European Radiology

, Volume 16, Issue 12, pp 2728–2738 | Cite as

Cardiac stress MR imaging with dobutamine

  • K. Strach
  • C. Meyer
  • H. Schild
  • T. SommerEmail author


Stress testing for detection of ischemia-induced wall-motion abnormalities has become a mainstay for noninvasive diagnosis and risk stratification of patients with suspected coronary artery disease (CAD). Recent technical developments in magnetic resonance imaging (MRI), including the adoption of balanced steady-state free precession (b-SSFP) sequences—preferentially in combination with parallel imaging techniques—have led to a significant reduction of imaging time and improved patient safety. The stress protocol includes application of high-dose dobutamine (up to 40 μg/kg/min) combined with fractionated atropine (up to a maximal dose of 1.0 mg). High-dose dobutamine stress MRI revealed good sensitivity (83–96%) and specificity (80–100%) for detection of significant CAD. Myocardial tagging methods have been shown to further increase sensitivity for CAD detection. Severe complications (sustained tachycardia, ventricular fibrillation, myocardial infarction, cardiogenic shock) are rare but may be expected in 0.1–0.3% of patients. Dobutamine stress MRI has emerged as a reliable and safe clinical alternative for noninvasive assessment of CAD. New pulse sequences, such as real-time imaging, might obviate the need for breath holding and electrocardiogram (ECG) triggering in patients with severe dyspnoea and cardiac arrhythmias, which may further improve the clinical impact and acceptance of stress MRI in the future.


Heart Ischemia Magnetic resonance (MR) Cine study Dobutamine stress testing 



The authors thank Harold Litt, MD and Adam Bernstein, MD for helpful discussions and advice.


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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  1. 1.Department of RadiologyUniversity of BonnBonnGermany

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