Functional Cardiac Magnetic Resonance Imaging in the Assessment of Myocardial Viability and Perfusion Health Technology Scientific Literature Review

Disclaimer This health technology scientific literature review was prepared by the Medical Advisory Secretariat, Ontario Ministry of Health and Long-Term Care arising from analysis, interpretation and comparison of scientific research and/or technology assessments conducted by other organizations. While every effort has been made to do so, this document may not fully reflect scientific research available. Additionally, other relevant scientific findings may have been reported since completion of the review. Please contact [email protected] if you are aware of new research findings that should inform the report or would like further information. Abbreviations/Acronyms CA Coronary angiography CABG Coronary artery bypass grafting CAD Coronary artery disease CFR Coronary flow reserve CI Confidence interval CMRI Contrast enhanced MRI DMRT Dobutamine MRI tagging DSE Low dose dobutamine stress echo FDG Fluorine 18-fluorodeoxyglucose FDI Functional diagnostic imaging HF Heart failure INAHTA International Agency for Health Technology Assessment LV Left ventricular LVEF Left ventricular ejection fraction MI Myocardial infarction MPI Myocardial perfusion imaging MPR Myocardial perfusion reserve MPRI Myocardial perfusion reserve index MRI Magnetic resonance imaging MV Myocardial viability NHSC National Horizon Scanning Centre NYHA New York Heart Association PET Positron emission tomography PCTA Percutaneous coronary transluminal angioplasty RF Radiofrequency SE Standard error SI Signal intensity SPECT Single photon emission tomography T Tesla Tl Thallium TEE Transesophageal echocardiography TEI Transmural extent of infarction WM Wall motion WMS Wall motion study or wall motion score WT Wall thickness Glossary Coronary angiography: Radiography of the vascular system of the heart muscle after injection of a contrast medium. Coronary flow reserve (CFR): The ratio of maximal achievable coronary flow under pharmacologic stimulation/exercise and baseline coronary flow. Cine magnetic resonance imaging: A type of imaging technique used primarily in the field of cardiology. By triggering a MRI sequence with prospective ECG gating, numerous short time frames evenly spaced in the cardiac cycle are produced. These images are sequenced together in a cinematic display so that wall motion of the ventricles, valve motion, and blood flow patterns in the heart and great vessels can be visualized. Gating: Use of an electronic signal from the cardiac cycle to trigger an event, such as in imaging separate phases of cardiac contraction. Infarct: An area of tissue death due to a local lack of oxygen. Magnetic Resonance Imaging (MRI): A special imaging technique used to image internal structures of the body, particularly the soft tissues. It uses the influence of a large magnet to polarize …