Schulich Heart Program, Sunnybrook Health Sciences Center, University of Toronto, Toronto, On, Canada.
Echocardiography laboratory, Sunnybrook Health Sciences Center Scientist, Sunnybrook Research Institute, Institute for Clinical Evaluative Sciences, Department of Medicine, Canadian Society for Cardiovascular Magnetic Resonance Director, University of Toronto, Toronto, Canada.
J Cardiovasc Magn Reson. 2022 Nov 21;24(1):65. doi: 10.1186/s12968-022-00890-0.
Cardiovascular magnetic resonance (CMR) is an important diagnostic test used in the evaluation of patients with heart failure (HF). However, the demographics and clinical characteristics of those undergoing CMR for evaluation of HF are unknown. Further, the impact of CMR on subsequent HF patient care is unclear. The goal of this study was to describe the characteristics of patients undergoing CMR for HF and to determine the extent to which CMR leads to changes in downstream patient management by comparing pre-CMR indications and post-CMR diagnoses.
We utilized the Society for Cardiovascular Magnetic Resonance (SCMR) Registry as our data source and abstracted data for patients undergoing CMR scanning for HF indications from 2013 to 2019. Descriptive statistics (percentages, proportions) were performed on key CMR and clinical variables of the patient population. The Fisher's exact test was used when comparing categorical variables. The Wilcoxon rank sum test was used to compare continuous variables.
3,837 patients were included in our study. 94% of the CMRs were performed in the United States with China, South Korea and India also contributing cases. Median age of HF patients was 59.3 years (IQR, 47.1, 68.3 years) with 67% of the scans occurring on women. Almost 2/3 of the patients were scanned on 3T CMR scanners. Overall, 49% of patients who underwent CMR scanning for HF had a change between the pre-test indication and post CMR diagnosis. 53% of patients undergoing scanning on 3T had a change between the pre-test indication and post CMR diagnosis when compared to 44% of patients who were scanned on 1.5T (p < 0.01).
Our results suggest a potential impact of CMR scanning on downstream diagnosis of patients referred for CMR for HF, with a larger potential impact on those scanned on 3T CMR scanners.
心血管磁共振（CMR）是评估心力衰竭（HF）患者的重要诊断测试。然而，接受 CMR 评估 HF 的患者的人口统计学和临床特征尚不清楚。此外，CMR 对后续 HF 患者治疗的影响也不清楚。本研究的目的是描述接受 CMR 评估 HF 的患者的特征，并通过比较 CMR 前的指征和 CMR 后的诊断，确定 CMR 对下游患者管理的影响程度。
我们利用心血管磁共振学会（SCMR）注册中心作为数据来源，从 2013 年至 2019 年提取了因 HF 指征接受 CMR 扫描的患者数据。对患者人群的关键 CMR 和临床变量进行描述性统计（百分比、比例）。比较分类变量时使用 Fisher 精确检验。比较连续变量时使用 Wilcoxon 秩和检验。
本研究共纳入 3837 例患者。94%的 CMR 在美国进行，中国、韩国和印度也有病例。HF 患者的中位年龄为 59.3 岁（IQR，47.1，68.3 岁），67%的扫描为女性。近 2/3的患者在 3T CMR 扫描仪上进行扫描。总体而言，因 HF 接受 CMR 扫描的患者中，有 49%的患者在 CMR 前的检查指征和 CMR 后的诊断之间发生了变化。与在 1.5T 扫描仪上扫描的患者（44%）相比，在 3T 扫描仪上扫描的患者中有 53%的患者在 CMR 前的检查指征和 CMR 后的诊断之间发生了变化（p < 0.01）。
我们的研究结果表明，CMR 扫描对因 HF 接受 CMR 检查的患者的下游诊断可能有潜在影响，而对在 3T CMR 扫描仪上扫描的患者的潜在影响更大。
