A Bi-Center Cardiovascular Magnetic Resonance Prognosis Study Focusing on Dobutamine Wall Motion and Late Gadolinium Enhancement in 3,138 Consecutive Patients

Kelle, Sebastian; Nagel, Eike; Voss, Andreas; Hofmann, Nina; Gitsioudis, Gitsios; Buss, Sebastian J.; Chiribiri, Amedeo; Wellnhofer, Ernst; Klein, Christoph; Schneeweis, Christopher; Egnell, Christina; Vierecke, Juliane; Berger, Alexander; Giannitsis, Evangelos; Fleck, Eckart; Katus, Hugo A.; Korosoglou, Grigorios

doi:10.1016/j.jacc.2013.02.063

Cited by 33 publications

(18 citation statements)

References 12 publications

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“…Our results in an obese population are in keeping with recent large reports in overall referral populations attesting to the prognostic role of stress CMR (22,23), suggesting the generalizability of standard perfusion techniques to obese patients. In a recent large study involving dobutamine stress CMR in 3,138 patients, Kelle et al (23) describe complementary prognostic information from wall motion abnormalities and LGE, though data on average BMI in this cohort was not provided.…”

Section: Discussionsupporting

confidence: 90%

Vasodilator Stress Perfusion CMR Imaging Is Feasible and Prognostic in Obese Patients

Shah

Heydari

Coelho‐Filho

et al. 2014

JACC: Cardiovascular Imaging

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Objectives This study sought to determine feasibility and prognostic performance of stress cardiac magnetic resonance (CMR) in obese patients (body mass index [BMI] ≥30 kg/m2). Background Current stress imaging methods remain limited in obese patients. Given the impact of the obesity epidemic on cardiovascular disease, alternative methods to effectively risk stratify obese patients are needed. Methods Consecutive patients with a BMI ≥30 kg/m2 referred for vasodilating stress CMR were followed for major adverse cardiovascular events (MACE), defined as cardiac death or nonfatal myocardial infarction. Univariable and multivariable Cox regressions for MACE were performed to determine the prognostic association of inducible ischemia or late gadolinium enhancement (LGE) by CMR beyond traditional clinical risk indexes. Results Of 285 obese patients, 272 (95%) completed the CMR protocol, and among these, 255 (94%) achieved diagnostic imaging quality. Mean BMI was 35.4 ± 4.8 kg/m2, with a maximum weight of 200 kg. Reasons for failure to complete CMR included claustrophobia (n = 4), intolerance to stress agent (n = 4), poor gating (n = 4), and declining participation (n = 1). Sedation was required in 19 patients (7%; 2 patients with intravenous sedation). Sixteen patients required scanning by a 70-cm-bore system (6%). Patients without inducible ischemia or LGE experienced a substantially lower annual rate of MACE (0.3% vs. 6.3% for those with ischemia and 6.7% for those with ischemia and LGE). Median follow-up of the cohort was 2.1 years. In a multivariable stepwise Cox regression including clinical characteristics and CMR indexes, inducible ischemia (hazard ratio 7.5; 95% confidence interval: 2.0 to 28.0; p = 0.002) remained independently associated with MACE. When patients with early coronary revascularization (within 90 days of CMR) were censored on the day of revascularization, both presence of inducible ischemia and ischemia extent per segment maintained a strong association with MACE. Conclusions Stress CMR is feasible and effective in prognosticating obese patients, with a very low negative event rate in patients without ischemia or infarction.

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Section: Discussionsupporting

confidence: 90%

Vasodilator Stress Perfusion CMR Imaging Is Feasible and Prognostic in Obese Patients

Shah

Heydari

Coelho‐Filho

et al. 2014

JACC: Cardiovascular Imaging

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“…However, limited echogenic windows and radiation exposure, respectively may limit the precision and serial applicability of these modalities. Cardiac magnetic resonance (CMR) imaging, on the other hand, is a non-invasive imaging technique that allows accurate assessment of myocardial function and viability with high spatial and temporal resolution and without radiation exposure for the patients [5][6][7][8]. Due to its tomographic nature, CMR allows for assessment of myocardial function and scar in identical myocardial slices, providing excellent reproducibility of the acquired results.…”

Section: Introductionmentioning

confidence: 99%

Prediction of functional recovery by cardiac magnetic resonance feature tracking imaging in first time ST-elevation myocardial infarction. Comparison to infarct size and transmurality by late gadolinium enhancement

Buss

Krautz

Hofmann

et al. 2015

International Journal of Cardiology

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“…In our previous work we were able to demonstrate by multivariable analysis that inducible wall motion abnormalities were independent predictors of hard cardiac events [4]. Differentiation according to varying BMI has not been performed so far.…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 94%

“…Our patient cohort consisted of 2585 consecutive patients with suspected or known CAD who were reported on in a previous study [4]. The study was conducted in accordance with the ethical standards defined by local law.…”

Section: To the Editormentioning

confidence: 99%

“…In general, written informed consent from patients was obtained before their inclusion in the study. Patients were examined in clinical 1.5-Tesla whole-body CMR scanners and wall motion abnormalities were assessed and interpreted as also described before [4]. Clinical follow-up data were collected by reviewing the clinical records or by phone interviews with either the patients or their primary physicians.…”

Section: To the Editormentioning

confidence: 99%

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BMI does not influence the prediction of cardiac events using stress CMR

Kelle

Giuşcă

Buss

et al. 2015

International Journal of Cardiology

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A Bi-Center Cardiovascular Magnetic Resonance Prognosis Study Focusing on Dobutamine Wall Motion and Late Gadolinium Enhancement in 3,138 Consecutive Patients

Cited by 33 publications

References 12 publications

Vasodilator Stress Perfusion CMR Imaging Is Feasible and Prognostic in Obese Patients

Vasodilator Stress Perfusion CMR Imaging Is Feasible and Prognostic in Obese Patients

Prediction of functional recovery by cardiac magnetic resonance feature tracking imaging in first time ST-elevation myocardial infarction. Comparison to infarct size and transmurality by late gadolinium enhancement

BMI does not influence the prediction of cardiac events using stress CMR

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