MRI could spare heart patients ‘risky’ invasive tests

Credit: Getty Images/magicmine

By Lily Canter

Doctors may soon be able to assess heart failure using a routine MRI scan instead of an invasive test, according to researchers.

The scan could replace right heart catheterisation to measure oxygen levels in the blood in heart failure, a team from the University of East Anglia has concluded.

It comes after researchers, in collaboration with the University of Leeds and Newcastle University, developed a way to estimate the crucial measurement of blood oxygen using a standard cardiac MRI.

Moving away from the invasive procedure which can be an unpleasant experience for patients, and carries risks, especially for older, frail or unwell patients, could be a “game changer” they added.

“It could allow us to measure risk more safely and more often, especially for patients who are too frail or high-risk for an invasive catheter procedure,” said lead researcher Professor Pankaj Garg, consultant cardiologist at the Norfolk and Norwich University Hospital.

The researchers developed a method that uses a routine type of MRI measurement called T2 mapping to estimate how much oxygen is left in the blood as it returns to the heart.

They first tested the technique in 30 patients and found the MRI results closely matched the invasive catheter readings.

They then analysed 628 people with newly diagnosed heart failure, following them for around three years. Those with healthier oxygen readings on MRI were significantly less likely to die or end up in hospital due to their condition.

Faster, safer heart checks

Now, they hope their findings – published in the journal JACC Advances – could potentially spare thousands from undergoing the risky and invasive tube procedure in the future.

"Doctors often need detailed information about a patient’s circulation to decide on the best treatment,” said Professor Garg.

“We wanted to develop a safe, non-invasive alternative which could allow far more patients to be properly assessed - and allow repeat monitoring without the risks of a catheter test,” he added.

“Blood with different oxygen levels behaves slightly differently in a magnetic field. By measuring how that blood reacts, we were able to develop a formula that predicts the oxygen reading without ever inserting a tube or taking a blood sample.”

Crucially, this MRI-based measure stayed accurate even after accounting for age, other illnesses and overall heart function.

Senior author Dr Peter Swoboda, from the University of Leeds, said doctors may be able to read off a crucial haemodynamic number from an everyday scan “turning a routine MRI into a much more powerful test, without putting a tube into the heart”.

Co-author Dr Gareth Matthews, from the University of East Anglia, said: “Because this can be done as part of a standard cardiac MRI, it needs no extra hardware and no contrast dye, and adds only seconds to the scan.

“It has real potential to widen access to safer heart failure assessment across the NHS,” he added.

The researchers said further studies are needed to confirm the findings in different hospitals and patient groups, and to understand how best to use the measure in day-to-day decision-making.

Reference: JACC Adv DOI: 10.1016/j.jacadv.2025.102484

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