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Update on Dobutamine Stress Magnetic Resonance

  • Cardiac Magnetic Resonance (E Nagel, Section Editor)
  • Published:
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Abstract

Over the past years dobutamine stress magnetic resonance imaging (DSMR) has matured into a highly valuable clinical tool for the assessment of myocardial ischemia and viability. Furthermore, the results of DSMR can be utilized to direct clinical management and to determine cardiac prognosis. This article gives an update on recently published data regarding the performance of DSMR including technical developments, diagnostic accuracy, prognosis, and the implications on clinical management in patients with coronary artery disease (CAD).

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Pennell DJ. Cardiovascular magnetic resonance. Circulation. 2010;121:692–705.

    Article  PubMed  Google Scholar 

  2. • Hundley WG, Bluemke DA, Finn JP, et al. ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. Circulation. 2010;121:2462–508. A recent expert consensus document on CMR endorsed by major societies.

    Article  PubMed  Google Scholar 

  3. Hundley WG, Hamilton CA, Thomas MS, et al. Utility of fast cine magnetic resonance imaging and display for the detection of myocardial ischemia in patients not well suited for second harmonic stress echocardiography. Circulation. 1999;100:1697–702.

    PubMed  CAS  Google Scholar 

  4. Hundley WG, Morgan TM, Neagle CM, et al. Magnetic resonance imaging determination of cardiac prognosis. Circulation. 2002;106:2328–33.

    Article  PubMed  Google Scholar 

  5. • Jahnke C, Nagel E, Gebker R, et al. Prognostic value of cardiac magnetic resonance stress tests: adenosine stress perfusion and dobutamine stress wall motion imaging. Circulation. 2007;115:1769–76. This study compares the prognostic value of adenosine stress perfusion and DSMR in the same patient population.

    Article  PubMed  Google Scholar 

  6. Nagel E, Lehmkuhl HB, Bocksch W, et al. Noninvasive diagnosis of ischemia-induced wall motion abnormalities with the use of high-dose dobutamine stress MRI: comparison with dobutamine stress echocardiography. Circulation. 1999;99:763–70.

    PubMed  CAS  Google Scholar 

  7. Paetsch I, Jahnke C, Wahl A, et al. Comparison of dobutamine stress magnetic resonance, adenosine stress magnetic resonance, and adenosine stress magnetic resonance perfusion. Circulation. 2004;110:835–42.

    Article  PubMed  CAS  Google Scholar 

  8. Wellnhofer E, Olariu A, Klein C, et al. Magnetic resonance low-dose dobutamine test is superior to SCAR quantification for the prediction of functional recovery. Circulation. 2004;109:2172–4.

    Article  PubMed  Google Scholar 

  9. Kozerke S, Tsao J, Razavi R, et al. Accelerating cardiac cine 3D imaging using k-t BLAST. Magn Reson Med. 2004;52:19–26.

    Article  PubMed  Google Scholar 

  10. Tsao J, Boesiger P, Pruessmann KP. k-t BLAST and k-t SENSE: dynamic MRI with high frame rate exploiting spatiotemporal correlations. Magn Reson Med. 2003;50:1031–42.

    Article  PubMed  Google Scholar 

  11. Tsao J, Kozerke S, Boesiger P, et al. Optimizing spatiotemporal sampling for k-t BLAST and k-t SENSE: application to high-resolution real-time cardiac steady-state free precession. Magn Reson Med. 2005;53:1372–82.

    Article  PubMed  Google Scholar 

  12. Jahnke C, Paetsch I, Gebker R, et al. Accelerated 4D dobutamine stress MR imaging with k-t BLAST: feasibility and diagnostic performance. Radiology. 2006;241:718–28.

    Article  PubMed  Google Scholar 

  13. Paetsch I, Jahnke C, Ferrari VA, et al. Determination of interobserver variability for identifying inducible left ventricular wall motion abnormalities during dobutamine stress magnetic resonance imaging. Eur Heart J. 2006;27:1459–64.

    Article  PubMed  Google Scholar 

  14. Kuijpers D, Ho KY, van Dijkman PR, et al. Dobutamine cardiovascular magnetic resonance for the detection of myocardial ischemia with the use of myocardial tagging. Circulation. 2003;107:1592–7.

    Article  PubMed  Google Scholar 

  15. Garot J, Bluemke DA, Osman NF, et al. Fast determination of regional myocardial strain fields from tagged cardiac images using harmonic phase MRI. Circulation. 2000;101:981–8.

    PubMed  CAS  Google Scholar 

  16. Aletras AH, Ding S, Balaban RS, et al. DENSE: displacement encoding with stimulated echoes in cardiac functional MRI. J Magn Reson. 1999;137:247–52.

    Article  PubMed  CAS  Google Scholar 

  17. Kim D, Gilson WD, Kramer CM, et al. Myocardial tissue tracking with two-dimensional cine displacement-encoded MR imaging: development and initial evaluation. Radiology. 2004;230:862–71.

    Article  PubMed  Google Scholar 

  18. Pan L, Stuber M, Kraitchman DL, et al. Real-time imaging of regional myocardial function using fast-SENC. Magn Reson Med. 2006;55:386–95.

    Article  PubMed  Google Scholar 

  19. Kraitchman DL, Sampath S, Castillo E, et al. Quantitative ischemia detection during cardiac magnetic resonance stress testing by use of FastHARP. Circulation. 2003;107:2025–30.

    Article  PubMed  Google Scholar 

  20. Korosoglou G, Futterer S, Humpert PM, et al. Strain-encoded cardiac MR during high-dose dobutamine stress testing: comparison to cine imaging and to myocardial tagging. J Magn Reson Imaging. 2009;29:1053–61.

    Article  PubMed  Google Scholar 

  21. Hor KN, Gottliebson WM, Carson C, et al. Comparison of magnetic resonance feature tracking for strain calculation with harmonic phase imaging analysis. JACC Cardiovasc Imaging. 2010;3:144–51.

    Article  PubMed  Google Scholar 

  22. Kelle S, Hamdan A, Schnackenburg B, et al. Dobutamine stress cardiovascular magnetic resonance at 3 Tesla. J Cardiovasc Magn Reson. 2008;10:44.

    Article  PubMed  CAS  Google Scholar 

  23. Strach K, Müller A, Kouwenhoven M, et al. Feasibility of high-dose dobutamine stress SSFP cine MRI at 3 Tesla with patient adaptive local RF shimming using dual-source RF transmission: initial results. J Cardiovasc Magn Reson. 2011:P101.

  24. Mieres JH, Shaw LJ, Arai A, et al. Role of noninvasive testing in the clinical evaluation of women with suspected coronary artery disease: Consensus statement from the Cardiac Imaging Committee, Council on Clinical Cardiology, and the Cardiovascular Imaging and Intervention Committee, Council on Cardiovascular Radiology and Intervention, American Heart Association. Circulation. 2005;111:682–96.

    Article  PubMed  Google Scholar 

  25. Botvinick EH. Breast attenuation artifacts in Tl-201 scintigraphy. Radiology. 1988;168:878–9.

    PubMed  CAS  Google Scholar 

  26. Geleijnse ML, Fioretti PM, Roelandt JR. Methodology, feasibility, safety and diagnostic accuracy of dobutamine stress echocardiography. J Am Coll Cardiol. 1997;30:595–606.

    Article  PubMed  CAS  Google Scholar 

  27. Gebker R, Jahnke C, Hucko T, et al. Dobutamine stress magnetic resonance imaging for the detection of coronary artery disease in women. Heart. 2010;96:616–20.

    Article  PubMed  CAS  Google Scholar 

  28. Nesto RW, Kowalchuk GJ. The ischemic cascade: temporal sequence of hemodynamic, electrocardiographic and symptomatic expressions of ischemia. Am J Cardiol. 1987;59:23C–30C.

    Article  PubMed  CAS  Google Scholar 

  29. Lubbers DD, Janssen CH, Kuijpers D, et al. The additional value of first pass myocardial perfusion imaging during peak dose of dobutamine stress cardiac MRI for the detection of myocardial ischemia. Int J Cardiovasc Imaging. 2008;24:69–76.

    Article  PubMed  Google Scholar 

  30. Gebker R, Jahnke C, Manka R, et al. Additional value of myocardial perfusion imaging during dobutamine stress magnetic resonance for the assessment of coronary artery disease. Circ Cardiovasc Imaging. 2008;1:122–30.

    Article  PubMed  Google Scholar 

  31. Gebker R, Frick M, Jahnke C, et al. Value of additional myocardial perfusion imaging during dobutamine stress magnetic resonance for the assessment of intermediate coronary artery disease. Int J Cardiovasc Imaging. 2010.

  32. Di Bella EV, Parker DL, Sinusas AJ. On the dark rim artifact in dynamic contrast-enhanced MRI myocardial perfusion studies. Magn Reson Med. 2005;54:1295–9.

    Article  PubMed  Google Scholar 

  33. Gebker R, Jahnke C, Manka R, et al. High spatial resolution myocardial perfusion imaging during high dose dobutamine/atropine stress magnetic resonance using k-t SENSE. Int J Cardiol. 2011.

  34. Manka R, Jahnke C, Gebker R, et al. Head-to-head comparison of first-pass MR perfusion imaging during adenosine and high-dose dobutamine/atropine stress. Int J Cardiovasc Imaging. 2010.

  35. • Gebker R, Mirelis JG, Jahnke C, et al. Influence of left ventricular hypertrophy and geometry on diagnostic accuracy of wall motion and perfusion magnetic resonance during dobutamine stress. Circ Cardiovasc Imaging. 2010;3:507–14. Demonstrates the influence of LVH and geometric patterns on the diagnostic accuracy of DSMR with and without additional perfusion imaging.

    Article  PubMed  Google Scholar 

  36. Kelle S, Chiribiri A, Vierecke J, et al. Long-term prognostic value of dobutamine stress CMR. JACC Cardiovasc Imaging. 2011;4:161–72.

    Article  PubMed  Google Scholar 

  37. Charoenpanichkit C, Little WC, Mandapaka S, et al. Impaired left ventricular stroke volume reserve during clinical dobutamine stress predicts future episodes of pulmonary edema. J Am Coll Cardiol. 2011;57:839–48.

    Article  PubMed  Google Scholar 

  38. Wallace EL, Morgan TM, Walsh TF, et al. Dobutamine cardiac magnetic resonance results predict cardiac prognosis in women with known or suspected ischemic heart disease. JACC Cardiovasc Imaging. 2009;2:299–307.

    Article  PubMed  Google Scholar 

  39. Jahnke C, Furundzija V, Gebker R, et al. Gender-based prognostic value of pharmacological cardiac magnetic resonance stress testing: head-to-head comparison of adenosine perfusion and dobutamine wall motion imaging. Int J Cardiovasc Imaging. 2011.

  40. • Dall’Armellina E, Morgan TM, Mandapaka S, et al. Prediction of cardiac events in patients with reduced left ventricular ejection fraction with dobutamine cardiovascular magnetic resonance assessment of wall motion score index. J Am Coll Cardiol. 2008;52:279–86. Identifies the limitation of DSMR to predict prognosis in patients with an LVEF <40%.

    Article  PubMed  Google Scholar 

  41. Smart SC, Knickelbine T, Malik F, et al. Dobutamine-atropine stress echocardiography for the detection of coronary artery disease in patients with left ventricular hypertrophy. Importance of chamber size and systolic wall stress. Circulation. 2000;101:258–63.

    PubMed  CAS  Google Scholar 

  42. Walsh TF, Dall’Armellina E, Chughtai H, et al. Adverse effect of increased left ventricular wall thickness on 5 year outcomes of patients with negative dobutamine stress. J Cardiovasc Magn Reson. 2009;11:25.

    Article  PubMed  Google Scholar 

  43. • Charoenpanichkit C, Morgan TM, Hamilton CA, et al. Left ventricular hypertrophy influences cardiac prognosis in patients undergoing dobutamine cardiac stress testing. Circ Cardiovasc Imaging. 2010;3:392–7. LVH was shown to be an independent prognostic marker over and above ischemia during DSMR.

    Article  PubMed  Google Scholar 

  44. • Korosoglou G, Elhmidi Y, Steen H, et al. Prognostic value of high-dose dobutamine stress magnetic resonance imaging in 1,493 consecutive patients: assessment of myocardial wall motion and perfusion. J Am Coll Cardiol. 2010;56:1225–34. A large single-center study on the complementary prognostic value of wall motion and perfusion imaging during DSMR.

    Article  PubMed  CAS  Google Scholar 

  45. Korosoglou G, Lehrke S, Wochele A, et al. Strain-encoded CMR for the detection of inducible ischemia during intermediate stress. JACC Cardiovasc Imaging. 2010;3:361–71.

    Article  PubMed  Google Scholar 

  46. Korosoglou G, Lossnitzer D, Schellberg D, et al. Strain-encoded cardiac MRI as an adjunct for dobutamine stress testing: incremental value to conventional wall motion analysis. Circ Cardiovasc Imaging. 2009;2:132–40.

    Article  PubMed  Google Scholar 

  47. • Korosoglou G, Gitsioudis G, Voss A, et al. Strain-encoded cardiac magnetic resonance during high-dose dobutamine stress testing for the estimation of cardiac outcomes comparison to clinical parameters and conventional wall motion readings. J Am Coll Cardiol. 2011;58:1140–49. This study demonstrates the added value of imaging strain during DSMR for prognostication.

    Article  PubMed  CAS  Google Scholar 

  48. • Gebker R, Jahnke C, Manka R, et al. The role of dobutamine stress cardiovascular magnetic resonance in the clinical management of patients with suspected and known coronary artery disease. J Cardiovasc Magn Reson. 2011;13:46. DSMR proved useful as an arbiter for clinical decision making with regard to invasive versus medical treatment.

    Article  PubMed  Google Scholar 

  49. Wahl A, Paetsch I, Gollesch A, et al. Safety and feasibility of high-dose dobutamine-atropine stress cardiovascular magnetic resonance for diagnosis of myocardial ischaemia: experience in 1000 consecutive cases. Eur Heart J. 2004;25:1230–6.

    Article  PubMed  Google Scholar 

  50. Shaw LJ, Berman DS, Maron DJ, et al. Optimal medical therapy with or without percutaneous coronary intervention to reduce ischemic burden: results from the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial nuclear substudy. Circulation. 2008;117:1283–91.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. German Heart Institute, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Alexander Berger, Eckart Fleck & Rolf Gebker

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  1. Alexander Berger
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  3. Rolf Gebker
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Correspondence to Rolf Gebker.

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Berger, A., Fleck, E. & Gebker, R. Update on Dobutamine Stress Magnetic Resonance. Curr Cardiovasc Imaging Rep 5, 116–125 (2012). https://doi.org/10.1007/s12410-012-9126-8

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  • DOI: https://doi.org/10.1007/s12410-012-9126-8

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