Introduction In clinical practice, CMR is most often used to make or confirm a diagnosis with the aim of improving management. In the EuroCMR registry in 62% of cases management is changed by CMR and in 9% the CMR diagnosis is different to that made before. We believe that a key role of CMR is the finding of a normal study where previous tests had resulted in the patient being labelled abnormal. This is not an outcome specifically addressed in the EuroCMR registry.
Methods 444 consecutive patient scans were reviewed from between July and December 2017. Diagnoses and management changes were recorded.
Results Of 444 patients, a new or unexpected diagnosis was found in 23%. In 62% of cases a change in management resulted. Importantly in 11% of cases the CMR was normal where previous imaging had suggested an abnormality. Most commonly this was underestimation of the left ventricular function.
Conclusion In line with the EuroCMR registry, CMR has an impact on patient management in just under two thirds of cases. However, there was a high proportion (11%) of patients for whom the CMR was normal despite previous imaging suggesting abnormality; most frequently this was a finding of normal LV function where other tests had suggested it would be low. This is important to consider for future research into patients with mid-range ejection fraction and clinically it prevents patients from potentially being labelled and treated for a problem that they may not have.
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