Disparity Between Dobutamine Stress and Physical Exercise Magnetic Resonance Imaging in Patients with an Intra-atrial Correction for Transposition of the Great Arteries

Oosterhof, Thomas; Tulevski, Igor I.; Roest, Arno A.W.; Steendijk, Paul; Vliegen, Hubert W.; Wall, Ernst E. van der; Roos, Albert de; Tijssen, Jan G.P.; Mulder, Barbara J.M.

doi:10.1081/jcmr-200053454

Cited by 46 publications

(51 citation statements)

References 23 publications

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“…However, minor side effects, such as headache, nausea, have been reported in up to 20% [4]. DCMR imaging has been combined with low-dose dobutamine stress-testing in patients with complex CHD in most studies [8][9][10][11][12][14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…Wall motion analysis is of lesser importance in this patient group with few coronary artery abnormalities. In several small studies abnormal stress responses of ventricular and vascular functions have been reported [8][9][10][11][12][13][14][15][16][17][18]. These abnormal stress responses are of special interest since they are potential surrogate markers related to primary endpoints relevant for the assessment of long-term outcome, such as death or functional impairment.…”

Section: Introductionmentioning

confidence: 99%

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Safety and observer variability of cardiac magnetic resonance imaging combined with low-dose dobutamine stress-testing in patients with complex congenital heart disease

Robbers‐Visser

Luijnenburg

Berg

et al. 2011

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Safety and observer variability of cardiac magnetic resonance imaging combined with low-dose dobutamine stress-testing in patients with complex congenital heart disease

Robbers‐Visser

Luijnenburg

Berg

et al. 2011

International Journal of Cardiology

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“…Care must be taken when comparing changes of ventricular and pulmonary vascular function induced by physical exercise with dobutamine stress. 30,32,42,43 Therefore, it would be inappropriate to directly translate our findings to exercise conditions. In addition, heart rate effects must be considered when interpreting our data of diastolic compliance.…”

Section: Limitationsmentioning

confidence: 99%

Pulmonary Vascular Resistance, Collateral Flow, and Ventricular Function in Patients With a Fontan Circulation at Rest and During Dobutamine Stress

Schmitt

Steendijk

Ovroutski

et al. 2010

Circ: Cardiovascular Imaging

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Background-The role, interplay, and relative importance of the multifactorial hemodynamic and myocardial mechanisms causing dysfunction of the Fontan circulation remain incompletely understood. Methods and Results-Using an MRI catheterization technique, we performed a differential analysis of pulmonary vascular resistance and aortopulmonary collateral blood flow in conjunction with global ventricular pump function, myocontractility (end-systolic pressure-volume relation), and diastolic compliance (end-diastolic pressure-volume relation) in 10 patients with a Fontan circulation at rest and during dobutamine stress. Pulmonary and ventricular pressures were measured invasively and synchronized with velocity-encoded MRI-derived pulmonary and aortic blood flows and cine MRI-derived ventricular volumes. Pulmonary vascular resistance and end-systolic and end-diastolic pressure-volume relations were then determined. Aortopulmonary collateral flow was calculated as the difference between aortic and pulmonary flow. Compared to rest, dobutamine caused a small increase in mean pulmonary pressures (PϽ0.05). Collateral flow was significantly augmented (PϽ0.001) and contributed importantly to an increase in pulmonary flow (PϽ0.01). Pulmonary vascular resistance decreased significantly (PϽ0.01). Dobutamine did not increase stroke volumes significantly despite slightly enhanced contractility (end-systolic pressure-volume relation). Active early relaxation () was inconspicuous, but the end-diastolic pressure-volume relation shifted upward, indicating reduced compliance. Conclusions-In patients with a Fontan circulation, aortopulmonary collateral flow contributes substantially to enhanced pulmonary flow during stress. Our data indicate that pulmonary vascular response to augmented cardiac output was adequate, but decreased diastolic compliance was identified as an important component of ventricular dysfunction. (Circ Cardiovasc Imaging. 2010;3:623-631.)

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“…Although feasible and reproducible for detection of wall motion abnormalities (3,4), it is not clear whether pharmacological stress mimics physiological exercise stress adequately. Biventricular response to pharmacological stress and physical exercise stress can differ significantly in some cardiac conditions (5,6). Therefore, establishment of an accurate and reliable cardiovascular MRI technique for biventricular volumetric assessment during physical exercise stress is desirable.…”

Section: Cardiovascular Magnetic Resonance Imag-ing (Mri)mentioning

confidence: 99%

Feasibility and reproducibility of biventricular volumetric assessment of cardiac function during exercise using real‐time radial k‐t SENSE magnetic resonance imaging

Lurz

Muthurangu

Schievano

et al. 2009

Magnetic Resonance Imaging

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Purpose:To assess the feasibility and reproducibility of real-time radial k-t sensitivity encoding (SENSE) magnetic resonance imaging (MRI) for biventricular volumetric assessment during exercise. Materials and Methods:In all, 12 healthy young adults underwent MRI at rest and during supine exercise at three different workload intensities. Biventricular volumes and function were assessed with 1) a radial k-t SENSE real-time sequence and 2) a scanner vendor supplied (standard) realtime sequence. Global image quality, motion fidelity, and agreement in right ventricular (RV) and left ventricular (LV) stroke volume (SV) as a surrogate measure for accuracy were assessed. Exercise MR was repeated within 1 month for assessment of reproducibility.Results: Imaging scores were superior for radial real-time k-t SENSE images (P Ͻ 0.001). Agreement in RV and LV SV during exercise was better with radial k-t real-time (SD of difference Ϯ3.43 vs. Ϯ8.97 mL; P Ͻ 0.001). Agreement in cardiac output (CO) in the same subject at two different imaging sessions was better for radial k-t SENSE. This was significant for the CO calculated for the RV (SD of difference Ϯ0.6 vs. Ϯ0.95 L/min; P ϭ 0.01) and LV (Ϯ0.45 vs. Ϯ0.92 L/min; P Ͻ 0.001). Conclusion:Radial k-t SENSE real-time imaging represents a feasible and reproducible imaging technique for biventricular assessment during exercise.

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Disparity Between Dobutamine Stress and Physical Exercise Magnetic Resonance Imaging in Patients with an Intra-atrial Correction for Transposition of the Great Arteries

Abstract: Dobutamine stress and physical exercise cannot be used interchangeably for assessment of systolic and diastolic function in patients with an intra-atrial correction for TGA. This may have consequences for the use of different stress CMR approaches in the clinical setting.

Cited by 46 publications

References 23 publications

Safety and observer variability of cardiac magnetic resonance imaging combined with low-dose dobutamine stress-testing in patients with complex congenital heart disease

Safety and observer variability of cardiac magnetic resonance imaging combined with low-dose dobutamine stress-testing in patients with complex congenital heart disease

Pulmonary Vascular Resistance, Collateral Flow, and Ventricular Function in Patients With a Fontan Circulation at Rest and During Dobutamine Stress

Feasibility and reproducibility of biventricular volumetric assessment of cardiac function during exercise using real‐time radial k‐t SENSE magnetic resonance imaging

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