Head-to-Head Comparison and Temporal Trends of Cardiac MRI Recommendations in ESC versus ACC/AHA Guidelines: A...

Area of Science:

• Cardiovascular Imaging
• Medical Guidelines
• Comparative Analysis

Background:

• Cardiac MRI is crucial for cardiovascular disease evaluation.
• Guidelines from ESC and ACC/AHA inform its clinical use.
• Understanding guideline differences is key for optimal practice.

Purpose of the Study:

• To compare cardiac MRI indications between ESC and ACC/AHA guidelines.
• To analyze temporal trends in these recommendations.
• To identify areas of consensus and divergence in cardiac MRI use.

Main Methods:

• Systematic review and meta-analysis of ESC and ACC/AHA guidelines (until May 2023).
• Comparison of Class of Recommendation (COR) and Level of Evidence (LOE) for cardiac MRI.
• Statistical analysis (chi-squared or Fisher exact tests) of guideline data.

Main Results:

• ESC guidelines (109) had more cardiac MRI recommendations than ACC/AHA (90).
• ACC/AHA guidelines showed higher COR I and LOE B proportions.
• Significant increase in cardiac MRI recommendations over time, notably in ESC guidelines.

Conclusions:

• ESC guidelines provide more cardiac MRI recommendations; ACC/AHA guidelines feature higher COR and LOE.
• Consensus exists for heart failure and hypertrophic cardiomyopathy; divergence in valvular heart disease, arrhythmias, and aortic disease.
• Increasing recommendations highlight the growing importance of cardiac MRI in cardiovascular disease management.