[Familiarity and perceptions of Portuguese cardiologists concerning cardiac magnetic resonance and cardiac computed tomography: the extent of the task ahead]

Abstract

Introduction: Rapid advances in cardiac magnetic resonance (CMR) and cardiac computed tomography angiography (CCTA) pose challenges for practicing physicians in terms of awareness of their indications, contraindications, advantages and pitfalls.

Methods: We conducted a nationwide online survey assessing the familiarity, perceptions and patterns of use concerning these imaging modalities based on a questionnaire sent to all physician members of the Portuguese Society of Cardiology.

Results: The responses from 205 physicians (21% response rate) were analyzed. Roughly half of them requested less than one CMR (51%) or CCTA (52%) per week. Suspected coronary artery disease in symptomatic patients with intermediate pretest probability was considered a good or excellent indication for CCTA by 59% of respondents when performed as a second-line exam, and by 29% as a first-line exam. Cardiac masses, congenital heart disease and cardiomyopathies were considered good or excellent indications for CMR by over 90% of respondents, while assessment of myocardial viability and acute myocardial infarction with normal coronary arteries were considered good or excellent indications by 75% and 65% of respondents, respectively. Less than half (39%) answered all the questions regarding contraindications for CMR correctly, and 15% were unaware that CMR does not involve ionizing radiation. The main reasons for not referring a patient for CMR were limited availability (45%) and cost (36%).

Conclusions: Portuguese cardiologists appear to be moderately aware of the indications, contraindications and advantages of these new imaging modalities. Greater efforts should be made to improve physician education on this subject in order to improve patient care.

Keywords: Angiotomografia computorizada cardíaca; Cardiac computed tomography; Cardiovascular magnetic resonance; Conhecimento médico; Medical knowledge; Ressonância magnética cardíaca.