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CLINICAL RESEARCH: CARDIAC IMAGING

EuroCMR (European Cardiovascular Magnetic Resonance) Registry

Results of the German Pilot Phase

Oliver Bruder, MD^_*,_*, Steffen Schneider, PhD, Detlef Nothnagel, MD, Thorsten Dill, MD, Vinzenz Hombach, MD^||, Jeanette Schulz-Menger, MD^¶, Eike Nagel, MD^#, Massimo Lombardi, MD^_**, Albert C. van Rossum, MD, Anja Wagner, MD, Juerg Schwitter, MD, Jochen Senges, MD, Georg V. Sabin, MD^_*, Udo Sechtem, MD^|||| and Heiko Mahrholdt, MD^||||

^_* Department of Cardiology and Angiology, Elisabeth Hospital, Essen, Germany
Institut für Herzinfarktforschung, Ludwigshafen, Germany
Department of Cardiology, Klinikum Ludwigsburg, Ludwigsburg, Germany
Department of Cardiology, Kerckhoff-Klinik, Bad Nauheim, Germany
^|| Department of Internal Medicine II, Cardiology, University of Ulm, Ulm, Germany
^¶ Franz-Volhard-Klinik, Klinik für Kardiologie, HELIOS Klinikum Berlin-Buch Charité Universitätsmedizin Berlin, Berlin, Germany
^# King's College London BHF Centre of Excellence, Division of Imaging Sciences, NIHR Biomedical Research Centre at Guy's and St. Thomas' NHS Trust Foundation, The Rayne Institute, St. Thomas' Hospital, London, United Kingdom
^_** Clinical Physiology Institute/G. Monasterio Foundation, Pisa, Italy
Department of Cardiology, VU Medical Centre, Amsterdam, the Netherlands
Hahnemann University Hospital, Drexel University College of Medicine, Philadelphia, Pennsylvania
Cardiac MR Centre, University Hospital Lausanne, Lausanne, Switzerland
^|||| Department of Cardiology, Robert Bosch Medical Centre, Stuttgart, Germany

Manuscript received May 13, 2009; revised manuscript received July 1, 2009, accepted July 6, 2009.

^_* Reprint requests and correspondence: Dr. Oliver Bruder, Elisabeth Hospital, Klara-Kopp-Weg 1, 45138 Essen, Germany (Email: o.bruder{at}contilia.de).

Objectives: During its German pilot phase, the EuroCMR (European Cardiovascular Magnetic Resonance) registry sought to evaluate indications, image quality, safety, and impact on patient management of routine CMR.

Background: CMR has a broad range of applications and is increasingly used in clinical practice.

Methods: This was a multicenter registry with consecutive enrollment of patients in 20 German centers.

Results: A total of 11,040 consecutive patients were enrolled. Eighty-eight percent of patients received gadolinium-based contrast agents. Twenty-one percent underwent adenosine perfusion, and 11% high-dose dobutamine-stress CMR. The most important indications were workup of myocarditis/cardiomyopathies (32%), risk stratification in suspected coronary artery disease/ischemia (31%), as well as assessment of viability (15%). Image quality was good in 90.1%, moderate in 8.1%, and inadequate in 1.8% of cases. Severe complications occurred in 0.05%, and were all associated with stress testing. No patient died during or due to CMR. In nearly two-thirds of patients, CMR findings impacted patient management. Importantly, in 16% of cases the final diagnosis based on CMR was different from the diagnosis before CMR, leading to a complete change in management. In more than 86% of cases, CMR was capable of satisfying all imaging needs so that no further imaging was required.

Conclusions: CMR is frequently performed in clinical practice in many participating centers. The most important indications are workup of myocarditis/cardiomyopathies, risk stratification in suspected coronary artery disease/ischemia, and assessment of viability. CMR imaging as used in the centers of the pilot registry is a safe procedure, has diagnostic image quality in 98% of cases, and its results have strong impact on patient management.

Key Words: cardiovascular magnetic resonance • registry • patient management • therapeutic implications

Abbreviations and Acronyms   CAD = coronary artery disease   CMR = cardiovascular magnetic resonance   HCM = hypertrophic cardiomyopathy   SCMR = Society for Cardiovascular Magnetic Resonance   SPECT = single-photon emission tomography

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J. Am. Coll. Cardiol. 2009 54: A26. [Full Text] [PDF]