Published Online
on March 31, 2003

A more recent version of this article appeared on April 22, 2003

This Article Full Text (PDF) All Versions of this Article: 107/15/2025    most recent 01.CIR.0000062684.47526.47v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kraitchman, D. L. Articles by Osman, N. F. Search for Related Content PubMed PubMed Citation Articles by Kraitchman, D. L. Articles by Osman, N. F. Related Collections Animal models of human disease Imaging CT and MRI

Submitted on October 28, 2002
Revised on January 16, 2003
Accepted on January 16, 2003

Quantitative Ischemia Detection During Cardiac Magnetic Resonance Stress Testing by Use of FastHARP

Dara L. Kraitchman VMD, PhD^*, Smita Sampath MSE, Ernesto Castillo MD, John A. Derbyshire PhD, Raymond C. Boston PhD, David A. Bluemke MD, PhD, Bernhard L. Gerber MD, PhD, Jerry L. Prince PhD, and Nael F. Osman PhD

From Johns Hopkins University, School of Medicine, Departments of Radiology (D.L.K., E.C., D.A.B., N.F.O.) and Medicine, Division of Cardiology (B.L.G.), and Department of Electrical Engineering (S.S., J.L.P., N.F.O.), Baltimore, Md; National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, Md (J.A.D.); and University of Pennsylvania, School of Veterinary Medicine, Kennett Square, Pa (R.C.B.).

^* To whom correspondence should be addressed. E-mail: dara{at}mri.jhu.edu.

Background--Because ECG alterations caused by ischemia cannot be reliably detected in the high-field MRI environment, detection of wall motion abnormalities is often used to ensure patient safety during stress testing. However, an experienced observer is needed to detect these abnormalities. In this study, we investigate the use of fast harmonic phase (FastHARP) MRI for the quantitative, operator-independent detection of the onset of ischemia during acute coronary occlusion.

Methods and Results--Eight mongrel dogs underwent an acute 2-minute closed-chest coronary artery occlusion while continuous FastHARP images were acquired. Full regional wall strain was determined every other heartbeat in a single short-axis imaging slice. After 5 minutes of reperfusion, a second 2-minute ischemic episode was induced during the acquisition of conventional cine wall-motion images. The time at which ECG alterations were observed during the first ischemic period was recorded. The time from occlusion to the detection of ischemia, based on a consensus of 2 blinded observers, was determined for MRI. No significant ischemia was present in 2 animals. In the remaining animals, the onset of ischemia was detected significantly earlier by FastHARP than by cine MRI (9.5±5 versus 33±14 seconds, P<0.01). HARP ischemia detection preceded ECG changes, on average, by 54 seconds.

Conclusions--The rapid acquisition and detection of induced ischemia with FastHARP MRI shows promise as a nonsubjective method to diagnose significant coronary lesions during MR stress testing.

Key words: magnetic resonance imaging • myocardial contraction • coronary disease • systole • ischemia

This article has been cited by other articles:

				S. Kelle, S. D. Roes, C. Klein, T. Kokocinski, A. de Roos, E. Fleck, J. J. Bax, and E. Nagel Prognostic value of myocardial infarct size and contractile reserve using magnetic resonance imaging. J. Am. Coll. Cardiol., November 3, 2009; 54(19): 1770 - 1777. [Abstract] [Full Text] [PDF]

				I. Yoshioka, Y. Saiki, A. Ichinose, K. Takase, S. Takahashi, T. Ohashi, M. Sato, and K. Tabayashi Tagged cine magnetic resonance imaging with a finite element model can predict the severity of retrosternal adhesions prior to redo cardiac surgery J. Thorac. Cardiovasc. Surg., April 1, 2009; 137(4): 957 - 962. [Abstract] [Full Text] [PDF]

				K. C. Bilchick, V. Dimaano, K. C. Wu, R. H. Helm, R. G. Weiss, J. A. Lima, R. D. Berger, G. F. Tomaselli, D. A. Bluemke, H. R. Halperin, et al. Cardiac magnetic resonance assessment of dyssynchrony and myocardial scar predicts function class improvement following cardiac resynchronization therapy. J. Am. Coll. Cardiol. Img., September 1, 2008; 1(5): 561 - 568. [Abstract] [Full Text] [PDF]

				R. P. Gallegos and R. M. Bolman III Stem Cell Induced Regeneration of Myocardium Card. Surg. Adult, January 1, 2008; 3(2008): 1657 - 1668. [Full Text]

				M. Tumkosit, C. G. Martin, E. Bayram, T. M. Morgan, K. S. Lane, P. Rerkpattanapipat, C. A. Hamilton, K. M. Link, and W. G. Hundley Left Ventricular Spherical Remodeling and Apical Myocardial Relaxation: Cardiovascular MR Imaging Measurement of Myocardial Segments Radiology, August 1, 2007; 244(2): 411 - 418. [Abstract] [Full Text] [PDF]

				K. Nasir, M. Tsai, B. D. Rosen, V. Fernandes, D. A. Bluemke, A. R. Folsom, and J. A.C. Lima Elevated Homocysteine Is Associated With Reduced Regional Left Ventricular Function: The Multi-Ethnic Study of Atherosclerosis Circulation, January 16, 2007; 115(2): 180 - 187. [Abstract] [Full Text] [PDF]

				V. R.S. Fernandes, J. F. Polak, T. Edvardsen, B. Carvalho, A. Gomes, D. A. Bluemke, K. Nasir, D. H. O'Leary, and J. A.C. Lima Subclinical Atherosclerosis and Incipient Regional Myocardial Dysfunction in Asymptomatic Individuals: The Multi-Ethnic Study of Atherosclerosis (MESA) J. Am. Coll. Cardiol., June 20, 2006; 47(12): 2420 - 2428. [Abstract] [Full Text] [PDF]

				I. Paetsch, C. Jahnke, V. A. Ferrari, F. E. Rademakers, P. A. Pellikka, W. G. Hundley, D. Poldermans, J. J. Bax, K. Wegscheider, E. Fleck, et al. Determination of interobserver variability for identifying inducible left ventricular wall motion abnormalities during dobutamine stress magnetic resonance imaging Eur. Heart J., June 2, 2006; 27(12): 1459 - 1464. [Abstract] [Full Text] [PDF]

				B. D. Rosen, M. F. Saad, S. Shea, K. Nasir, T. Edvardsen, G. Burke, M. Jerosch-Herold, D. K. Arnett, S. Lai, D. A. Bluemke, et al. Hypertension and Smoking Are Associated With Reduced Regional Left Ventricular Function in Asymptomatic Individuals: The Multi-Ethnic Study of Atherosclerosis J. Am. Coll. Cardiol., March 21, 2006; 47(6): 1150 - 1158. [Abstract] [Full Text] [PDF]

				A. C. Lardo, T. P. Abraham, and D. A. Kass Magnetic Resonance Imaging Assessment of Ventricular Dyssynchrony: Current and Emerging Concepts J. Am. Coll. Cardiol., December 20, 2005; 46(12): 2223 - 2228. [Abstract] [Full Text] [PDF]

				I. Paetsch, C. Jahnke, E. Fleck, and E. Nagel Current clinical applications of stress wall motion analysis with cardiac magnetic resonance imaging Eur J Echocardiogr, October 1, 2005; 6(5): 317 - 326. [Abstract] [Full Text] [PDF]

				I. Paetsch, D. Foll, A. Kaluza, R. Luechinger, M. Stuber, A. Bornstedt, A. Wahl, E. Fleck, and E. Nagel Magnetic resonance stress tagging in ischemic heart disease Am J Physiol Heart Circ Physiol, June 1, 2005; 288(6): H2708 - H2714. [Abstract] [Full Text] [PDF]

				R. R. Edelman Contrast-enhanced MR Imaging of the Heart: Overview of the Literature Radiology, September 1, 2004; 232(3): 653 - 668. [Abstract] [Full Text] [PDF]

				E. Wellnhofer, A. Olariu, C. Klein, M. Grafe, A. Wahl, E. Fleck, and E. Nagel Magnetic Resonance Low-Dose Dobutamine Test Is Superior to Scar Quantification for the Prediction of Functional Recovery Circulation, May 11, 2004; 109(18): 2172 - 2174. [Abstract] [Full Text] [PDF]

				K. C. Wu and J. A.C. Lima Noninvasive Imaging of Myocardial Viability: Current Techniques and Future Developments Circ. Res., December 12, 2003; 93(12): 1146 - 1158. [Abstract] [Full Text] [PDF]

				E. Castillo, J. A. C. Lima, and D. A. Bluemke Regional Myocardial Function: Advances in MR Imaging and Analysis RadioGraphics, October 1, 2003; 23(90001): S127 - 140. [Abstract] [Full Text] [PDF]