Nav: Home

CNIC is the coordinator of an international consensus document on the use of magnetic resonance

July 08, 2019

The Centro Nacional de Investigaciones Cardiovasculares (CNIC) has coordinated the first international consensus document providing guidelines on the conduct of magnetic resonance imaging studies after a myocardial infarction in clinical trials or experimental models. The document concludes that the main outcome parameter in studies assessing new treatments should be absolute infarct size: the percentage of the left ventricle that is irreversibly damaged. The recommended timing for magnetic resonance imaging is between 3 and 7 days after the infarction.

Recent years have witnessed an exponential rise in the use of magnetic resonance imaging after a heart attack to assess patients' risk of future events, understand the changes taking place in cardiac tissue, and evaluate the benefit of treatments. The colossal technological advances in this area have generated a plethora of new options for studying these parameters. The lead scientists on the consensus document are Dr Borja Ibañez--Clinical Research Director at the CNIC, consultant cardiologist at Fundación Jiménez Díaz hospital, and a member of the CIBERCV cardiovascular research network--and Dr Valentín Fuster--Director of the Cardiovascular Institute and Medical Director at Mount Sinai Hospital in New York. The document addresses the need within the cardiovascular community for guidance on the best protocols, the best techniques, and the most appropriate situations for conducting a magnetic resonance imaging study after a heart attack. The document is published today in one of the world-leading cardiovascular research journals, the Journal of the American College of Cardiology (JACC).

Dr Valentín Fuster commented that "magnetic resonance imaging is one of the best methods for studying the heart after an infarction. It allows the study of heart anatomy, function, and tissue composition in a very precise way without exposing the patient to radiation. Magnetic resonance imaging is the ideal method for assessing the effect of new treatments. However, until now the community has lacked consistent recommendations on the specific procedures to follow after an acute myocardial infarction in order the assess the effect of these treatments."

Describing the new document, first author Dr Borja Ibañez explained that "consensus documents of this type provide guidelines to ensure consistency in the use of important tools such as this one. Currently, many clinical trials use magnetic resonance imaging to assess a principal outcome, but it is very difficult to compare these studies because they use widely different protocols. Myocardial infarction affects millions of people in the world every year, and this is therefore a highly active field of research. Because of this, the implications of the new consensus document are enormous."

In addition to establishing absolute infarct size as the main outcome measure to assess in studies evaluating new treatments, the document recommends that magnetic resonance scans should be carried out between days 3 and 7 after the infarction. Study co-author Dr Rodrigo Fernández-Jiménez commented that "the scientific evidence indicates that the period between 3 and 7 days after an infarction is when magnetic resonance parameters are more stable and less affected by rapid changes occurring in the heart as it attempts to repair itself. This time window is also practical, since most patients remain in hospital for at least 3 days after having a heart attack. This time window should be used in clinical trials related to myocardial infarction."

Another of the authors is Javier Sánchez-González, a physicist from Philips based at the CNIC, where he coordinates the joint development program in cardiovascular imaging. According to Sánchez-González, "magnetic resonance imaging allows highly exhaustive assessment of processes taking place in cardiac tissue and is without doubt the most powerful tool available for this task. The new techniques for mapping the heart are helping us to understand processes in the infarcted heart that previously could only be observed by pathological anatomy of post mortem specimens. The ability to observe these processes in living patients using a noninvasive technology is without doubt a major medical advance."

The document's contents were defined during an international meeting held at the CNIC with support from Philips. The meeting brought together a multidisciplinary group of 16 experts in the field from the USA, Canada, the UK, France, Germany, Sweden, the Netherlands, Greece, Switzerland, Singapore, and Spain, including Dr David García-Dorado of the CIBERCV.
About the CNIC

The Centro Nacional de Investigaciones Cardiovasculares (CNIC), directed by Dr. Valentín Fuster, is dedicated to cardiovascular research and the translation of knowledge gained into real benefits for patients. The CNIC, recognized by the Spanish government as a Severo Ochoa center of excellence, is financed through a pioneering public-private partnership between the government (through the Carlos III Institute of Health) and the Pro CNIC Foundation, which brings together 13 of the most important Spanish private companies.

Centro Nacional de Investigaciones Cardiovasculares Carlos III (F.S.P.)

Related Heart Attack Articles:

Muscle protein abundant in the heart plays key role in blood clotting during heart attack
A prevalent heart protein known as cardiac myosin, which is released into the body when a person suffers a heart attack, can cause blood to thicken or clot--worsening damage to heart tissue, a new study shows.
New target identified for repairing the heart after heart attack
An immune cell is shown for the first time to be involved in creating the scar that repairs the heart after damage.
Heart cells respond to heart attack and increase the chance of survival
The heart of humans and mice does not completely recover after a heart attack.
A simple method to improve heart-attack repair using stem cell-derived heart muscle cells
The heart cannot regenerate muscle after a heart attack, and this can lead to lethal heart failure.
Mount Sinai discovers placental stem cells that can regenerate heart after heart attack
Study identifies new stem cell type that can significantly improve cardiac function.
Fixing a broken heart: Exploring new ways to heal damage after a heart attack
The days immediately following a heart attack are critical for survivors' longevity and long-term healing of tissue.
Heart patch could limit muscle damage in heart attack aftermath
Guided by computer simulations, an international team of researchers has developed an adhesive patch that can provide support for damaged heart tissue, potentially reducing the stretching of heart muscle that's common after a heart attack.
How the heart sends an SOS signal to bone marrow cells after a heart attack
Exosomes are key to the SOS signal that the heart muscle sends out after a heart attack.
Heart attack patients taken directly to heart centers have better long-term survival
Heart attack patients taken directly to heart centers for lifesaving treatment have better long-term survival than those transferred from another hospital, reports a large observational study presented today at Acute Cardiovascular Care 2019, a European Society of Cardiology congress.
Among heart attack survivors, drug reduces chances of second heart attack or stroke
In a clinical trial involving 18,924 patients from 57 countries who had suffered a recent heart attack or threatened heart attack, researchers at the University of Colorado Anschutz Medical Campus and fellow scientists around the world have found that the cholesterol-lowering drug alirocumab reduced the chance of having additional heart problems or stroke.
More Heart Attack News and Heart Attack Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: Reinvention
Change is hard, but it's also an opportunity to discover and reimagine what you thought you knew. From our economy, to music, to even ourselves–this hour TED speakers explore the power of reinvention. Guests include OK Go lead singer Damian Kulash Jr., former college gymnastics coach Valorie Kondos Field, Stockton Mayor Michael Tubbs, and entrepreneur Nick Hanauer.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Dispatch 6: Strange Times
Covid has disrupted the most basic routines of our days and nights. But in the middle of a conversation about how to fight the virus, we find a place impervious to the stalled plans and frenetic demands of the outside world. It's a very different kind of front line, where urgent work means moving slow, and time is marked out in tiny pre-planned steps. Then, on a walk through the woods, we consider how the tempo of our lives affects our minds and discover how the beats of biology shape our bodies. This episode was produced with help from Molly Webster and Tracie Hunte. Support Radiolab today at