Title
Improving cardiovascular magnetic resonance access in low- and middle-income countries for cardiomyopathy assessment: Rapid cardiovascular magnetic resonance
Date Issued
07 July 2022
Access level
open access
Resource Type
journal article
Author(s)
Ramirez, Sara
Perez A.
Dragonetti L.
Perez De Arenaza D.
Katekaru, Diana
Munive, Sara
Rodriguez, Bertha
Shimabukuro, Ana
Cupe K.
Bansal R.
Bhargava V.
Seraphim A.
Knott K.
Abdel-Gadir A.
Guerrero, Salomón
Lazo, Marco
Uscamaita D.
Rivero M.
Amaya N.
Sharma S.
Peix A.
Treibel T.
Manisty C.
Mohiddin S.
Litt H.
Han Y.
Fernandes J.
Jacob R.
Westwood M.
Ntusi N.
Herrey A.
Walker J.M.
Moon J.
University College London
Hospital de la Fuerza Aérea del Perú
Hospital Militar Nacional
Hospital Sermedial
Hospital Nacional Ramiro Priale
Publisher(s)
Oxford University Press
Abstract
Aims: To evaluate the impact of a simplified, rapid cardiovascular magnetic resonance (CMR) protocol embedded in care and supported by a partner education programme on the management of cardiomyopathy (CMP) in low- and middle-income countries (LMICs). Methods and results: Rapid CMR focused particularly on CMP was implemented in 11 centres, 7 cities, 5 countries, and 3 continents linked to training courses for local professionals. Patients were followed up for 24 months to assess impact. The rate of subsequent adoption was tracked. Five CMR conferences were delivered (920 attendees - potential referrers, radiographers, reporting cardiologists, or radiologists) and five new centres starting CMR. Six hundred and one patients were scanned. Cardiovascular magnetic resonance indications were 24% non-contrast T2∗ scans [myocardial iron overload (MIO)] and 72% suspected/known cardiomyopathies (including ischaemic and viability). Ninety-eighty per cent of studies were of diagnostic quality. The average scan time was 22 ± 6 min (contrast) and 12 ± 4 min (non-contrast), a potential cost/throughput reduction of between 30 and 60%. Cardiovascular magnetic resonance findings impacted management in 62%, including a new diagnosis in 22% and MIO detected in 30% of non-contrast scans. Nine centres continued using rapid CMR 2 years later (typically 1-2 days per week, 30 min slots). Conclusions: Rapid CMR of diagnostic quality can be delivered using available technology in LMICs. When embedded in care and a training programme, costs are lower, care is improved, and services can be sustained over time.
Start page
2496
End page
2507
Volume
43
Issue
26
Language
English
OCDE Knowledge area
Sistema cardiaco, Sistema cardiovascular
Scopus EID
2-s2.0-85134360796
PubMed ID
Source
European Heart Journal
ISSN of the container
0195668X
Sources of information: Directorio de Producción Científica Scopus