CHRONIC CORONARY INSUFFICIENCY: INNOVATIONS IN CARDIACMAGNETIC RESONANCE

The identification of ischemic repercussion of coronary atherosclerotic disease (CAD) by non-invasive methods aims not only at diagnosis, but also at prognostic evaluation and adequate therapeutic guidance. Cardiac magnetic resonance (CMR) combines availabi-lity and multiparametric information superior to other methods. Combined with positron emission tomography, CMR has the best diagnostic accuracy statistics among ischemia research methods, making it a highly robust test in chronic CAD. Several prospective and comparative studies among ischemia research methods demonstrate the importance of CMR in optimizing management in the context of chronic CAD, and may even be superior to invasive fractional flow reserve (FFR). The investigation of ischemia under stress, combined with the identification of myocardial fibrosis using the delayed enhancement technique, is currently the core of CMR in the context of coronary insufficiency, but the new possibilities for assessments of cardiac mapping and coronary flow reserve extend the scope of the study even further, especially for the prognostic evaluation of CAD.