Dobutamine Cardiovascular Magnetic Resonance for the Detection of Myocardial Ischemia With the Use of Myocardial Tagging

Kuijpers, Dirkjan; Ho, Kai Yiu J.A.M.; Dijkman, Paul R. M. van; Vliegenthart, Rozemarijn; Oudkerk, Matthijs

doi:10.1161/01.cir.0000060544.41744.7c

Cited by 157 publications

(111 citation statements)

References 26 publications

(31 reference statements)

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“…Our study has shown the feasibility of a high-dose dobutamine stress tagging protocol at 3 T. In addition, myocardial tagging increased the sensitivity for detection of significant CAD (14/16 true-positive cases by SPAMM-GRE vs 13/16 by sGRE alone) and allowed for the detection of WMAs at a lower stress level in 3 patients. In the study by Kuijpers et al [23], the impact of tagging on the detection of WMAs under dobutamine stress was comparable (68 patients identified with tagging vs 58 patients without) with our study. However, Kuijpers et al did not report the maximum dobutamine dose at which the WMAs were detected by either the sGRE sequence or the SPAMM-GRE sequence.…”

Section: Diagnostic Performancesupporting

confidence: 86%

Dobutamine stress tagging and gradient-echo imaging for detection of coronary heart disease at 3 T

Thomas

Meyer²,

Strach³

et al. 2011

BJR

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Objective: The purpose of this study was to evaluate the feasibility and diagnostic accuracy of a combined spoiled gradient-echo (sGRE) and tagged gradient-echo (SPAMM-GRE) protocol for detection of coronary artery disease (CAD) during high-dose dobutamine stress at 3 T. Method: The study protocol was approved by the local ethics committee. For stress testing, a standard high-dose dobutamine protocol was employed. Image quality at the highest stress level and diagnostic accuracy of the sGRE and SPAMM-GRE sequences were comparedThe final study population consisted of 37 patients. Results: The mean image quality score was 2.6¡0.6 for the sGRE sequence and 2.4¡0.6 for the SPAMM-GRE sequence (p.0.05). Sensitivity, specificity and diagnostic accuracy were 0.81, 0.86, 0.84 and 0.88, 0.86, 0.86 for the sGRE and SPAMM-GRE, respectively. In three cases with new wall motion abnormalities (WMAs), detected by sGRE and SPAMM-GRE, WMAs were detected at a lower stress level by tagging. Conclusion:The combined sGRE and SPAMM-GRE high-dose dobutamine protocol at 3 T is feasible and delivers good diagnostic accuracy. Tagging increases the sensitivity of high-dose dobutamine stress testing for detection of CAD and may allow for detection of new WMAs at lower stress levels compared with sGRE alone.

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Section: Diagnostic Performancesupporting

confidence: 86%

Dobutamine stress tagging and gradient-echo imaging for detection of coronary heart disease at 3 T

Thomas

Meyer²,

Strach³

et al. 2011

BJR

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“…13 Currently, tagged MR offers a reproducible measure of regional myocardial strain that can be used for a detailed analysis of regional ventricular function with high spatial resolution and accuracy. 14, 15 Adenosine triphosphate (ATP) induces hyperemia in normal coronary arteries and relative hypoperfusion in stenotic coronary arteries. Its effect on myocardial wall motion has been studied, 16 but the effect on myocardial strain has not been elucidated quantitatively by tagged MR and has not been used ardiovascular magnetic resonance (CMR) is a valuable imaging modality that can be used to investigate ventricular function, myocardial perfusion, viability, and coronary artery anatomy during a single examination, without radiation exposure.…”

mentioning

confidence: 99%

Stress/Rest Circumferential Strain in Non-Ischemia, Ischemia, and Infarction

Nagao

Kido

Kurata

et al. 2013

Circ J

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Background: Adenosine triphosphate (ATP) induces relative hypoperfusion in significantly stenotic coronary arteries, but its effect on myocardial strain has not been used clinically for the detection of ischemia. The purpose of this study was to quantify ATP-stress-induced contractile impairment as altered myocardial strain in coronary artery disease (CAD) using tagged magnetic resonance (MR) and to evaluate its diagnostic capability in comparison with ATP-stress myocardial perfusion-MR. Methods and Results:Tagged MR and perfusion-MR under ATP-stress and rest conditions and late gadolinium enhancement (LGE) MR imaging were performed in 22 patients with suspected CAD. The peak absolute value of the circumferential strain (C-strain) was measured in 12 segments. Myocardial segments were categorized as nonischemic (n=201), ischemic (n=42), or infarcted (n=21) according to the perfusion-MR and LGE MR imaging results. The absolute C-strain was significantly greater under ATP-stress (19±13%) (mean ± SD) than under at-rest (15±11%, P<0.001) conditions in non-ischemic segments. Conversely, the absolute C-strain was significantly lower under ATP-stress (10±13%) than under at-rest (16±6%, P<0.01) conditions in ischemic segments. Optimal cutoff values for stress C-strain (-17.5%) could successfully differentiate segments with ischemia or infarction from non-ischemic ones with a sensitivity of 86%, a specificity of 65%, and an area under the curve of 0.79. Conclusions:C-strain analysis using tagged MR could detect ATP-stress-induced contractile impairment in ischemic myocardium. (Circ J 2013; 77: 1235 -1241

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“…A radiofrequency (RF) prepulse labels the myocardium with dark grids, and enables detailed analysis of rotation, shortening, and strain of regional myocardium (11,12). Myocardial tagged MRI with strain quantification allows for more accurate assessment of regional wall motion abnormality compared to a wall-thickening analysis on cine MRI without tagging (13,14). A recent study by Bree et al (15) demonstrated that 3D strain analysis of low-dose dobutamine stress tagged MRI can provide precise identification, quantification, and display of regionally varying ventricular function in patients with ischemic cardiomyopathies.…”

Section: Mr Assessment Of Cardiac Functionmentioning

confidence: 99%

Magnetic resonance imaging for ischemic heart disease

Sakuma

2007

Magnetic Resonance Imaging

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Cardiac MRI has long been recognized as an accurate and reliable means of evaluating cardiac anatomy and ventricular function. Considerable progress has been made in the field of cardiac MRI, and cardiac MRI can provide accurate evaluation of myocardial ischemia and infarction (MI). Late gadolinium (Gd)-enhanced MRI can clearly delineate subendocardial infarction, and the assessment of transmural extent of infarction on late enhanced MRI has been shown to be useful in predicting functional recovery of dysfunctional myocardium in patients after MI. Stress first-pass contrast-enhanced (CE) myocardial perfusion MRI can be used to detect subendocardial ischemia, and recent studies have demonstrated the high diagnostic accuracy of stress myocardial perfusion MRI for detecting significant coronary artery disease (CAD). Free-breathing, whole-heart coronary MR angiography (MRA) was recently introduced as a method that can provide visualization of all three major coronary arteries within a single three-dimensional (3D) acquisition. With further improvements in MRI techniques and the establishment of a standardized study protocol, cardiac MRI will play a pivotal role in managing patients with ischemic heart disease.

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Dobutamine Cardiovascular Magnetic Resonance for the Detection of Myocardial Ischemia With the Use of Myocardial Tagging

Cited by 157 publications

References 26 publications

Dobutamine stress tagging and gradient-echo imaging for detection of coronary heart disease at 3 T

Dobutamine stress tagging and gradient-echo imaging for detection of coronary heart disease at 3 T

Stress/Rest Circumferential Strain in Non-Ischemia, Ischemia, and Infarction

Magnetic resonance imaging for ischemic heart disease

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