SPC365

The Portuguese National Registry of Cardiac Imaging (RNPIC): First Nationwide Insights into Cardiac MRI Utilization, Access, and Clinical Profiles

Session: Sessão de Comunicações Orais 16 – Imagiologia avançada para estratificação de risco: do ECV à RMC em contexto de vida real
Speaker: Ana Filipa Mesquita Gerardo

Congress: CPC 2026
Topic: B. Imaging
Theme: 03. Imaging
Subtheme: 03.3 Cardiac Magnetic Resonance
Session Type: Comunicações Orais
FP Number: ---
Authors: Filipa Gerardo; João Augusto; António Ferreira; Pedro Matos; Ana Almeida; Catarina Ferreira; Lígia Mendes; Mariana Vasconcelos; Marta António; Vera Ferreira; Nuno Jalles; Nuno Bettencourt

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="color:black">Introduction:</span></strong><br />
<span style="color:black">Cardiovascular magnetic resonance (CMR) has become central to the diagnosis and management of a wide spectrum of cardiovascular diseases. Despite its expanding clinical relevance, the real-world landscape of CMR practice in Portugal remains insufficiently characterized.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="color:black">Objectives:</span></strong><br />
<span style="color:black">To describe the national distribution, clinical indications, patient characteristics, and imaging patterns of CMR in Portugal, based on the initial results of the Portuguese National Registry of Cardiac Imaging (RNPIC).</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="color:black">Methods:</span></strong><br />
<span style="color:black">RNPIC is a nationwide, multicenter, prospective registry conducted between March 1 and April 30, 2023. All Portuguese centers capable of performing at least one advanced imaging modality (CMR, cardiac CT, and/or nuclear cardiology) were invited. Participating centers consecutively enrolled all referred patients who provided informed consent over a 30-day period. Demographic data, cardiovascular risk factors, referral specialty, clinical indications, CMR protocol, stress agents, contrast type and dose, and exam outcomes were recorded.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="color:black">Results:</span></strong><br />
<span style="color:black">A total of</span>&nbsp;<span style="color:black">1,154 CMR studies</span>&nbsp;<span style="color:black">were included. The mean age was</span>&nbsp;<span style="color:black">55&plusmn;19 years, and</span>&nbsp;<span style="color:black">39%</span>&nbsp;<span style="color:black">were women (n=445). Cardiovascular risk factors were frequent: hypertension</span>&nbsp;<span style="color:black">43%, dyslipidemia</span>&nbsp;<span style="color:black">41%, diabetes</span>&nbsp;<span style="color:black">17%, active smoking</span>&nbsp;<span style="color:black">13%, and previous cardiovascular disease</span>&nbsp;<span style="color:black">53%. &nbsp;Cardiology accounted for most referrals (82%), followed by internal medicine (7%) and pediatric cardiology (5%).<br />
The most common indications were</span>&nbsp;<span style="color:black">ischemia assessment (33%),</span>&nbsp;<span style="color:black">cardiomyopathy evaluation (25%),</span>&nbsp;<span style="color:black">heart failure (12%), and</span>&nbsp;<span style="color:black">arrhythmias (10%). Only</span>&nbsp;<span style="color:black">4%</span>&nbsp;<span style="color:black">of studies were performed without contrast. Stress perfusion was performed in</span>&nbsp;<span style="color:black">38%, mainly with</span>&nbsp;<span style="color:black">adenosine (64%)</span>&nbsp;<span style="color:black">and</span>&nbsp;<span style="color:black">regadenoson (35%);</span>&nbsp;<span style="color:black">22%</span>&nbsp;<span style="color:black">demonstrated inducible ischemia.<br />
Gadobutrol was the preferred contrast agent (82%), followed by gadoterate (14%). Late gadolinium enhancement (LGE) was present in</span>&nbsp;<span style="color:black">48% of patients, predominantly non-ischemic (59% of LGE-positive cases). Adverse events were rare (&lt;1%), with five contrast reactions.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="color:black">Conclusions:</span></strong><br />
<span style="color:black">This first nationwide multicenter registry provides the most comprehensive snapshot to date of CMR practice in Portugal. Ischemia assessment was the primary indication for examination, with a high prevalence of positives exams likely reflecting a high pre-test probability among the selected population. Almost half of the patients had LGE in CMR, further supporting the presence of significant cardiovascular disease. Exams were safe and well tolerated. </span></span></span></p>