Role of CMR in the Guidelines of the European Society of Cardiology (ESC)

An article titled, The Role of CMR in the Guidelines of the ESC, has recently been published by Florian von Knobelsdorff and Jeanette Schulz-Menger from Charité and HELIOS clinics (Berlin / Germany) in the Journal of Cardiovascular Magnetic Resonance. The aim of the paper was to analyze all of the ESC guidelines, to determine whether cardiovascular MR (CMR) is mentioned within the guideline and which recommendations are made concerning the use of CMR. This analysis should serve as a ground for future discussions, such as reimbursement and education.

In total, 26 ESC guidelines published until 2015 have been included in the analysis. Fourteen contain in total 63 specific recommendations (39 x class 1, 12 x class IIa, 10 x class IIb, 2 x class III). In nine, CMR is at least mentioned in the text. Most of the recommendations are made in the context of coronary artery disease, followed by vessel assessment and cardiomyopathies.

The article lists all relevant recommendations and text passages from the guidelines in detail. Moreover, it contains a summary table with clinical scenarios and groups of diagnoses, for which a specific ESC recommendation exists.

This analysis underlines that CMR is already established in many ESC guidelines as a recommended diagnostic tool. Furthermore, there are several known clinical scenarios with evidence for the usefulness of CMR, but without being represented in ESC guidelines (e.g. sarcoid disease) – this should be updated in future guideline versions.

To guarantee that all patients have access to guideline-conform treatment including CMR, infrastructural improvements are needed. This article is intended to support this motivation. 

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