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June 6, 2026European Heart Journal - Imaging Methods and PracticeOpen Access

Among 283 respondents across 46 countries, main barriers to CMR delivery were inadequate reimbursement (46%), insufficient training (38%), and limited scanner capacity (29%).

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Population

283 survey respondents from 46 European Society of Cardiology (ESC) member and affiliate countries

Design

Cross-sectional

Key result

Among 283 respondents across 46 countries, main barriers to CMR delivery were inadequate reimbursement (46%), insufficient training (38%), and limited scanner capacity (29%).

Authors

EAEmmanuel AndroulakisTBTesfamariam BetemariamMDMarc R Dweck

Discussion

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Overview

Barriers limit equitable CMR access across Europe; leaves open whether targeted reimbursement and training reforms will increase utilization.

Key Points

  • The study aims to identify barriers affecting the use of cardiovascular magnetic resonance (CMR) in Europe.
  • Mixed methods design including qualitative interviews and quantitative surveys conducted from January to September 2025.
  • Countries were grouped into ESC subregions for analysis, with quantitative data evaluated using chi-square tests.
  • Qualitative responses were analysed using thematic analysis and synthesized through triangulation.
  • Inadequate reimbursement (46%), insufficient training (38%), and limited scanner capacity (29%) are the primary barriers identified.
  • Eastern European countries reported more significant training deficits compared to Northern and Southern Europe (56% vs 14%, p<0.001).
  • Qualitative findings revealed structural inefficiencies and suggested strategies such as remote supervision and regional collaboration to address barriers.

Study Design

Type

Cross-Sectional (n=283)

Multicenter

Yes

Structured PICO

P
Population
283 respondents from 46 ESC member and affiliate countries surveyed to identify barriers to cardiovascular magnetic resonance practice.
O
Outcome
Barriers to Cardiovascular Magnetic Resonance (CMR) practice and reporting

Main Result

Absolute Event Rate: 56% vs 14%

p-value: p=<0.001

Despite being established in guidelines, CMR utilization across Europe is significantly hindered by inadequate reimbursement, insufficient training, and limited scanner capacity, requiring targeted investments and standardized education.

Cite This Study

Androulakis et al. (2026) conducted a cross-sectional in Cardiovascular magnetic resonance (CMR) practice (n=283). Cardiovascular magnetic resonance (CMR) practice was evaluated on Training deficits as a barrier to CMR (p=<0.001). Among 283 respondents across 46 countries, main barriers to CMR delivery were inadequate reimbursement (46%), insufficient training (38%), and limited scanner capacity (29%).

synapsesocial.com/papers/6a23bc2a71a5da9775e77922https://doi.org/10.1093/ehjimp/qyag104
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