Researchers Evaluate Safer, More Convenient Heart Disease Test
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"We've developed a rapid, noninvasive, low-risk way to find out, if
you've had an angioplasty, whether your arteries have blocked up again,"
says W. Gregory Hundley, MD, lead author of the study. "You don't have to
have an angiogram, and the result is equivalent." Hundley is assistant
professor of internal medicine (cardiology) and radiology at Wake Forest
University Baptist Medical Center in Winston-Salem, N.C.
Hundley believes that MRI has many advantages over angiography: it is
noninvasive, it doesn't use ionizing radiation, and it is quicker. Direct costs
for an angiogram would be about $3,000, he estimates, compared to $200 to $300
for an MRI. "This sort of work can be performed [with] hardware that's
widely available," he says.
"The Wake Forest research is in line with what we've been seeing in
other studies of MRI and the heart," says Fayad. "Little by little,
studies have been showing that MRI is effective in detecting coronary artery
blockages. In the future, it will complement the tools we already use to assess
However, Thomas Davis, MD, an independent observer, is far more cautious
about the potential usefulness of MRI. "The Wake Forest study only looked
at 17 patients. MRI may in fact turn out to be the cat's meow, but we don't
have sufficient convincing data yet to start using it. First, I'd want to see
studies on thousands of patients, all kinds of patients." Davis is medical
director of the cardiac intensive care unit and cardiovascular center at St.
John Hospital in Detroit.
Fayad believes successful use of MRI depends on physicians' degree of
experience and effort, and how aggressive they are in their research. "Some
people don't know how to use this method yet, but in experienced hands, we
think it does pretty well." However, he agrees that much larger studies are
needed. "The jury is still out," he says.
This research was funded by the National Institutes of Health, the American
Heart Association North Carolina affiliate, and the North Carolina Baptist
Medical Center Technology Development Fund.