Heart Podcast Can we use cardiac MRI alone to exclude ischaemic cardiomyopathy in patients with heart failure?
Jul 15, 2025
Dr. Louis-Marie Desroches, an interventional cardiologist and clinical researcher from Reunion Island, discusses the pivotal role of cardiac MRI in diagnosing heart failure. He highlights how relying solely on this technology can lead to missed diagnoses and undertreatment. Desroches emphasizes integrating MRI with other diagnostic tools to optimize patient care. The conversation touches on the challenges of obtaining accurate results, including the notable sensitivity issues and the need for standardized image quality in cardiac evaluations.
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Desroches' Clinical Frustration Sparked Study
- Louis-Marie Desroches was frustrated performing many unnecessary coronary angiographies in patients with new LV dysfunction.
- This inspired his research to use cardiac MRI to avoid invasive procedures when possible.
CMR Sensitivity for CAD is Limited
- Resting gadolinium-enhanced CMR had only 57% sensitivity for detecting significant coronary artery disease.
- Nearly half of patients with important CAD would be missed if relying on CMR alone.
CMR Image Quality Affects Accuracy
- About 22% of CMR images were suboptimal in quality, impacting interpretation.
- Poor image quality was linked to disagreement between local and central readings, stressing experience importance.