Comparative assessment of the diagnostic value of echocardiography and magnetic resonance imaging in determining myocardial viability

Abstract

Aim. To compare myocardial imaging methods in patients with complicated coronary artery disease with significantly decreased myocardial contractility.Material and methods. This single-center retrospective study included 109 patients with complicated coronary artery disease who underwent surgical treatment between 2014 and 2020. All patients had indications for delayed contrast-enhanced cardiac magnetic resonance imaging (MRI) in order to determine myocardial viability due to a pronounced decrease in left ventricular contractility according to echocardiography (ejection fraction (EF) ≤30%).Results. Impairment of local contractility according to MRI and echocardiography significantly correlates with depth of contrast accumulation (p=0,0000000018 and p=0,0000034, respectively). Delayed contrast-enhanced cardiac MRI with cine sequences allows to determine higher number of impaired contractility cases compared with echocardiography (p=0,000006).Conclusion. MRI with cine sequence allowed to determine higher number of impaired contractility cases compared with echocardiography. Delayed contrastenhanced MRI is a reliably more sensitive method than electrocardiography in detecting left ventricular scarring. The depth of contrast agent accumulation correlates with local contractility impairment detected by echocardiography and delayed contrast-enhanced cardiac MRI.

Keywords

• cardiac mri
• coronary artery disease
• myocardial viability
• heart failure
• ischemic cardiomyopathy
• myocardial dysfunction