Techniques and Methods Session 4: Rethinking Imaging of Function, Flow, Perfusion, and Morphology (2020)-Techniques for Myocardial Function and Perfusion Assessment

Techniques for Myocardial Function and Perfusion Assessment

Video Transcription

Video Summary

The speaker argues that cardiac MRI (CMR) is underused despite its major value in heart failure diagnosis, prognosis, and treatment planning. In heart failure with reduced ejection fraction, CMR can provide more accurate and reproducible measurements than echo, sometimes changing management, such as ICD referral. In HFpEF, CMR may help classify heterogeneous patients earlier and more precisely using tools like feature tracking, left atrial function analysis, right ventricular motion assessment, and machine learning. CMR-derived strain and scar imaging may also guide therapies, including CRT lead placement, early detection of cardiotoxicity, and timing of valve interventions. For myocardial perfusion, stress CMR shows strong prognostic value, but widespread use is limited by workflow burdens, breath-holds, contrast issues, and cumbersome analysis. The speaker emphasizes that future CMR advances should prioritize accessibility, usability, and automation to improve clinical outcomes.

Keywords

cardiac MRI

heart failure

HFpEF

myocardial perfusion

strain imaging