Researchers Evaluate Safer, More Convenient Heart Disease Test
"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 cardiovascular disease."
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.