Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Non-invasive view into the heart

24.06.2019

The non-invasive measurement of blood flow to the heart using magnetic resonance imaging (MRI) is on par with cardiac catheterization. This was the result of an international study published in the current issue of the New England Journal of Medicine and headed by researchers from Goethe University.

For patients with chest pain and presumably stable coronary heart disease (CHD), therapy depends primarily on how constricted the arteries that support the heart are (coronary arteries). This is often determined using an invasive procedure called cardiac catheterization.


Measuring blood flow in the myocardium with magnet resonance imaging (top). The dark area in the myocardium (arrows) shows a pronounced reduction of blood flow. The cardiac catheterization of the same patient (bottom) shows a clear constriction of the artery.

Copyright: Eike Nagel, Institute for Experimental and Translational Cardiovascular Imaging, Goethe Universität, Frankfurt am Main

If necessary, the pressure in the coronary arteries is also measured. The combination of these methods is the currently the recognized standard for making therapy decisions. Cardiovascular magnetic resonance imaging (MRI) is an alternative for directly measuring the blood flow in the myocardium.

In contrast to cardiac catheterization, MRI is non-invasive, works without ionising radiation, can be done in 40 minutes and delivers direct measurements of the blood flow to the heart.

The team headed by Professor Eike Nagel, Director of the Institute for Experimental and Translational Cardio Vascular Imaging at Goethe University was able to demonstrate that MRI measurements are as safe to guide decision-making as the currently used invasive procedure.

Within the international MR-INFORM study, they examined 918 patients with an indication for cardiac catheterization to see if decision-making by an MRI scan led to the same results as the current invasive method.

Patients were randomly assigned to two groups. One group received the standard diagnostic investigation with cardiac catheterization and pressure measurement of the coronary arteries. The other had the 40 minute MRI scan of the heart to decide whether to send the patient on for invasive angiography.

In each study arm, constricted coronary vessels were dilated when indicated by the examination. In the following year, the physicians documented how many patients died, suffered a heart attack or required a repeated vascular dilation. In addition, they recorded whether the heart symptoms continued.

The result: in the group of patients examined by MRI, less than half required a diagnostic cardiac catheterization and fewer patients received a vascular dilation (36% vs 45 %). This means that with a fast and non-invasive MRI examination as the first test, both diagnostic and therapeutic cardiac catheterizations can be reduced. Importantly, the two groups did not differ in terms of continuing symptoms, the development of new symptoms, complications, or deaths.

“This means that patients with stable chest pains who previously would have received cardiac catheterization can alternatively be examined with MRI,” concludes Professor Eike Nagel. “The results for the patients are just as good, but an examination by MRI has many advantages: the procedure takes about 40 minutes, patients merely receive a small cannula in their arm and are not subject to radiation.” The physician hopes that the less invasive method will now be used as a method of first choice, reducing the need for cardiac catheterizations.

In contrast to Great Britain, where an MRI scan of the heart is paid for by the National Health Service (NHS), reimbursement is often difficult in Germany and usually has to be negotiated individually. In this regard, Nagel also hopes that the study will contribute to the acceptance of the non-invasive procedure and improve its availability.

Financial support was provided primarily by the British National Institute of Health Research (NIHR) via the Biomedical Research Centre (BRC) at Guy’s & St. Thomas’ Hospital, the German Centre for Cardiovascular Research (DZHK) and the company Bayer AG Deutschland.

A picture can be downloaded here: http://www.uni-frankfurt.de/78920068
Caption: Measuring blood flow in the myocardium with magnet resonance imaging (top). The dark area in the myocardium (arrows) shows a pronounced reduction of blood flow. The cardiac catheterization of the same patient (bottom) shows a clear constriction of the artery.
Credit: Eike Nagel, Goethe University

Wissenschaftliche Ansprechpartner:

Professor Eike Nagel, Institute for Experimental and Translational Cardiovascular Imaging, Faculty of Medicine, Niederrad Campus, Tel.: +49 151 4197 4195, eike.nagel@cardiac-imaging.org.

Originalpublikation:

Magnetic Resonance Perfusion or Fractional Flow Reserve in Coronary Disease
Eike Nagel, et al., N Engl J Med 2019;380:2418-28.
DOI: 10.1056/NEJMoa1716734

Dr. Anne Hardy | idw - Informationsdienst Wissenschaft

More articles from Medical Engineering:

nachricht Smartphones as ophthalmoscopes save sight: Cost-effective telemedical eye screening of people with diabetes in India
09.07.2019 | Rheinische Friedrich-Wilhelms-Universität Bonn

nachricht Shorter courses of proton therapy can be just as effective as full courses prostate cancer
08.07.2019 | University of Pennsylvania School of Medicine

All articles from Medical Engineering >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Megakaryocytes act as „bouncers“ restraining cell migration in the bone marrow

Scientists at the University Würzburg and University Hospital of Würzburg found that megakaryocytes act as “bouncers” and thus modulate bone marrow niche properties and cell migration dynamics. The study was published in July in the Journal “Haematologica”.

Hematopoiesis is the process of forming blood cells, which occurs predominantly in the bone marrow. The bone marrow produces all types of blood cells: red...

Im Focus: Artificial neural network resolves puzzles from condensed matter physics: Which is the perfect quantum theory?

For some phenomena in quantum many-body physics several competing theories exist. But which of them describes a quantum phenomenon best? A team of researchers from the Technical University of Munich (TUM) and Harvard University in the United States has now successfully deployed artificial neural networks for image analysis of quantum systems.

Is that a dog or a cat? Such a classification is a prime example of machine learning: artificial neural networks can be trained to analyze images by looking...

Im Focus: Extremely hard yet metallically conductive: Bayreuth researchers develop novel material with high-tech prospects

An international research group led by scientists from the University of Bayreuth has produced a previously unknown material: Rhenium nitride pernitride. Thanks to combining properties that were previously considered incompatible, it looks set to become highly attractive for technological applications. Indeed, it is a super-hard metallic conductor that can withstand extremely high pressures like a diamond. A process now developed in Bayreuth opens up the possibility of producing rhenium nitride pernitride and other technologically interesting materials in sufficiently large quantity for their properties characterisation. The new findings are presented in "Nature Communications".

The possibility of finding a compound that was metallically conductive, super-hard, and ultra-incompressible was long considered unlikely in science. It was...

Im Focus: Modelling leads to the optimum size for platinum fuel cell catalysts: Activity of fuel cell catalysts doubled

An interdisciplinary research team at the Technical University of Munich (TUM) has built platinum nanoparticles for catalysis in fuel cells: The new size-optimized catalysts are twice as good as the best process commercially available today.

Fuel cells may well replace batteries as the power source for electric cars. They consume hydrogen, a gas which could be produced for example using surplus...

Im Focus: The secret of mushroom colors

Mushrooms: Darker fruiting bodies in cold climates

The fly agaric with its red hat is perhaps the most evocative of the diverse and variously colored mushroom species. Hitherto, the purpose of these colors was...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

2nd International Conference on UV LED Technologies & Applications – ICULTA 2020 | Call for Abstracts

24.06.2019 | Event News

SEMANTiCS 2019 brings together industry leaders and data scientists in Karlsruhe

29.04.2019 | Event News

Revered mathematicians and computer scientists converge with 200 young researchers in Heidelberg!

17.04.2019 | Event News

 
Latest News

New safer, inexpensive way to propel small satellites

16.07.2019 | Power and Electrical Engineering

UCI electrical engineering team develops 'beyond 5G' wireless transceiver

16.07.2019 | Information Technology

Robert Alfano team identifies new 'Majorana Photons'

16.07.2019 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>