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欧洲心血管磁共振(EuroCMR)注册研究:德国试点阶段的结果。

EuroCMR (European Cardiovascular Magnetic Resonance) registry: results of the German pilot phase.

作者信息

Bruder Oliver, Schneider Steffen, Nothnagel Detlef, Dill Thorsten, Hombach Vinzenz, Schulz-Menger Jeanette, Nagel Eike, Lombardi Massimo, van Rossum Albert C, Wagner Anja, Schwitter Juerg, Senges Jochen, Sabin Georg V, Sechtem Udo, Mahrholdt Heiko

机构信息

Department of Cardiology and Angiology, Elisabeth Hospital, Essen, Germany.

出版信息

J Am Coll Cardiol. 2009 Oct 6;54(15):1457-66. doi: 10.1016/j.jacc.2009.07.003. Epub 2009 Aug 13.

DOI:10.1016/j.jacc.2009.07.003
PMID:19682818
Abstract

OBJECTIVES

During its German pilot phase, the EuroCMR (European Cardiovascular Magnetic Resonance) registry sought to evaluate indications, image quality, safety, and impact on patient management of routine CMR.

BACKGROUND

CMR has a broad range of applications and is increasingly used in clinical practice.

METHODS

This was a multicenter registry with consecutive enrollment of patients in 20 German centers.

RESULTS

A total of 11,040 consecutive patients were enrolled. Eighty-eight percent of patients received gadolinium-based contrast agents. Twenty-one percent underwent adenosine perfusion, and 11% high-dose dobutamine-stress CMR. The most important indications were workup of myocarditis/cardiomyopathies (32%), risk stratification in suspected coronary artery disease/ischemia (31%), as well as assessment of viability (15%). Image quality was good in 90.1%, moderate in 8.1%, and inadequate in 1.8% of cases. Severe complications occurred in 0.05%, and were all associated with stress testing. No patient died during or due to CMR. In nearly two-thirds of patients, CMR findings impacted patient management. Importantly, in 16% of cases the final diagnosis based on CMR was different from the diagnosis before CMR, leading to a complete change in management. In more than 86% of cases, CMR was capable of satisfying all imaging needs so that no further imaging was required.

CONCLUSIONS

CMR is frequently performed in clinical practice in many participating centers. The most important indications are workup of myocarditis/cardiomyopathies, risk stratification in suspected coronary artery disease/ischemia, and assessment of viability. CMR imaging as used in the centers of the pilot registry is a safe procedure, has diagnostic image quality in 98% of cases, and its results have strong impact on patient management.

摘要

目的

在德国试点阶段,欧洲心血管磁共振(EuroCMR)注册研究旨在评估常规CMR(心血管磁共振成像)的适应症、图像质量、安全性以及对患者管理的影响。

背景

CMR有广泛的应用,且在临床实践中使用越来越多。

方法

这是一项多中心注册研究,在德国20个中心连续纳入患者。

结果

共连续纳入11040例患者。88%的患者接受了钆基造影剂。21%的患者接受了腺苷灌注,11%的患者接受了高剂量多巴酚丁胺负荷CMR。最重要的适应症是心肌炎/心肌病的检查(32%)、疑似冠状动脉疾病/缺血的风险分层(31%)以及存活能力评估(15%)。90.1%的病例图像质量良好,8.1%为中等,1.8%不足。严重并发症发生率为0.05%,均与负荷试验有关。没有患者在CMR检查期间或因CMR检查死亡。近三分之二的患者,CMR检查结果影响了患者管理。重要的是,在16%的病例中,基于CMR的最终诊断与CMR检查前的诊断不同,导致管理方式完全改变。在超过86%的病例中,CMR能够满足所有成像需求,因此无需进一步成像。

结论

在许多参与研究的中心,CMR在临床实践中经常进行。最重要的适应症是心肌炎/心肌病的检查、疑似冠状动脉疾病/缺血的风险分层以及存活能力评估。试点注册研究中心所使用的CMR成像检查是一种安全的检查方法,98%的病例具有诊断图像质量,其结果对患者管理有很大影响。

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