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Cardiac MRI Endpoints in Myocardial Infarction Experimental and Clinical Trials: JACC Scientific Expert Panel

Borja Ibanez1, Anthony H Aletras2, Andrew E Arai3

  • 1Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBERCV, Madrid, Spain; Cardiology Department, IIS Fundación Jiménez Díaz Hospital, Madrid, Spain.

Journal of the American College of Cardiology
|July 13, 2019
PubMed

Insights

Standardizing cardiac magnetic resonance (CMR) methods is crucial for evaluating cardioprotective strategies after myocardial infarction (MI). This consensus document recommends CMR endpoints based on pathophysiology to improve clinical trial translation and patient outcomes.

Area of Science:

  • Cardiovascular Research
  • Medical Imaging
  • Translational Science

Background:

  • Myocardial infarction (MI) triggers dynamic tissue changes impacting long-term prognosis.
  • Cardiac magnetic resonance (CMR) is the gold standard for noninvasive myocardial tissue characterization and assessing cardioprotective strategies.
  • Heterogeneity in CMR methodologies across trials hinders translation of findings into clinical practice.

Purpose of the Study:

  • To provide expert recommendations for selecting standardized CMR endpoints in experimental and clinical trials.
  • To align CMR endpoint selection with underlying pathophysiology and association with hard clinical outcomes.
  • To improve the consistency and translational value of CMR in cardiovascular research.

Main Methods:

  • A scientific expert panel convened to review current CMR methodologies in MI research.
  • Recommendations were developed based on the pathophysiology of post-MI tissue changes.
  • Emphasis was placed on linking CMR findings to hard clinical outcomes.

Main Results:

  • Identified critical need for standardization in CMR acquisition protocols and endpoint selection.
  • Proposed a framework for selecting CMR endpoints that reflect pathophysiological processes post-MI.
  • Highlighted the importance of correlating CMR metrics with hard clinical outcomes.

Conclusions:

  • Standardized CMR endpoints are essential for robust evaluation of cardioprotective therapies.
  • Recommendations aim to enhance the reliability and clinical applicability of CMR in MI trials.
  • Adoption of these guidelines will facilitate better translation of research findings to patient care.

Keywords:
STEMIarea at riskclinical trialedemaendpointinfarct sizemagnetic resonance imagingmyocardial infarction

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