SCMR/Medis: CMR in Heart Failure: How to do it?-SCMR/MEDIS: CMR in Heart Failure: How to do it?

Video Transcription

Video Summary

The session introduced two experts discussing cardiac MRI (CMR) for heart failure assessment using the MEDIS platform.<br /><br />Dr. Jadranka Stojanska focused on left ventricular (LV) function in heart failure. She reviewed heart failure classification by ejection fraction: preserved (>50%), mid-range (40–49%), and reduced (<40%). She emphasized CMR as the gold standard for accurate, reproducible LV and right ventricular (RV) volumetric analysis, especially for serial follow-up and device decisions such as ICD placement. She demonstrated MEDIS auto-contouring, noting that the software is highly efficient and usually requires minimal manual adjustment. She also highlighted that CMR is not routinely used for diastolic function assessment, which is generally better evaluated by echocardiography. A cited study showed that mid-range heart failure may resemble preserved EF for some mapping/perfusion features but reduced EF for ischemic burden, underscoring the importance of accurate EF measurement.<br /><br />Dr. Manuel Barrero presented two real-world cases showing the added value of advanced CMR. In the first, an elderly woman on ibrutinib developed acute symptoms with elevated troponin; CMR showed edema and mild dysfunction, suggesting drug-related myocarditis or stress cardiomyopathy. Follow-up CMR after stopping the drug showed recovery of function and normalization of tissue parameters. In the second case, a younger man with cardiomyopathy and LV hypertrophy had severely abnormal strain, diffuse fibrosis, and subendocardial late gadolinium enhancement despite normal coronaries; CMR findings helped guide device therapy, and he later received appropriate ICD therapy for ventricular tachycardia. Barrero stressed that mapping, strain, and late enhancement can reveal prognostic and diagnostic information beyond ejection fraction alone.

Keywords

cardiac MRI

heart failure

MEDIS platform

left ventricular function

ejection fraction

auto-contouring

myocarditis

strain imaging

late gadolinium enhancement

ICD therapy