PMID- 17309909
OWN - NLM
STAT- MEDLINE
DCOM- 20071126
LR  - 20220331
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Print)
IS  - 1355-6037 (Linking)
VI  - 93
IP  - 11
DP  - 2007 Nov
TI  - Safety and diagnostic accuracy of stress cardiac magnetic resonance imaging vs 
      exercise tolerance testing early after acute ST elevation myocardial infarction.
PG  - 1363-8
AB  - OBJECTIVE: To determine the safety and diagnostic accuracy of adenosine-stress 
      cardiac magnetic resonance (CMR) perfusion imaging early after acute ST elevation 
      myocardial infarction (STEMI) compared with standard exercise tolerance testing 
      (ETT). DESIGN AND SETTING: Cross sectional observational study in a university 
      teaching hospital. PATIENTS: 35 patients admitted with first acute STEMI. 
      INTERVENTIONS: All patients underwent a CMR imaging protocol which included rest 
      and adenosine-stress perfusion, viability, and cardiac functional assessment. All 
      patients also had an ETT (modified Bruce protocol) and x ray coronary 
      angiography. MAIN OUTCOME MEASURES: Safety and diagnostic accuracy of 
      adenosine-stress perfusion CMR vs ETT early after STEMI in identifying patients 
      with significant coronary stenosis (>or=70%) and the need for coronary 
      revascularisation. Also, to determine if CMR can distinguish between ischaemia in 
      the peri-infarct zone and ischaemia in remote myocardium. RESULTS: CMR imaging 
      was well tolerated (all patients completed the protocol) and no complications 
      occurred. CMR was more sensitive (86% vs 48%, p = 0.0074) and more specific than 
      ETT (100% vs 50%, p<0.0001) for detecting significant coronary stenosis, and more 
      sensitive for predicting revascularisation (94% vs 56%, p = 0.039). Inducible 
      ischaemia in the infarct related artery territory was seen in 21 of 35 patients 
      and was associated with smaller infarct size and less transmurality of 
      infarction. CONCLUSIONS: Adenosine-stress CMR imaging is safe early after acute 
      STEMI and identifies patients with significant coronary stenosis more accurately 
      than ETT.
FAU - Greenwood, J P
AU  - Greenwood JP
AD  - Academic Unit of Cardiovascular Medicine, G-floor, Jubilee Wing, Leeds General 
      Infirmary, Great George Street, Leeds LS1 3EX, UK. j.greenwood@leeds.ac.uk
FAU - Younger, J F
AU  - Younger JF
FAU - Ridgway, J P
AU  - Ridgway JP
FAU - Sivananthan, M U
AU  - Sivananthan MU
FAU - Ball, S G
AU  - Ball SG
FAU - Plein, S
AU  - Plein S
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
DEP - 20070219
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
RN  - K72T3FS567 (Adenosine)
SB  - IM
MH  - Adenosine
MH  - Aged
MH  - Coronary Angiography
MH  - Coronary Stenosis/diagnosis/therapy
MH  - Cross-Sectional Studies
MH  - Electrocardiography
MH  - Exercise Test/methods
MH  - Exercise Tolerance
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging/adverse effects/methods
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*diagnosis/physiopathology/therapy
MH  - Myocardial Revascularization
MH  - Patient Selection
PMC - PMC2016919
COIS- Competing interests: None declared.
EDAT- 2007/02/21 09:00
MHDA- 2007/12/06 09:00
PMCR- 2010/11/01
CRDT- 2007/02/21 09:00
PHST- 2007/02/21 09:00 [pubmed]
PHST- 2007/12/06 09:00 [medline]
PHST- 2007/02/21 09:00 [entrez]
PHST- 2010/11/01 00:00 [pmc-release]
AID - hrt.2006.106427 [pii]
AID - ht106427 [pii]
AID - 10.1136/hrt.2006.106427 [doi]
PST - ppublish
SO  - Heart. 2007 Nov;93(11):1363-8. doi: 10.1136/hrt.2006.106427. Epub 2007 Feb 19.