PMID- 18844984
OWN - NLM
STAT- MEDLINE
DCOM- 20090122
LR  - 20240117
IS  - 1532-429X (Electronic)
IS  - 1097-6647 (Print)
IS  - 1097-6647 (Linking)
VI  - 10
IP  - 1
DP  - 2008 Oct 9
TI  - Dobutamine stress cardiovascular magnetic resonance at 3 Tesla.
PG  - 44
LID - 10.1186/1532-429X-10-44 [doi]
AB  - PURPOSE: The assessment of inducible wall motion abnormalities during high-dose 
      dobutamine-stress cardiovascular magnetic resonance (DCMR) is well established 
      for the identification of myocardial ischemia at 1.5 Tesla. Its feasibility at 
      higher field strengths has not been reported. The present study was performed to 
      prospectively determine the feasibility and diagnostic accuracy of DCMR at 3 
      Tesla for depicting hemodynamically significant coronary artery stenosis (> or = 
      50% diameter stenosis) in patients with suspected or known coronary artery 
      disease (CAD). MATERIALS AND METHODS: Thirty consecutive patients (6 women) (66 
      +/- 9.3 years) were scheduled for DCMR between January and May 2007 for detection 
      of coronary artery disease. Patients were examined with a Philips Achieva 3 Tesla 
      system (Philips Healthcare, Best, The Netherlands), using a spoiled gradient echo 
      cine sequence. Technical parameters were: spatial resolution 2 x 2 x 8 mm3, 30 
      heart phases, spoiled gradient echo TR/TE: 4.5/2.6 msec, flip angle 15 degrees . 
      Images were acquired at rest and stress in accordance with a standardized 
      high-dose dobutamine-atropine protocol during short breath-holds in three short 
      and three long-axis views. Dobutamine was administered using a standard protocol 
      (10 microg increments every 3 minutes up to 40 microg dobutamine/kg body 
      weight/minute plus atropine if required to reach target heart rate). The study 
      protocol included administration of 0.1 mmol/kg/body weight Gd-DTPA before the 
      cine images at rest were acquired to improve the image quality. The examination 
      was terminated if new or worsening wall-motion abnormalities or chest pain 
      occurred or when > 85% of age-predicted maximum heart rate was reached. 
      Myocardial ischemia was defined as new onset of wall-motion abnormality in at 
      least one segment. In addition, late gadolinium enhancement (LGE) was performed. 
      Images were evaluated by two blinded readers. Diagnostic accuracy was determined 
      with coronary angiography as the reference standard. Image quality and 
      wall-motion at rest and maximum stress level were evaluated using a four-point 
      scale. RESULTS: In 27 patients DCMR was performed successfully, no patient had to 
      be excluded due to insufficient image quality. Twenty-two patients were examined 
      by coronary angiography, which depicted significant stenosis in 68.2% of the 
      patients. Patient-based sensitivity and specificity were 80.0% and 85.7% 
      respectively and accuracy was 81.8%. Interobserver variability for assessment of 
      wall motion abnormalities was 88% (kappa = 0.760; p < 0.0001). Negative and 
      positive predictive values were 66.7% and 92.3%, respectively. No significant 
      differences in average image quality at rest versus stress for short or long-axis 
      cine images were found. CONCLUSION: High-dose DCMR at 3T is feasible and an 
      accurate method to depict significant coronary artery stenosis in patients with 
      suspected or known CAD.
FAU - Kelle, S
AU  - Kelle S
AD  - Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, 
      Germany. kelle@dhzb.de
FAU - Hamdan, A
AU  - Hamdan A
FAU - Schnackenburg, B
AU  - Schnackenburg B
FAU - Kohler, U
AU  - Kohler U
FAU - Klein, C
AU  - Klein C
FAU - Nagel, E
AU  - Nagel E
FAU - Fleck, E
AU  - Fleck E
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20081009
PL  - England
TA  - J Cardiovasc Magn Reson
JT  - Journal of cardiovascular magnetic resonance : official journal of the Society 
      for Cardiovascular Magnetic Resonance
JID - 9815616
RN  - 0 (Cardiotonic Agents)
RN  - 0 (Contrast Media)
RN  - 0 (Muscarinic Antagonists)
RN  - 3S12J47372 (Dobutamine)
RN  - 7C0697DR9I (Atropine)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
MH  - Aged
MH  - Atropine
MH  - *Cardiotonic Agents
MH  - Contrast Media
MH  - Coronary Angiography
MH  - *Coronary Circulation
MH  - Coronary Stenosis/*pathology/physiopathology
MH  - *Dobutamine
MH  - *Exercise Test
MH  - Feasibility Studies
MH  - Female
MH  - Gadolinium DTPA
MH  - Humans
MH  - *Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Middle Aged
MH  - Muscarinic Antagonists
MH  - Myocardium/*pathology
MH  - Observer Variation
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Sensitivity and Specificity
MH  - Severity of Illness Index
PMC - PMC2572055
EDAT- 2008/10/11 09:00
MHDA- 2009/01/23 09:00
PMCR- 2008/10/09
CRDT- 2008/10/11 09:00
PHST- 2008/05/28 00:00 [received]
PHST- 2008/10/09 00:00 [accepted]
PHST- 2008/10/11 09:00 [pubmed]
PHST- 2009/01/23 09:00 [medline]
PHST- 2008/10/11 09:00 [entrez]
PHST- 2008/10/09 00:00 [pmc-release]
AID - S1097-6647(23)01261-9 [pii]
AID - 1532-429X-10-44 [pii]
AID - 10.1186/1532-429X-10-44 [doi]
PST - epublish
SO  - J Cardiovasc Magn Reson. 2008 Oct 9;10(1):44. doi: 10.1186/1532-429X-10-44.