Quicker, cheaper CMR protocol may improve cardio care in developing nations

A streamlined cardiac magnetic resonance (CMR) imaging protocol utilizing a contrast agent allowed Peruvian clinicians to improve care for patients with various heart conditions, a new Journal of the American Heart Association study found. The findings may prove invaluable in bringing CMR imaging to developing regions.  

Cardiovascular disease (CVD) accounts for 17.9 million global deaths annually, with the highest rates in low- and middle-income countries.

In high-income countries CMR delivers valuable clinical information such as function, scar, perfusion, flow mapping and angiography—leading to more precise treatment. However, as lead author James C. Moon, MD, and colleagues noted, the technique typically takes 45 minutes and cost-prohibitive for developing countries.

Moon et al. tested a more rapid CMR approach first developed in the United Kingdom that utilized contrast dye to measure cardiac structure, function and scarring.

Testing the new protocol, which took 18 minutes and totaled $150 per patient, influenced management for 56 percent of the 98-person cohort.

Additionally, the rapid CMR technique revealed previously unsuspected diagnoses in 19 percent of patients and therapeutic management changes in another 37 percent.

“Our CMR strategy was three to five times cheaper than current CMR exams in Peru,” Moon, a professor at Barts Heart Center at St. Bartholomew’s Hospital in London said in a press release. “It also can be delivered two to three times faster and is easier than conventional CMR.”

In an accompanying editorial, Christopher M. Kramer, MD, with the University of Virginia Health System in Charlottesville, argued incorporating the streamlined CMR approach will require additional education and training.

“To make this proof-of-principle study a reality in much of the developing world, imagers will need to be trained at sites with appropriate scanner technology,” Kramer concluded. “Only in this way will an abbreviated protocol for evaluation of cardiomyopathies be implemented. This is an exciting time for the potential of broadening the impact of CMR throughout the developing world.”