Stress Cardiac MR Imaging

Sayari, Saeed Al; Kopp, Sebastién; Bremerich, Jens

doi:10.1016/j.rcl.2014.11.006

Cited by 9 publications

(3 citation statements)

References 59 publications

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“…Moreover, cardiac MR (CMR) imaging for ischemic heart disease is routinely performed with pharmacological stressors, which might increase the incidence of acute adverse events in general, and GBCA-related acute adverse events in specific [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Acute adverse events in cardiac MR imaging with gadolinium-based contrast agents: results from the European Society of Cardiovascular Radiology (ESCR) MRCT Registry in 72,839 patients

Contributors¹,

Uhlig²,

Luecke

et al. 2019

Eur Radiol

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Objectives To assess the incidence of acute adverse events (AAEs) in gadolinium-enhanced cardiac magnetic resonance (CMR) imaging. Methods Gadolinium-based contrast agent (GBCA)–enhanced CMR data from the multinational, multicenter European Society of Cardiovascular Radiology MRCT Registry was included. AAE severity was classified according to the American College of Radiology Manual on Contrast Media (mild, moderate, severe). Multivariable generalized linear mixed effect models were used to assess the likelihood of AAEs in various GBCA, adjusting for pharmacological stressor, main indications (i.e., suspected or known coronary artery disease or myocarditis), age, sex, and submitting center as a random effect. Results In the study population of 72,839 GBCA-enhanced CMRs, a total of 260 AAEs were reported (0.36%), with a minority of severe AAEs ( n = 24, 0.033%). Allergic-like AAEs were less likely than physiologic AAEs (29% versus 71%). Patients without pharmacological stress imaging had a lower AAE rate (0.22%) compared to stress imaging (0.75%), with the highest AAE rates for regadenoson (2.95%). AAE rates also varied by GBCA subtype (overall p < 0.001). There was significant interaction between GBCA and pharmacological stressor (interaction p = 0.025), with AAE rates ranging between 0 and 10% for certain GBCA/stressor combinations. There was further marginal evidence that higher GBCA volume was associated with higher AAE incidence (OR = 1.02, p = 0.05). Conclusion GBCA-enhanced CMR imaging demonstrates low AAE rates comparable to those of other body regions. AAE likelihood correlates with GBCA subtype, pharmacological stressor, and imaging indication. Intravenous fluid administration in patients with cardiac impairment might contribute to these findings. Key Points • Acute adverse event rates in cardiac magnetic resonance (CMR) imaging with gadolinium-based contrast agents (GBCAs) are low (0.36%), especially for severe adverse events (0.033%). • Mild and moderate adverse events are more frequent during stress CMR imaging. • Physiologic AAEs are more common than allergic AAEs in CMR imaging. Electronic supplementary material The online version of this article (10.1007/s00330-019-06171-2) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Acute adverse events in cardiac MR imaging with gadolinium-based contrast agents: results from the European Society of Cardiovascular Radiology (ESCR) MRCT Registry in 72,839 patients

Contributors¹,

Uhlig²,

Luecke

et al. 2019

Eur Radiol

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“…11,12 Notably, stress-MRI has higher accuracy than other myocardial stress imaging techniques. 13,14 In addition, advances in quantitative myocardial perfusion techniques now allow myocardial blood flow (MBF) and myocardial perfusion reserve (MPR) to be quantified at the pixel level and to be evaluated by the blood flow per gram of myocardium per minute. 15,16 Patients with CTO have varying degrees of myocardial dysfunction, myocardial ischemia, and scarring.…”

mentioning

confidence: 99%

“…Stress‐MRI identifies ischemic myocardium by detecting reduced myocardial perfusion caused by the loss of the reserve capacity of vascular regulation in stenotic vessels during maximal hyperemia 11,12 . Notably, stress‐MRI has higher accuracy than other myocardial stress imaging techniques 13,14 . In addition, advances in quantitative myocardial perfusion techniques now allow myocardial blood flow (MBF) and myocardial perfusion reserve (MPR) to be quantified at the pixel level and to be evaluated by the blood flow per gram of myocardium per minute 15,16 …”

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confidence: 99%

Assessment of Myocardial Viability and Risk Stratification in Coronary Chronic Total Occlusion: A Qualitative and Quantitative Stress Cardiac MRI Study

Jiang

Chen

Yang

et al. 2023

Magnetic Resonance Imaging

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BackgroundIndicators for assessing myocardial viability and risk stratification in patients with coronary chronic total occlusion (CTO) are still in the research stage.PurposeTo use stress‐MRI to assess myocardial function, blood perfusion, and viability and to explore their relationship with collateral circulation.Study TypeProspective.SubjectsFifty‐one patients with CTO in at least one major artery confirmed by X‐ray coronary angiography (male: 46; age 55.2 ± 10.8 years).Field Strength/Sequence3.0T; TurboFlash, balanced steady‐state free precession cine, and phase‐sensitive inversion recovery sequences.AssessmentStress‐MRI was used to obtain qualitative and quantitative parameters of segmental myocardium. Myocardial segments supplied by CTO target vessels were grouped according to the degree of collateral circulation assessed by radiographic coronary angiography (no/mild, moderate, or good). Depending on qualitative stress perfusion assessment and late gadolinium enhancement (LGE) extent, segments were also categorized as negative, viable, or trans‐infarcted.Statistical TestsIndependent sample Student's t‐test, one‐way analysis of variance (ANOVA) test, Mann–Whitney U test, Kruskal–Wallis test, Spearman correlation coefficient (r). P < 0.05 was considered statistically significant.ResultsA total of 334 segments were supplied by CTO target vessels. The radial strain (RS), circumferential strain (CS), longitudinal strain (LS) of the negative, viable, and trans‐infarcted regions showed a significant and stepwise impairment. Myocardial blood flow at rest was positively correlated with RS, CS, and LS (r = 0.42, 0.43, 0.38, respectively). Among the different collateral circulation, there were no significant differences in RS, CS, LS, and LGE volume (P = 0.788, 0.562, 0.122, 0.170, respectively), and there were also no statistically significant differences in the proportions of negative, viable, and trans‐infarcted regions (P = 0.372).Data ConclusionMyocardial perfusion obtained by stress‐MRI combined with strain and LGE may comprehensively evaluate myocardial function and viability, and has potential to facilitate risk stratification of CTO.Evidence Level2Technical EfficacyStage 1

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