah AM, Hussain ST, Perera D, Plein S, Bucciarelli-Ducci C, Paul M, Westwood MA, Marber M, Richter WS, Puntmann VO, Schwenke C, Schulz-Menger J, Das R, Wong J, Hausenloy DJ, Steen H, Berry C; MR-INFORM Investigators. Magnetic Resonance Perfusion or Fractional Flow Reserve in Coronary Disease. N Engl J Med. 2019 Jun 20;380(25):2418-2428.

2. Greenwood JP, Ripley DP, Berry C, McCann GP, Plein S, Bucciarelli-Ducci C, Dall'Armellina E, Prasad A, Bijsterveld P, Foley JR, Mangion K, Sculpher M, Walker S, Everett CC, Cairns DA, Sharples LD, Brown JM; CE-MARC 2 Investigators. Effect of Care Guided by Cardiovascular Magnetic Resonance, Myocardial Perfusion Scintigraphy, or NICE Guidelines on Subsequent Unnecessary Angiography Rates: The CE-MARC 2 Randomized Clinical Trial. JAMA. 2016 Sep 13;316(10):1051-60.

3. Nagel E, Klein C, Paetsch I, Hettwer S, Schnackenburg B, Wegscheider K, Fleck E. Magnetic resonance perfusion measurements for the noninvasive detection of coronary artery disease. Circulation. 2003 Jul 29;108(4):432-7.

4. Greenwood JP, Maredia N, Younger JF, Brown JM, Nixon J, Everett CC, Bijsterveld P, Ridgway JP, Radjenovic A, Dickinson CJ, Ball SG, Plein S. Cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary heart disease (CE-MARC): a prospective trial. Lancet. 2012 Feb 4;379(9814):453-60. doi: 10.1016/S0140-6736(11)61335-4.