Cardiac MRI and ischemic heart disease: role in diagnosis and risk stratification

This review situates cardiac MRI within ischemic heart disease — what it sees, and where it changes decisions.

The authors lay out MRI’s comprehensive reach: assessing ventricular function, perfusion (blood supply under stress), and viability (salvageable muscle) in a single exam, validated against landmark studies. The argument is that combining these in one radiation-free test makes MRI a cornerstone for both diagnosing ischemia and stratifying risk.

The practical takeaway is to consider cardiac MRI a central tool for evaluating known or suspected ischemic heart disease, especially when viability and perfusion both matter. The resistance is the familiar institutional pull of nuclear imaging and echocardiography.

We rate the evidence moderate: a well-referenced (76-citation) synthesis of high-quality studies, but a narrative review without new data. Its clinical significance is moderate — a useful consolidation of where cardiac MRI fits in ischemic heart disease, overlapping with the several other MRI reviews in this library, bounded as ever by access and expertise.