How cardiac MRI can help determine if women have heart disease

Researchers have determined that coronary artery wall thickness, as documented by cardiac MRI scans, is associated with heart disease in women. The team shared its findings in the debut issue of Radiology: Cardiothoracic Imaging.

Coronary computed tomography angiography (CCTA) is often used to image patients with suspected cardiovascular disease, but CCTA is not recommended for regular use just to assess a patient’s risk. As the authors noted, this is where MRI has potential to make a significant impact on patient care.

“Despite the significant advances in CCTA technology, it is not appropriate to send all asymptomatic people to CCTA because of the exposure to radiation and chemical dyes used for imaging,” lead author Khaled Z. Abd-Elmoniem, PhD, MHS, of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) in Bethesda, Maryland, said in a prepared statement. “MRI might be a safe alternative that can be used more broadly to assist in the diagnosis of coronary artery disease without exposing patients to a procedure that carries some risk. The advantage of MRI in this situation is that it can tell us that there is a thickening before stenosis, which is difficult to do with CCTA.”

Abd-Elmoniem et al. examined how a newly developed MRI technique for visualizing coronary wall thickness compared to CCTA by using both modalities to image 62 male patients and 62 female patients. The findings revealed that the two groups had different independent risk factors.

“When we separated the patients into men and women, coronary artery disease in men was, as expected, associated with aging and a high Framingham score,” Abd-Elmoniem said in the same statement. “However, in women, both age and the Framingham score were not factors. Vessel wall thickness, as measured by MRI, was the strongest variable associated with coronary artery disease.”

These results suggest that MRI may provide value as an effective tool for assessing if women are suffering from cardiovascular disease.

“A single image and measurement of coronary vessel wall thickness with MRI can be used to gauge the extent of coronary plaque in asymptomatic women, who then can be appropriately referred for further exams and/or treatment,” Abd-Elmoniem said.

"MRI provides another way to help guide physicians toward therapy,"

Ahmed M. Gharib, MD., a co-author of the study who also works at the NIDDK, added in the same statement that MRI “can also be useful in monitoring the effectiveness of any therapy.”

“This is a wonderful example of how a multidisciplinary team of biomedical engineers and radiologists can expedite translational research to clinical radiological applications,” Gharib said.