Prognosebeurteilung von KHK-Patienten: Die Rolle der Kardio-MRT-Bildgebung

Abstract

Assessment of prognosis of patients with coronary artery disease is of paramount importance. This is particularly necessary for patients with stable coronary artery disease and for patients after acute myocardial infarction because this might help clinical decision making. The current review focuses on prognosis assessment by cardiac magnetic resonance imaging. The prognostic impact of stress imaging using wall motion assessment using dobutamine, stress perfusion using adenosine, chronic and acute infarct imaging, oedema imaging as well as imaging of microvascular obstruction is analyzed based on the current literature.

Kernaussagen

Mittels der kardialen Magnetresonanztomografie lassen sich bei Verdacht auf KHK, bekannter KHK, chronischen und akuten Myokardinfarkten prognostisch wertvolle zusätzliche Informationen ableiten.

Die eingesetzten Methoden sind

• die Ischämiediagnostik mittels Wandbewegungsanalyse,

• die Ischämiediagnostik mittels Stress-Perfusion,

• die Darstellung der Narbe oder Nekrose,

• die Darstellung der Periinfarktzone,

• die Darstellung der mikrovaskulären Obstruktion.

Für den individuellen Patienten lassen sich aber aufgrund der derzeit noch eingeschränkten Patientenzahlen keine zuverlässigen Rückschlüsse ziehen.

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