Representation of cardiovascular magnetic resonance in the AHA / ACC guidelines
Abstract Background Whereas evidence supporting the diagnostic value of cardiovascular magnetic resonance (CMR) has increased, there exists significant worldwide variability in the clinical utilization of CMR. A recent study demonstrated that CMR is represented in the majority of European Society fo...
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doaj-ba4fa540a60e4d81b3d317e5cee649ea2020-11-24T23:56:42ZengBMCJournal of Cardiovascular Magnetic Resonance1532-429X2017-09-0119112110.1186/s12968-017-0385-zRepresentation of cardiovascular magnetic resonance in the AHA / ACC guidelinesFlorian von Knobelsdorff-Brenkenhoff0Guenter Pilz1Jeanette Schulz-Menger2Department of Cardiology, Clinic Agatharied, Ludwig-Maximilians-University MunichDepartment of Cardiology, Clinic Agatharied, Ludwig-Maximilians-University MunichCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, DZHK (German Centre for Cardiovascular Research), partner site BerlinAbstract Background Whereas evidence supporting the diagnostic value of cardiovascular magnetic resonance (CMR) has increased, there exists significant worldwide variability in the clinical utilization of CMR. A recent study demonstrated that CMR is represented in the majority of European Society for Cardiology (ESC) guidelines, with a large number of specific recommendations in particular regarding coronary artery disease. To further investigate the gap between the evidence and clinical use of CMR, this study analyzed the role of CMR in the guidelines of the American College of Cardiology (ACC) and American Heart Association (AHA). Methods Twenty-four AHA/ACC original guidelines, updates and new editions, published between 2006 and 2017, were screened for the terms “magnetic”, “MRI”, “CMR”, “MR” and “imaging”. Non-cardiovascular MR examinations were excluded. All CMR-related paragraphs and specific recommendations for CMR including the level of evidence (A, B, C) and the class of recommendation (I, IIa, IIb, III) were extracted. Results Twelve of the 24 guidelines (50.0%) contain specific recommendations regarding CMR. Four guidelines (16.7%) mention CMR in the text only, and 8 (33.3%) do not mention CMR. The 12 guidelines with recommendations for CMR contain in total 65 specific recommendations (31 class-I, 23 class-IIa, 6 class-IIb, 5 class-III). Most recommendations have evidence level C (44/65; 67.7%), followed by level B (21/65; 32.3%). There are no level A recommendations. 22/65 recommendations refer to vascular imaging, 17 to congenital heart disease, 8 to cardiomyopathies, 8 to myocardial stress testing, 5 to left and right ventricular function, 3 to viability, and 2 to valvular heart disease. Conclusions CMR is represented in two thirds of the AHA/ACC guidelines, which contain a number of specific recommendations for the use of CMR. In a simplified comparison with the ESC guidelines, CMR is less represented in the AHA/ACC guidelines in particular in the field of coronary artery disease.http://link.springer.com/article/10.1186/s12968-017-0385-zCardiac magnetic resonanceGuidelineCardiologyReimbursement |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Florian von Knobelsdorff-Brenkenhoff Guenter Pilz Jeanette Schulz-Menger |
spellingShingle |
Florian von Knobelsdorff-Brenkenhoff Guenter Pilz Jeanette Schulz-Menger Representation of cardiovascular magnetic resonance in the AHA / ACC guidelines Journal of Cardiovascular Magnetic Resonance Cardiac magnetic resonance Guideline Cardiology Reimbursement |
author_facet |
Florian von Knobelsdorff-Brenkenhoff Guenter Pilz Jeanette Schulz-Menger |
author_sort |
Florian von Knobelsdorff-Brenkenhoff |
title |
Representation of cardiovascular magnetic resonance in the AHA / ACC guidelines |
title_short |
Representation of cardiovascular magnetic resonance in the AHA / ACC guidelines |
title_full |
Representation of cardiovascular magnetic resonance in the AHA / ACC guidelines |
title_fullStr |
Representation of cardiovascular magnetic resonance in the AHA / ACC guidelines |
title_full_unstemmed |
Representation of cardiovascular magnetic resonance in the AHA / ACC guidelines |
title_sort |
representation of cardiovascular magnetic resonance in the aha / acc guidelines |
publisher |
BMC |
series |
Journal of Cardiovascular Magnetic Resonance |
issn |
1532-429X |
publishDate |
2017-09-01 |
description |
Abstract Background Whereas evidence supporting the diagnostic value of cardiovascular magnetic resonance (CMR) has increased, there exists significant worldwide variability in the clinical utilization of CMR. A recent study demonstrated that CMR is represented in the majority of European Society for Cardiology (ESC) guidelines, with a large number of specific recommendations in particular regarding coronary artery disease. To further investigate the gap between the evidence and clinical use of CMR, this study analyzed the role of CMR in the guidelines of the American College of Cardiology (ACC) and American Heart Association (AHA). Methods Twenty-four AHA/ACC original guidelines, updates and new editions, published between 2006 and 2017, were screened for the terms “magnetic”, “MRI”, “CMR”, “MR” and “imaging”. Non-cardiovascular MR examinations were excluded. All CMR-related paragraphs and specific recommendations for CMR including the level of evidence (A, B, C) and the class of recommendation (I, IIa, IIb, III) were extracted. Results Twelve of the 24 guidelines (50.0%) contain specific recommendations regarding CMR. Four guidelines (16.7%) mention CMR in the text only, and 8 (33.3%) do not mention CMR. The 12 guidelines with recommendations for CMR contain in total 65 specific recommendations (31 class-I, 23 class-IIa, 6 class-IIb, 5 class-III). Most recommendations have evidence level C (44/65; 67.7%), followed by level B (21/65; 32.3%). There are no level A recommendations. 22/65 recommendations refer to vascular imaging, 17 to congenital heart disease, 8 to cardiomyopathies, 8 to myocardial stress testing, 5 to left and right ventricular function, 3 to viability, and 2 to valvular heart disease. Conclusions CMR is represented in two thirds of the AHA/ACC guidelines, which contain a number of specific recommendations for the use of CMR. In a simplified comparison with the ESC guidelines, CMR is less represented in the AHA/ACC guidelines in particular in the field of coronary artery disease. |
topic |
Cardiac magnetic resonance Guideline Cardiology Reimbursement |
url |
http://link.springer.com/article/10.1186/s12968-017-0385-z |
work_keys_str_mv |
AT florianvonknobelsdorffbrenkenhoff representationofcardiovascularmagneticresonanceintheahaaccguidelines AT guenterpilz representationofcardiovascularmagneticresonanceintheahaaccguidelines AT jeanetteschulzmenger representationofcardiovascularmagneticresonanceintheahaaccguidelines |
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