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Abstract
Cardiovascular magnetic resonance imaging (CMR) has emerged as a potential modality for the diagnosis and risk stratification of patients with documented or suspected coronary artery disease. As such, it may be used as an alternative to other accepted noninvasive modalities. In the Clinical Evaluation of Magnetic Resonance Imaging in Coronary Heart Disease (CE-MARC) study, Greenwood et al. enrolled 752 patients with suspected angina pectoris and at least one cardiovascular risk factor, and evaluated the diagnostic accuracy of multiparametric CMR and single photon emission computed tomography (SPECT), and compared them with invasive coronary angiography as the reference standard. The authors reported significantly higher sensitivity and negative predictive values for CMR (86.5 and 90.5%, respectively) compared with SPECT (66.5 and 79.1%, respectively) and recommended that CMR be used more frequently than at present for the investigation of coronary artery disease. This robustly designed landmark trial certainly adds to the already impressive diagnostic data available with CMR in such patients, but being a new technique, it lacks the large outcome data available with SPECT. In summary, the results of this study confirm the promise for CMR, but further work and larger multicenter studies are required before its adoption into routine clinical practice.
Financial & competing interests disclosure
G Dwivedi is supported by Dowager Countess Eleanor Peel trust (Rothwell-Jackson travelling fellowship, UK) and Whit and Heather Tucker Cardiology endowed research fellowship grants. RG Wells collaborates on research studies with GE Healthcare and Nordion. BJW Chow is supported by CIHR New Investigator Award MSH-83718 and received research support from GE Healthcare and educational support from TeraRecon. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.