August 2017
Improved Coverage Policy for CMR Services

In a positive step forward for patients and the field of cardiovascular magnetic resonance (CMR), Aetna, one of America's largest US-American health insurance companies covering more than 23 million lives, updated their coverage policy for CMR services. The recommendations now also include coverage of CMR fo r the detection of coronary artery disease, specifically:  The detection and localization of inducible myocardial perfusion deficits or inducible contractile dysfunction; detection or quantification of the extent of acute or chronic myocardial infarction; differentiation of recent from remote myocardial infarction; and demonstration of complications from infarction.  The new policy also strengthens coverage to evaluate non-ischemic cardiomyopathies.  To view the new Aetna CMR policy, effective as of mid-July 2017, visit their website .

CMS Considers MRI Coverage

The American College of Cardiology (ACC), along with SCMR, submitted the attached comments to the Centers for Medicare and Medicaid Services (CMS), asking the agency to consider the value of MRIs for certain cardiovascular indications as it reconsiders its MRI coverage policies.

The ACC/SCMR letter highlights recent documents that address the management of patients with implantable cardiac devices who would benefit from MRI. "We encourage CMS to rely upon this document to find a coverage framework that allows physicians and their patients to have a conversation to evaluate the risks and benefits of imaging options and decide the best path forward for that patient without worry that their imaging may not be covered because of the patient's implantable device," said ACC President Mary Norine Walsh, MD, FACC, and SCMR President Matthias G. Friedrich, MD, FACC.

CMS must issue a proposed coverage decision by Jan. 12, 2018, but this could come sooner. Stakeholders will again have a 30-day comment period to offer feedback at that time. The current MRI coverage policy was last reviewed in 2011 when CMS added coverage for patients with pacemakers when used according to U.S. Food and Drug Administration-approved labeling in an MRI environment or in a clinical study.

The SCMR is actively engaged in informing payers to support appropriate coverage of CMR services.  We are monitoring review cycles for payer  policies on CMR and endeavor to provide comments to major national payers. In this ongoing effort, we ask all SCMR members to be our eyes and ears on the ground. Please tell us about inappropriately denied coverage for CMR services by local payers.  We will provide guidance and tools to help you successfully negotiate for adequate reimbursement. Please contact SCMR Headquarters for more information.

The SCMR Registry Steering Committee would like to invite SCMR members to participate in a self-assessment exercise evaluating 10 commonly encountered CMR cases.  Every case that you interpret will be compared against a consensus interpretation by several CMR experts. In addition, every reader that completes all 10 cases will receive a private report compared against the expert read and a detailed explanation of each case. The final diagnosis and the results of all available clinical workup of the 10 cases will also be provided to you.

The intent of this exercise is to assess the consistencies in CMR interpretation across geographic regions or readers' background and training. The results may help plan the growth of future developments of the SCMR Registry.

Overcoming the Difficulties to Adequately Detect Myocardial Ischaemia in Women

Ischaemia testing in women has been frustrating for decades due to their smaller hearts, smaller vessels, shielding of the cardiac signal by breast tissue in combination with the development of cardiovascular diseases later in life, which is often combined with co-morbidities and, thus, with less specific symptoms in comparison with men. View full article >>

Magnetic Resonance in Transthyretin Cardiac Amyloidosis

The authors used CMR with extracellular volume fraction (ECV) measurement to characterize cardiac involvement in relation to outcome in ATTR. View full article >>

Cardiac Magnetic Resonance In Takotsubo Syndrome

This review focuses on the emerging role of cardiac magnetic resonance for the characterization , differential diagnosis as well as risk stratification of patients with Takotsubo syndrome. View full article >>

Detection of Left Ventricular Thrombus by Cardiac Magnetic Resonance in Embolic Stroke of Undetermined Source

The authors aimed to use contrast-enhanced cardiac magnetic resonance (CE-CMR) imaging to elucidate the prevalence of left ventricular (LV) thrombus in patients suspected of embolic stroke of undetermined source (ESUS) with previous myocardial infarction or LV dysfunction (LV ejection fraction [LVEF] <50%). View full article >>

Long-Term Incremental Prognostic Value of CMR After ST-Segment Elevation Myocardial Infarction

This study sought to investigate whether early post-infarction cardiac magnetic resonance (CMR) parameters provide additional long-term prognostic value beyond traditional outcome predictors in ST-segment elevation myocardial infarction (STEMI) patients. View full article >>

Comprehensive Echocardiographic and CMR Evaluation Differentiates Among Heart Failure With Preserved Ejection Fraction Patients, Hypertensive Patients, and Healthy Control Subjects

The aim of this study was to investigate the utility of a comprehensive imaging protocol including echocardiography and cardiac magnetic resonance in the diagnosis and differentiation of hypertensive heart disease and heart failure with preserved ejection fraction (HFpEF).  View full article >>


Recent articles published in the journal include:

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To Improve Cardiovascular Health by Advancing the Field of CMR