Date Published: 23 December 2011

Leeds Univ finds MRI scan for coronary heart disease beats alternatives

According to recent research conducted at Leeds University (Yorkshire, England), a magnetic resonance imaging (MRI) scan for coronary heart disease is better than the most commonly-used alternative. This has important implications for the way that people with suspected heart disease are assessed and might even remove the need for invasive tests or the use of ionising radiation in this context in the future.

Coronary heart disease (CHD) is a major cause of death and disability in the UK where an around 2.6 million people are said to have symptoms of coronary heart disease. This is thought to cost the UK NHS approx £9 billion per year.

Coronary heart disease occurs when vital arteries serving the heart become narrowed or blocked due to an accumulation of fatty substances. This can lead to severe chest pain called angina. If the condition becomes worse and remains untreated, patients may have a heart attack.

Patients with chest pain who are suspected of having angina are usually sent to hospital for further tests. The purpose of such tests is to confirm (or deny) the coronary heart disease diagnosis and so help clinicians to make decisions about the most appropriate course of treatment. For example, treatment may involve drug therapy, a balloon 'stretch and stent' procedure to open-up narrowings in the heart's blood vessels - or a heart bypass operation. At present patients with suspected angina are likely to be tested either by having an angiogram (which is an invasive test in which dye is injected directly into the arteries in the patients heart) or a non-invasive imaging test called SPECT. Unlike magnetic resonance imaging (MRI) scans, angiograms and SPECT tests both involve use of ionising radiation.

Over the last five years medical researchers at Leeds University (UK) have compared the usefulness and reliability of MRI scans with the current accepted methods of testing patients for evidence of coronary heart disease. This significant study involved 752 patients and showed that an MRI scan is a reliable way of detecting signs of significant coronary heart disease. Further, the researchers also showed that MRI was better than SPECT at both diagnosing coronary heart disease and at ruling out heart disease in patients who did not have the condition.

These important results might lead healthcare policy-makers to re-consider guidance about the tests that patients with suspected coronary heart disease should be offered.

University of Leeds' Dr John Greenwood, who led the study, said:

" We have shown convincingly that of the options available to doctors in diagnosing coronary heart disease, MRI is better than the more commonly-used SPECT imaging test. As well as being more accurate, it has the advantage of not using any ionising radiation, sparing patients and health professionals from unnecessary exposure.
_The MRI technique could be used widely and not just in the UK," Dr Greenwood added. "The scans were all carried out on a standard 1.5 Tesla scanner - exactly the type of MRI scanner that you would find in most hospitals today."

Ref. to Research Paper:
CE-MARC: A Prospective Evaluation of Cardiovascular Magnetic Resonance and Single-Photon Emission Computed Tomography in Coronary Heart Disease by Greenwood et. al., published Online First in The Lancet: DOI:10.1016/S0140-6736(11)61335-4

This work was funded by a £1.3 million grant from the British Heart Foundation (BHF), the leading UK heart health charity. See also Books about Heart Disease.

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