Contemporary cardiac MRI in chronic coronary artery disease

This review presses an ambitious claim: that cardiac MRI deserves a far bigger role in chronic coronary disease than it currently holds.

Its strength is breadth in a single scan. The authors describe MRI’s multiparametric reach — assessing heart function, perfusion (blood supply under stress), and scar in one non-invasive, radiation-free exam — and argue it outperforms older, symptom- or catheter-led approaches for diagnosing and managing stable angina and chronic CAD.

The practical takeaway is a proposed shift away from reflexive invasive angiography toward MRI-led decision-making. The resistance is entrenched: echocardiography and catheterization dominate workflows, MRI access is limited, and the expertise to read cardiac MRI is unevenly distributed.

We rate the evidence moderate: a 49-reference narrative review from a conflict-free academic group, but no new data and an advocacy bent. Its clinical significance is moderate — the potential to cut unnecessary invasive procedures is real, but availability and training keep cardiac MRI from the central role the authors envision.