Congestive heart failure cardiac MRI

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Medical Therapy:

Summary
Acute Pharmacotherapy
Chronic Pharmacotherapy in HFpEF
Chronic Pharmacotherapy in HFrEF
Diuretics
ACE Inhibitors
Angiotensin receptor blockers
Aldosterone Antagonists
Beta Blockers
Ca Channel Blockers
Nitrates
Hydralazine
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Associated conditions

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Surgical Therapy:

Biventricular Pacing or Cardiac Resynchronization Therapy (CRT)
Implantation of Intracardiac Defibrillator
Ultrafiltration
Cardiac Surgery
Left Ventricular Assist Devices (LVADs)
Cardiac Transplantation

ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
Hospitalized Patient
Patients With a Prior MI
Sudden Cardiac Death Prevention
Surgical/Percutaneous/Transcather Interventional Treatments of HF
Patients at high risk for developing heart failure (Stage A)
Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)
Patients with current or prior symptoms of heart failure (Stage C)
Patients with refractory end-stage heart failure (Stage D)
Coordinating Care for Patients With Chronic HF
Quality Metrics/Performance Measures

Implementation of Practice Guidelines

Congestive heart failure end-of-life considerations

Specific Groups:

Special Populations
Patients who have concomitant disorders
Obstructive Sleep Apnea in the Patient with CHF
NSTEMI with Heart Failure and Cardiogenic Shock

Congestive heart failure cardiac MRI On the Web

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Risk calculators and risk factors for Congestive heart failure cardiac MRI

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Edzel Lorraine Co, DMD, MD[3]

Overview

Cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE), T1 mapping, and extracellular volume may diagnosis myocardial fibrosis/scar in subendocardial area for patients with ischaemic heart disease (IHD) and scar in mid-wall area for dilated cardiomyopathy (DCM). Moreover, CMR may identify myocardial characterization including myocarditis, amyloidosis, sarcoidosis, Chagas disease, Fabry disease, LV non-compaction cardiomyopathy, haemochromatosis, and arrhythmogenic cardiomyopathy.

Cardiac MRI

2021 European Society of Cardiology (ESC) Guidelines (DO NOT EDIT) [1]

Class I

LV non-compaction,amyloid, sarcoidosis, iron overload/hemochromatosis(Level of Evidence: C)

Class IIa

2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [2]

Class I
"4. In patients for whom echocardiography is inadequate, alternative imaging (eg, cardiac magnetic resonance [CMR], cardiac computed tomography [CT], radionuclide imaging) is recommended for assessment of LVEF.[3][4][5][6][7][8][9][10](Level of Evidence: C-LD) "

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References

  1. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland J, Coats A, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam C, Lyon AR, McMurray J, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano G, Ruschitzka F, Kathrine Skibelund A (September 2021). "2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure". Eur Heart J. 42 (36): 3599–3726. doi:10.1093/eurheartj/ehab368. PMID 34447992 Check |pmid= value (help). Vancouver style error: initials (help)
  2. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM; et al. (2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e876–e894. doi:10.1161/CIR.0000000000001062. PMID 35363500 Check |pmid= value (help).
  3. Bellenger NG, Burgess MI, Ray SG, Lahiri A, Coats AJ, Cleland JG; et al. (2000). "Comparison of left ventricular ejection fraction and volumes in heart failure by echocardiography, radionuclide ventriculography and cardiovascular magnetic resonance; are they interchangeable?". Eur Heart J. 21 (16): 1387–96. doi:10.1053/euhj.2000.2011. PMID 10952828.
  4. Grothues F, Smith GC, Moon JC, Bellenger NG, Collins P, Klein HU; et al. (2002). "Comparison of interstudy reproducibility of cardiovascular magnetic resonance with two-dimensional echocardiography in normal subjects and in patients with heart failure or left ventricular hypertrophy". Am J Cardiol. 90 (1): 29–34. doi:10.1016/s0002-9149(02)02381-0. PMID 12088775.
  5. Longmore DB, Klipstein RH, Underwood SR, Firmin DN, Hounsfield GN, Watanabe M; et al. (1985). "Dimensional accuracy of magnetic resonance in studies of the heart". Lancet. 1 (8442): 1360–2. doi:10.1016/s0140-6736(85)91786-6. PMID 2861314.
  6. Doherty JU, Kort S, Mehran R, Schoenhagen P, Soman P, Dehmer GJ; et al. (2019). "ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2019 Appropriate Use Criteria for Multimodality Imaging in the Assessment of Cardiac Structure and Function in Nonvalvular Heart Disease: A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and the Society of Thoracic Surgeons". J Am Coll Cardiol. 73 (4): 488–516. doi:10.1016/j.jacc.2018.10.038. PMID 30630640.
  7. van Royen N, Jaffe CC, Krumholz HM, Johnson KM, Lynch PJ, Natale D; et al. (1996). "Comparison and reproducibility of visual echocardiographic and quantitative radionuclide left ventricular ejection fractions". Am J Cardiol. 77 (10): 843–50. doi:10.1016/s0002-9149(97)89179-5. PMID 8623737.
  8. Fu H, Wang X, Diao K, Huang S, Liu H, Gao Y; et al. (2019). "CT compared to MRI for functional evaluation of the right ventricle: a systematic review and meta-analysis". Eur Radiol. 29 (12): 6816–6828. doi:10.1007/s00330-019-06228-2. PMID 31134368.
  9. Kaniewska M, Schuetz GM, Willun S, Schlattmann P, Dewey M (2017). "Noninvasive evaluation of global and regional left ventricular function using computed tomography and magnetic resonance imaging: a meta-analysis". Eur Radiol. 27 (4): 1640–1659. doi:10.1007/s00330-016-4513-1. PMID 27510625.
  10. Takx RA, Moscariello A, Schoepf UJ, Barraza JM, Nance JW, Bastarrika G; et al. (2012). "Quantification of left and right ventricular function and myocardial mass: comparison of low-radiation dose 2nd generation dual-source CT and cardiac MRI". Eur J Radiol. 81 (4): e598–604. doi:10.1016/j.ejrad.2011.07.001. PMID 21831552.
  11. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW (May 2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e895–e1032. doi:10.1161/CIR.0000000000001063. PMID 35363499 Check |pmid= value (help).

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