Published online before print March 17, 2003, doi: 10.1161/01.CIR.0000060544.41744.7C
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(Circulation. 2003;107:1592.)
© 2003 American Heart Association, Inc.
Clinical Investigation and Reports |
Dobutamine Cardiovascular Magnetic Resonance for the Detection of Myocardial Ischemia With the Use of Myocardial Tagging
From the Departments of Radiology and Cardiology, University Hospital Groningen (D.K., K.Y.J.A.M.H., R.V., M.O.); Bronovo Hospital, The Hague (D.K., P.R.M.v.D.), the Netherlands; and the Department of Cardiology, Leiden University Medical Center (P.R.M.v.D.), Leiden, the Netherlands.
Correspondence to Dirkjan Kuijpers, MD, Department of Radiology, University Hospital Groningen, Hanzeplein 1, 9713GZ Groningen, The Netherlands. E-mail kps{at}xs4all.nl
Background— The purpose of this study was to assess the value of high-dose dobutamine cardiovascular magnetic resonance (CMR) with myocardial tagging for the detection of wall motion abnormalities as a measure of myocardial ischemia in patients with known or suspected coronary artery disease.
Methods and Results— Two hundred eleven consecutive patients with chest pain underwent dobutamine-CMR 4 days after antianginal medication was stopped. Dobutamine-CMR was performed at rest and during increasing doses of dobutamine. Cine-images were acquired during breath-hold with and without myocardial tagging at 3 short-axis levels. Regional wall motion was assessed in a 16-segment short-axis model. Patients with new wall motion abnormalities (NWMA) were examined by coronary angiography. Dobutamine-CMR was successfully performed in 194 patients. Dobutamine-CMR without tagging detected NWMA in 58 patients, whereas NWMA were detected in 68 patients with tagging (P=0.002, McNemar). Coronary angiography showed coronary artery disease in 65 (96%) of these 68 patients. All but 3 of the 65 patients needed revascularization. In the 112 patients with a negative dobutamine-CMR study, without baseline wall motion abnormalities, the cardiovascular occurrence-free survival rate was 98.2% during the mean follow-up period of 17.3 months (range, 7 to 31).
Conclusions— Dobutamine-CMR with myocardial tagging detected more NWMA compared with dobutamine-CMR without tagging and reliably separated patients with a normal life expectancy from those at increased risk of major adverse cardiac events.
Key Words: magnetic resonance imaging • myocardium • stress • ischemia
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