Cardiovascular magnetic resonance in women with cardiovascular disease: position statement from the Society for Cardiovascular Magnetic Resonance&nbsp;(SCMR)

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Abstract

This document is a position statement from the Society for Cardiovascular Magnetic Resonance (SCMR) on recommendations for clinical utilization of cardiovascular magnetic resonance (CMR) in women with cardiovascular disease. The document was prepared by the SCMR Consensus Group on CMR Imaging for Female Patients with Cardiovascular Disease and endorsed by the SCMR Publications Committee and SCMR Executive Committee. The goals of this document are to (1) guide the informed selection of cardiovascular imaging methods, (2) inform clinical decision-making, (3) educate stakeholders on the advantages of CMR in specific clinical scenarios, and (4) empower patients with clinical evidence to participate in their clinical care. The statements of clinical utility presented in the current document pertain to the following clinical scenarios: acute coronary syndrome, stable ischemic heart disease, peripartum cardiomyopathy, cancer therapy-related cardiac dysfunction, aortic syndrome and congenital heart disease in pregnancy, bicuspid aortic valve and aortopathies, systemic rheumatic diseases and collagen vascular disorders, and cardiomyopathy-causing mutations. The authors cite published evidence when available and provide expert consensus otherwise. Most of the evidence available pertains to translational studies involving subjects of both sexes. However, the authors have prioritized review of data obtained from female patients, and direct comparison of CMR between women and men. This position statement does not consider CMR accessibility or availability of local expertise, but instead highlights the optimal utilization of CMR in women with known or suspected cardiovascular disease. Finally, the ultimate goal of this position statement is to improve the health of female patients with cardiovascular disease by providing specific recommendations on the use of CMR.

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2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.

Piotr Ponikowski, Adriaan A. Voors, Stefan D. Anker … (2016)

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Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016

Yuan-Pang Wang, Maheswar Satpathy, Elisabete Weiderpass … (2018)

Summary Background Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specific mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends. Methods We estimated cause-specific deaths and years of life lost (YLLs) by age, sex, geography, and year. YLLs were calculated from the sum of each death multiplied by the standard life expectancy at each age. We used the GBD cause of death database composed of: vital registration (VR) data corrected for under-registration and garbage coding; national and subnational verbal autopsy (VA) studies corrected for garbage coding; and other sources including surveys and surveillance systems for specific causes such as maternal mortality. To facilitate assessment of quality, we reported on the fraction of deaths assigned to GBD Level 1 or Level 2 causes that cannot be underlying causes of death (major garbage codes) by location and year. Based on completeness, garbage coding, cause list detail, and time periods covered, we provided an overall data quality rating for each location with scores ranging from 0 stars (worst) to 5 stars (best). We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to generate estimates for each location, year, age, and sex. We assessed observed and expected levels and trends of cause-specific deaths in relation to the Socio-demographic Index (SDI), a summary indicator derived from measures of average income per capita, educational attainment, and total fertility, with locations grouped into quintiles by SDI. Relative to GBD 2015, we expanded the GBD cause hierarchy by 18 causes of death for GBD 2016. Findings The quality of available data varied by location. Data quality in 25 countries rated in the highest category (5 stars), while 48, 30, 21, and 44 countries were rated at each of the succeeding data quality levels. Vital registration or verbal autopsy data were not available in 27 countries, resulting in the assignment of a zero value for data quality. Deaths from non-communicable diseases (NCDs) represented 72·3% (95% uncertainty interval [UI] 71·2–73·2) of deaths in 2016 with 19·3% (18·5–20·4) of deaths in that year occurring from communicable, maternal, neonatal, and nutritional (CMNN) diseases and a further 8·43% (8·00–8·67) from injuries. Although age-standardised rates of death from NCDs decreased globally between 2006 and 2016, total numbers of these deaths increased; both numbers and age-standardised rates of death from CMNN causes decreased in the decade 2006–16—age-standardised rates of deaths from injuries decreased but total numbers varied little. In 2016, the three leading global causes of death in children under-5 were lower respiratory infections, neonatal preterm birth complications, and neonatal encephalopathy due to birth asphyxia and trauma, combined resulting in 1·80 million deaths (95% UI 1·59 million to 1·89 million). Between 1990 and 2016, a profound shift toward deaths at older ages occurred with a 178% (95% UI 176–181) increase in deaths in ages 90–94 years and a 210% (208–212) increase in deaths older than age 95 years. The ten leading causes by rates of age-standardised YLL significantly decreased from 2006 to 2016 (median annualised rate of change was a decrease of 2·89%); the median annualised rate of change for all other causes was lower (a decrease of 1·59%) during the same interval. Globally, the five leading causes of total YLLs in 2016 were cardiovascular diseases; diarrhoea, lower respiratory infections, and other common infectious diseases; neoplasms; neonatal disorders; and HIV/AIDS and tuberculosis. At a finer level of disaggregation within cause groupings, the ten leading causes of total YLLs in 2016 were ischaemic heart disease, cerebrovascular disease, lower respiratory infections, diarrhoeal diseases, road injuries, malaria, neonatal preterm birth complications, HIV/AIDS, chronic obstructive pulmonary disease, and neonatal encephalopathy due to birth asphyxia and trauma. Ischaemic heart disease was the leading cause of total YLLs in 113 countries for men and 97 countries for women. Comparisons of observed levels of YLLs by countries, relative to the level of YLLs expected on the basis of SDI alone, highlighted distinct regional patterns including the greater than expected level of YLLs from malaria and from HIV/AIDS across sub-Saharan Africa; diabetes mellitus, especially in Oceania; interpersonal violence, notably within Latin America and the Caribbean; and cardiomyopathy and myocarditis, particularly in eastern and central Europe. The level of YLLs from ischaemic heart disease was less than expected in 117 of 195 locations. Other leading causes of YLLs for which YLLs were notably lower than expected included neonatal preterm birth complications in many locations in both south Asia and southeast Asia, and cerebrovascular disease in western Europe. Interpretation The past 37 years have featured declining rates of communicable, maternal, neonatal, and nutritional diseases across all quintiles of SDI, with faster than expected gains for many locations relative to their SDI. A global shift towards deaths at older ages suggests success in reducing many causes of early death. YLLs have increased globally for causes such as diabetes mellitus or some neoplasms, and in some locations for causes such as drug use disorders, and conflict and terrorism. Increasing levels of YLLs might reflect outcomes from conditions that required high levels of care but for which effective treatments remain elusive, potentially increasing costs to health systems. Funding Bill & Melinda Gates Foundation.

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Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015

Gregory A Roth, Catherine Johnson, Amanuel Abajobir … (2018)

Background The burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world. Objectives The GBD (Global Burden of Disease) 2015 study integrated data on disease incidence, prevalence, and mortality to produce consistent, up-to-date estimates for cardiovascular burden. Methods CVD mortality was estimated from vital registration and verbal autopsy data. CVD prevalence was estimated using modeling software and data from health surveys, prospective cohorts, health system administrative data, and registries. Years lived with disability (YLD) were estimated by multiplying prevalence by disability weights. Years of life lost (YLL) were estimated by multiplying age-specific CVD deaths by a reference life expectancy. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. Results In 2015, there were an estimated 422.7 million cases of CVD (95% uncertainty interval: 415.53 to 427.87 million cases) and 17.92 million CVD deaths (95% uncertainty interval: 17.59 to 18.28 million CVD deaths). Declines in the age-standardized CVD death rate occurred between 1990 and 2015 in all high-income and some middle-income countries. Ischemic heart disease was the leading cause of CVD health lost globally, as well as in each world region, followed by stroke. As SDI increased beyond 0.25, the highest CVD mortality shifted from women to men. CVD mortality decreased sharply for both sexes in countries with an SDI >0.75. Conclusions CVDs remain a major cause of health loss for all regions of the world. Sociodemographic change over the past 25 years has been associated with dramatic declines in CVD in regions with very high SDI, but only a gradual decrease or no change in most regions. Future updates of the GBD study can be used to guide policymakers who are focused on reducing the overall burden of noncommunicable disease and achieving specific global health targets for CVD.

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Author and article information

Contributors

Karen G. Ordovas:

ORCID: http://orcid.org/0000-0001-5438-4669

ordovask@uw.edu

Journal

Journal ID (nlm-ta): J Cardiovasc Magn Reson

Journal ID (iso-abbrev): J Cardiovasc Magn Reson

Title: Journal of Cardiovascular Magnetic Resonance

Publisher: BioMed Central (London )

ISSN (Print): 1097-6647

ISSN (Electronic): 1532-429X

Publication date (Electronic): 10 May 2021

Publication date PMC-release: 10 May 2021

Publication date Collection: 2021

Volume: 23

Electronic Location Identifier: 52

Affiliations

[1 ]GRID grid.34477.33, ISNI 0000000122986657, University of Washington, ; Seattle, USA

[2 ]GRID grid.47100.32, ISNI 0000000419368710, Yale University, ; New Haven, CT USA

[3 ]GRID grid.410421.2, ISNI 0000 0004 0380 7336, Bristol Heart Institute, ; Bristol, UK

[4 ]Bristol National Institute of Health Research (NIHR) Biomedical , Research Centre, Bristol, UK

[5 ]GRID grid.410421.2, ISNI 0000 0004 0380 7336, University Hospitals Bristol, ; Bristol, UK

[6 ]GRID grid.5337.2, ISNI 0000 0004 1936 7603, University of Bristol, ; Bristol, UK

[7 ]GRID grid.16753.36, ISNI 0000 0001 2299 3507, Department of Radiology, , Northwestern University Feinberg School of Medicine, ; Chicago, IL USA

[8 ]Jose Michel Kalaf Research Institute, Radiologia Clinica de Campinas, São Paulo, Brazil

[9 ]GRID grid.454382.c, Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, , British Heart Foundation Centre of Research Excellence, Oxford NIHR Biomedical Research Centre, University of Oxford, ; Oxford, UK

[10 ]GRID grid.30760.32, ISNI 0000 0001 2111 8460, Medical College of Wisconsin, ; Wisconsin, USA

[11 ]GRID grid.419873.0, ISNI 0000 0004 0622 7521, Onassis Cardiac Surgery Center, ; Athens, Greece

[12 ]GRID grid.5216.0, ISNI 0000 0001 2155 0800, Kapodistrian University of Athens, ; Athens, Greece

[13 ]GRID grid.7836.a, ISNI 0000 0004 1937 1151, University of Cape Town, ; Cape Town, South Africa

[14 ]GRID grid.413335.3, ISNI 0000 0004 0635 1506, Groote Schuur Hospital, ; Cape Town, South Africa

[15 ]GRID grid.4514.4, ISNI 0000 0001 0930 2361, Department of Clinical Sciences Lund, Clinical Physiology, , Skåne University Hospital Lund, Lund University, ; Lund, Sweden

[16 ]GRID grid.429814.2, Division of Cardiology, Department of Medicine, , Loma Linda University Health, ; Loma Linda, CA USA

[17 ]Magnetic Resonance Imaging Unit, Fondazione G. Monasterio C.N.R., Pisa, Italy

[18 ]GRID grid.257413.6, ISNI 0000 0001 2287 3919, Krannert Institute of Cardiology, Indiana University, ; Indianapolis, USA

[19 ]GRID grid.260026.0, ISNI 0000 0004 0372 555X, Department of Radiology, , Mie University School of Medicine, ; Mie, Japan

[20 ]GRID grid.7468.d, ISNI 0000 0001 2248 7639, harite Hospital, University of Berlin, ; Berlin, Germany

[21 ]HELIOS-Clinics Berlin-Buch, Berlin, Germany

[22 ]GRID grid.413678.f, American British Cowdray Medical Center, ; Mexico City, Mexico

[23 ]Boston Children’s Hospital, Brigham and Women’s Hospital, Boston, USA

[24 ]GRID grid.213910.8, ISNI 0000 0001 1955 1644, Georgetown University School of Medicine, ; Washington, USA

Author information

Karen G. Ordovas http://orcid.org/0000-0001-5438-4669

Article

Publisher ID: 746

DOI: 10.1186/s12968-021-00746-z

PMC ID: 8108343

PubMed ID: 33966639

SO-VID: 381efdd8-32a9-46b5-b50a-cf2629a489c8

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Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 21 February 2021

Date accepted : 17 March 2021

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ScienceOpen disciplines: Cardiovascular Medicine

Keywords: cardiovascular magnetic resonance,women,cardiovascular disease,society for cardiovascular magnetic resonance,position statement

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ScienceOpen disciplines: Cardiovascular Medicine

Keywords: cardiovascular magnetic resonance, women, cardiovascular disease, society for cardiovascular magnetic resonance, position statement

Cardiovascular magnetic resonance in women with cardiovascular disease: position statement from the Society for Cardiovascular Magnetic Resonance (SCMR)

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Most cited references 138

Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016

Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015

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