Contemporary cardiac MRI in chronic coronary artery disease
Michael Kolentinis, MD, Minh Le, MD, Eike Nagel, MD PhD, Valentina O Puntmann, MD PhD · Narrative review
BlueRipple Assessment
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.
The original source
Kolentinis M, Le M, Nagel E, Puntmann VO. Contemporary cardiac MRI in chronic coronary artery disease. Eur Cardiol. 2020 Jun 15;15:e50. doi: 10.15420/ecr.2019.17.