Can cardiac magnetic resonance myocardial scar features affect treatment decisions for patients with coronary artery disease and heart failure?

Abstract

With the growing prevalence of type 2 diabetes, obesity, and the increasing average age of the population, coronary artery disease (CAD) has become an escalating health care burden in most western countries. CAD has been the most common cause of death in the U.S. for decades, and in recent years, this pattern has become a worldwide phenomenon (1). Despite the benefits of effective therapies developed in the past decades, the age-adjusted decline in CAD mortality in the U.S. has not been paralleled by a similar reduction in sudden cardiac death (SCD) (2). Some estimate that with the growing prevalence of CAD, the absolute number of SCDs is actually on the rise in the U.S. Although major multicenter studies have documented the importance of left ventricular ejection fraction (LVEF) and New York Heart Association functional class as the strongest predictors of risk for cardiac mortality in survivors of acute myocardial infarction (MI) (3), more novel risk-stratifying schemes are undoubtedly necessary in order to reduce SCD.