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Imaging the myocardial ischemic cascade

Arthur E Stillman1, Matthijs Oudkerk2, David A Bluemke3

  • 1Department of Radiology and Imaging Sciences, Emory University, 1365 Clifton Rd NE, Atlanta, GA, 30322, USA. aestill@emory.edu.

The International Journal of Cardiovascular Imaging
|March 21, 2018
PubMed

Insights

Non-invasive imaging is crucial for diagnosing and managing ischemic heart disease across its spectrum. Advanced imaging techniques like coronary computed tomography angiography (CCTA) and cardiac magnetic resonance (CMR) are vital for risk assessment and guiding treatment decisions.

Area of Science:

  • Cardiovascular Imaging
  • Ischemic Heart Disease Diagnosis

Background:

  • Non-invasive imaging is increasingly vital for ischemic heart disease (IHD) management.
  • Expert consensus from North American and European societies guides imaging's role.

Purpose of the Study:

  • To review the current status of non-invasive imaging in IHD.
  • To organize imaging's role within the myocardial ischemic cascade.
  • To assess imaging's utility in surgical planning and cost-effectiveness.

Main Methods:

  • Review of current non-invasive imaging modalities for IHD.
  • Framework organization based on the myocardial ischemic cascade.
  • Consideration of cost-effectiveness and surgical planning applications.

Main Results:

  • Coronary artery calcium scoring assesses preclinical disease and risk.
  • Echocardiography, CCTA, SPECT, PET, and CMR are useful for symptomatic patients.
  • CCTA serves as a cost-effective gatekeeper; CMR and PET are preferred post-infarction.

Conclusions:

  • Non-invasive imaging is integral to IHD diagnosis and management.
  • Imaging guides surgical planning for procedures like coronary artery bypass.
  • Strategic use of imaging offers cost-effective patient care.

Keywords:
Cardiac imagingCoronary artery diseaseIschemic heart disease

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