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(Circulation. 1999;100:1676-1679.)
© 1999 American Heart Association, Inc.

Editorials

The Role of Cardiac MRI Stress Testing

"Make a Better Mouse Trap ... "

Gerald M. Pohost, MD; Robert W. W. Biederman, MD

From the Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Alabama.

Key Words: Editorials • echocardiography • magnetic resonance imaging • stress testing • coronary artery disease

	Introduction

 
Near the turn of the 20th century, Ralph Waldo Emerson said, "If a man can make a better mouse trap than his neighbor, the world will make a beaten path to his door." In the 1900s, we have seen particularly illuminating examples of this prediction: from the model T Ford, which in one decade eliminated the horse-and-buggy era, to the introduction of the heart-lung machine by John Gibbon, Jr, in 1953, which indelibly changed medicine, and, more recently, Andreas Gruentzig's intrepid introduction of intracoronary angioplasty, revolutionizing the treatment of coronary artery disease (CAD).

We are now on the brink of another revolution, reaffirming Emerson's adage. Cardiac imaging has seen little to parallel its rapid advancement. In a short time, we have moved from x-ray methods for imaging coronary artery calcification in the 1950s by simple fluoroscopy, to the selective coronary arteriogram of Mason Sones in 1958, to the translation of postwar military ultrasound technology by Inge Edler and physicist C. Hellmuth Hertz into basic echocardiographic principles. In the early 1970s, a discovery was made that was little noticed in the medical profession, a formidable technology that would rise up to challenge the existing paradigms. From the adaptation of Lauterbur's work in 1973, investigators¹ would set the stage for another challenger in the field of cardiac imaging: cardiovascular nuclear MRI. The improvements in resolution and contrast along with the ability for respiratory and cardiac gating generated diagnostic images of the highest quality, generating a wave of enthusiasm for this relatively new . . . [Full Text of this Article]

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