EVALUATION OF CARDIAC MRI FOR EARLY DIAGNOSIS OF ISCHEMIC HEART DISEASE: A COMPARATIVE STUDY

Аннотация

Ischemic heart disease (IHD) remains one of the most significant global health challenges, accounting for a substantial proportion of cardiovascular morbidity and mortality. According to the World Health Organization (WHO), cardiovascular diseases, including IHD, are responsible for approximately 17.9 million deaths annually, with ischemic events being the predominant cause. The increasing prevalence of risk factors such as hypertension, diabetes mellitus, obesity, dyslipidemia, and smoking further exacerbates the burden of IHD, emphasizing the critical need for accurate and early diagnosis to facilitate timely medical intervention and reduce complications. Early detection of IHD is essential for preventing adverse outcomes such as myocardial infarction, heart failure, arrhythmias, and sudden cardiac death. Traditional diagnostic methods, including electrocardiography (ECG), echocardiography (EchoCG), and coronary angiography, play a crucial role in assessing coronary artery disease (CAD) and myocardial function. However, these techniques have certain limitations. ECG primarily detects electrical abnormalities but may fail to identify ischemia in cases of silent or intermittent myocardial ischemia. EchoCG provides structural and functional information about the heart but may not always detect microvascular dysfunction or small infarcted areas. Coronary angiography remains the gold standard for evaluating coronary artery stenosis, but it is an invasive procedure with associated risks, and it does not directly assess myocardial tissue viability or microvascular circulation. Cardiac magnetic resonance imaging (MRI) has emerged as a powerful non-invasive imaging modality that offers comprehensive evaluation of myocardial structure, function, perfusion, and viability. Unlike conventional methods, cardiac MRI allows for precise assessment of myocardial ischemia, detection of myocardial fibrosis through late gadolinium enhancement (LGE), and evaluation of microvascular dysfunction. Additionally, stress cardiac MRI enables the identification of inducible ischemia, aiding in the differentiation of reversible and irreversible myocardial injury. These capabilities make cardiac MRI a superior diagnostic tool in certain clinical scenarios where traditional methods fall short. This study aims to analyze the effectiveness of cardiac MRI in detecting early signs of IHD and compare its diagnostic accuracy with standard techniques such as ECG, EchoCG, and coronary angiography. By reviewing real-world clinical cases, this study illustrates how cardiac MRI enhances the detection of myocardial ischemia, fibrosis, and microvascular dysfunction in patients suspected of having IHD. The findings contribute to the growing body of evidence supporting the integration of cardiac MRI into routine clinical practice, potentially improving risk stratification, patient management, and long-term cardiovascular outcomes. Keywords: Cardiac MRI, ischemic heart disease, myocardial ischemia, fibrosis, early diagnosis, coronary angiography, echocardiography. Objective: The primary goal of this research is to analyze the diagnostic efficiency of cardiac MRI in the early detection of IHD and compare its diagnostic accuracy with conventional methods, assessing its potential impact on clinical decision-making and treatment strategies. Materials and Methods: The study involved a cohort of 50 patients aged between 45 and 70 years who were referred to the cardiology department with suspected ischemic heart disease (IHD). The page 892 INTERNATIONAL JOURNAL OF ARTIFICIAL INTELLIGENCE ISSN: 2692-5206, Impact Factor: 12,23 American Academic publishers, volume 05, issue 03, 2025 Journal: https://www.academicpublishers.org/journals/index.php/ijai selection criteria for inclusion in the study were based on clinical presentation, risk factor assessment, and preliminary findings from non-invasive tests. Patients with a history of hypertension, diabetes mellitus, hyperlipidemia, smoking, or a family history of cardiovascular disease were prioritized due to their increased risk of developing coronary artery disease. Additionally, individuals experiencing symptoms such as chest pain, exertional dyspnea, palpitations, or atypical cardiovascular discomfort were enrolled in the study for further diagnostic evaluation. Each patient underwent a comprehensive diagnostic workup consisting of four key modalities: 1. Electrocardiography (ECG) – This was used as an initial screening tool to detect abnormalities such as ST-segment changes, T-wave inversions, arrhythmias, or conduction disturbances that might indicate ischemic events or previous myocardial damage. However, ECG alone is often insufficient for diagnosing IHD, especially in patients with non-ST elevation ischemia or silent ischemia. 2. Echocardiography (EchoCG) – A transthoracic echocardiogram was performed to assess left ventricular function, wall motion abnormalities, regional hypokinesia, and overall myocardial