Institute of Cardiovascular Science, University College London, London, UK.
Barts Heart Centre, Saint Bartholomew's Hospital, London, UK.
Expert Rev Cardiovasc Ther. 2021 May;19(5):387-398. doi: 10.1080/14779072.2021.1915130. Epub 2021 May 24.
: Cardiac Magnetic Resonance (CMR) is a crucial diagnostic imaging test that redefines diagnosis and enables targeted therapies, but the access to CMR is limited in low-middle Income Countries (LMICs) even though cardiovascular disease is an emergent primary cause of mortality in LMICs. New abbreviated CMR protocols can be less expensive, faster, whilst maintaining accuracy, potentially leading to a higher utilization in LMICs.: This article will review cardiovascular disease in LMICs and the current role of CMR in cardiac diagnosis and enable targeted therapy, discussing the main obstacles to prevent the adoption of CMR in LMICs. We will then review the potential utility of abbreviated, cost-effective CMR protocols to improve cardiac diagnosis and care, the clinical indications of the exam, current evidence and future directions.: Rapid CMR protocols, provided that they are utilized in potentially high yield cases, could reduce cost and increase effectiveness. The adoption of these protocols, their integration into care pathways, and prioritizing key treatable diagnoses can potentially improve patient care. Several LMIC countries are now pioneering these approaches and the application of rapid CMR protocols appears to have a bright future if delivered effectively.
心脏磁共振（CMR）是一种至关重要的诊断成像测试，它重新定义了诊断方法，并能够实现靶向治疗，但即使心血管疾病是中低收入国家（LMICs）的主要死亡原因之一，CMR 的应用在这些国家仍然受到限制。新的简化 CMR 方案可能更便宜、更快，同时保持准确性，这可能导致在 LMICs 中更高的利用率。本文将回顾 LMICs 中的心血管疾病以及 CMR 在心脏诊断和靶向治疗中的当前作用，讨论阻碍 CMR 在 LMICs 中应用的主要障碍。然后，我们将回顾简化、具有成本效益的 CMR 方案在改善心脏诊断和治疗方面的潜在效用，检查的临床适应症、当前证据和未来方向。快速 CMR 方案，如果在潜在高收益病例中使用，可以降低成本并提高效果。这些方案的采用、将其整合到护理路径中以及优先考虑可治疗的关键诊断，可以潜在地改善患者的护理。现在，一些 LMIC 国家正在率先采用这些方法，如果有效地实施，快速 CMR 方案的应用似乎有着光明的前景。
