1356541 - Cardiac MRI as a diagnostic tool in old and very old patients - lessons learned from everyday clinical practice

Due to demographic change, more and more elderly and very elderly patients with cardiovascular diseases will be treated in everyday clinical practice. Due to the lack of evidence, the question of adequate diagnostics often arises in these patients. 



Methods:

For this study, all patients over 80 years of age who underwent cMRI  (3T Verio und 1.5T Espree, Siemens, Erlangen, Germany) between February 2014 and November 2021 as part of their inpatient treatment were analyzed retrospectively. The focus of our analysis was on the indication for the MRI, if the MRI was fully carried out by the patient and if the MRI could be evaluated regarding the medical question.

Results:

A total of 1153 patients (567 male, 82±2.9 years) were included in the final analysis. The age range was between 80 and 100 years. Most patients were between 80 and 89 years old (1118; 97%), fewer patients ³90 years (35; 3%). The main indications for cardiac MRI were stress testing using adenosine or dobutamine (27.4%; n=316), vitality tests acute or chronic after myocardial infarction (26.4%; n=305), imaging before and after ablation for atrial fibrillation (19.8%, n=228) and myocarditis (18.6%; n=214). The remaining MRI (7.8%) related to less common indications such as tumors, thrombus or systemic diseases (Figure 1). A total of 45 (3.9%) of the MRI examinations were terminated prematurely by the patients. An evaluation in the sense of the question was possible in 1081 (93.8%) of the patients. A limited ability to assess was found in 69 (6%) of the patients (Figure 2).



Conclusion: Our results indicates that cardiac MRI is a robust diagnostic tool also in old and very old patients as very few patients discontinue the examination early and only a few examinations are unevaluable. Thus, cMRI should be considered as an effective diagnostic tool in elderly cardiovascular patients in this vulnerable population