Report from SCMR: Clinical applications push earns top billing at 2007 meeting

Efforts to advance cardiac MR applications that have immediate clinical uses appear in scientific papers highlighted at the 10th annual Society for Cardiac Magnetic Resonance meeting in Rome.

The most noteworthy papers being presented in three days of lectures and talks beginning Feb. 2 advance cardiac MR as a prognostic instrument that can improve understanding of disease processes, leading to better diagnosis and treatment, said SCMR spokesperson Dr. Eike Nagel.

"We have moved from a more technical, more research-based technique toward something that generates exactly the data we need to apply in a clinical routine," he said in a phone interview from Rome.

Trials demonstrating the prognostic value of cardiac MR cover the evaluation of various cardiac diseases. They include assessments of ischemia that can use perfusion MR and dobutamine stress MR for wall motion to stratify the risk for future cardiac events, Nagel said.

With cardiac MR of fibrosis, physicians can define patient subgroups susceptible to disease. Dr. Raymond Kwong, a radiologist in the cardiovascular MR unit at Brigham and Women's Hospital, will present a study showing that delayed-enhancement cardiac MR detects silent myocardial infarction in diabetic patients while predicting their risk of future cardiac events.

Dr. Valentin Fuster of Mount Sinai Medical Center in New York City evaluated the effect of beta-blocker therapy on pigs with induced myocardial infarction. He found that the infarcted area of the myocardium actually shrinks in animals that received beta blockers.

"We see that the infarcted area gets smaller, suggesting a cardioprotective effect from the beta blockers, explaining why they work," Nagel said.

The sudden prominence of cardiac CT has compelled cardiac MR researchers to emphasize the practical applications of their modality, he said. CT's advantage over MR for coronary artery imaging has been demonstrated, but cardiac MR evaluations of myocardial ischemia may be more important than coronary artery studies for recommending therapeutic actions and determining patient prognosis.

"We are answering the more important questions: Does the patient have relevant ischemia, not just is there a 50% or greater stenosis? With other techniques, we don't know if that stenosis is causing ischemia," Nagel said.

By returning to Europe for its annual meeting, the SCMR is underscoring the numerous contributions European researchers have made to MR's advancement. Dr. Juerg Schwitter's group at the University of Zurich in Switzerland completed the largest multicenter trials to examine cardiac MR perfusion imaging.

The German Heart Institute in Berlin has provided the largest amount of data on dobutamine stress imaging, including direct comparison between dobutamine stress and perfusion imaging, measuring the relative strengths and weaknesses of the two techniques. European researchers have made important contributions to the use of cardiac MR for understanding cardiomyopathy and heart failure.

A record 546 abstracts, compared with 377 last year, will be presented at 2007 meeting. More than 1000 physicians and technologists are expected to attend.

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