SCMR Mid-Year Meeting: Myocardial Perfusion CMR-Introduction to Stress CMR

Video Transcription

Video Summary

The transcript captures the opening of a stress CMR workshop in Washington, D.C., featuring multiple expert talks, practical reporting advice, and case-based discussion.<br /><br />The session begins with introductions by the organizers and housekeeping notes, emphasizing the workshop’s highly interactive format, short talks, and lots of case discussion. Dr. Amit Patel then presents the basics of pharmacologic stress CMR, reviewing the ischemic cascade, myocardial perfusion reserve, consequences of prolonged ischemia, and the role of gadolinium for first-pass perfusion imaging. He also explains the value of CMR’s high spatial resolution and late gadolinium enhancement (LGE) for identifying ischemia, scar, viability, and potential recovery after revascularization.<br /><br />Dr. Gabby Weissman discusses diagnostic accuracy and risk stratification. He reviews European and U.S. guidelines and key evidence supporting stress CMR, including trials showing it performs at least as well as SPECT, reduces unnecessary angiography, and predicts outcomes well in registry data. He highlights CMR’s strong negative predictive value, lack of radiation, and role in intermediate-to-high-risk chest pain patients.<br /><br />Dr. Chiara Bucciarelli-Ducci then shares a practical reporting algorithm, stressing that interpretation should be systematic, fast, and robust. Her approach focuses on visual analysis, comparing stress and rest side-by-side, checking timing relative to contrast arrival, and avoiding false positives from dark-rim artifact. She also introduces the emerging role of quantitative perfusion mapping.<br /><br />The talk ends with extensive case discussions covering dark-rim artifacts, ischemia versus scar, viability, device-related challenges, radiation-associated heart disease, and how to communicate significance to interventional cardiologists. Overall, the workshop emphasizes stress CMR as a powerful, one-stop test for ischemia, scar, function, and viability.

Keywords

stress CMR

pharmacologic stress

myocardial perfusion

late gadolinium enhancement

ischemic cascade

diagnostic accuracy

risk stratification

cardiac MRI

dark-rim artifact

quantitative perfusion mapping

myocardial viability

ischemia detection

revascularization

chest pain evaluation