Low-Field MRI Reduces Cost and Environmental Impact While Maintaining Diagnostic Performance in Resource-Limited Settings: A Narrative Review With Cardiovascular Focus.

High-field MRI (1.5-3 T) delivers excellent images but requires costly, energy-intensive infrastructure. Emerging low-field systems (<1 T) cut equipment and operating costs and consume far less power, making them attractive for low- and middle-income countries (LMICs). We conducted a narrative review of human studies from LMICs that reported clinical, economic or environmental outcomes of low-field MRI, paying special attention to cardiovascular applications and implementation issues in Pakistan. Across included papers, low-field scanners lowered capital expenditure, energy consumption and siting requirements while maintaining diagnostic performance comparable to high-field units in several settings, notably musculoskeletal imaging and intra-operative guidance. Evidence for cardiovascular imaging remains scarce, and key barriers-lower spatial resolution, limited local expertise and infrastructure gaps-persist. Nonetheless, low-field MRI offers Pakistan a feasible, environmentally sustainable option for clinical imaging more broadly; direct evidence for cardiovascular applications, however, remains limited and largely indirect, so routine cardiovascular use will require dedicated validation and further technical refinement before it can be recommended.