Avoiding the angiogram
26 Oct 2011 by Evoluted New Media
The painful experience of a catheter in the heart might be avoidable for some patients presenting with heart failure after a new study showed cardiac magnetic resonance (CMR) could provide a less invasive way to diagnose heart failure.
An angiogram – insertion of a catheter to the heart under local anaesthetic – is the standard test to detect coronary artery disease, but it may not detect dilated cardiomyopathy (DCM) – a scarring of the heart wall and damage to the heart muscle.
“Understanding the causes of heart failure is hugely important because it dictates the treatments you give patients,” said Dr Sanjay Prasad, from Imperial College London. “An angiogram can show up the blocked arteries which can cause heart failure, but for patients with DCM who have unobstructed arteries this won’t help to diagnose and treat the condition.”
In the study, 120 patients with heart failure were assessed with both CMR and an angiogram – the standard test to detect coronary heart disease. Two separate panels of doctors made a diagnosis using the two methods, and a gold standard panel made a diagnosis using all the data.
The results showed CMR produced a correct diagnosis 97% of patients, and angiogram in 95% of patients. Furthermore, if CMR was first used to rule out coronary artery disease, only 33 patients would have required an angiogram. This method of diagnosis would have led to a 26% cost saving on using angiogram alone on all patients.
“Using CMR, we were able to identify a pattern of scarring to the heart caused by DCm in patients who have early onset heart failure,” said Prasad. “Scanning can both accurately diagnose heart failure and collect information about that is happening to the heart.”
“We can develop the best possible treatment and support, including identifying who would benefit from having an angiogram. It means we’re moving patients from diagnosis to treatment as quickly and comfortably as possible.”
The work – published in Circulation – was funded by the British Heart Foundation and the cardiovascular Biomedical Research Unit.
