(Circulation. 1999;99:730-732.)
© 1999 American Heart Association, Inc.
Editorials |
Dobutamine MRI:
A Serious Contender in Pharmacological Stress Imaging?
Correspondence to William A. Zoghbi, MD, Echocardiography Research, Baylor College of Medicine, Section of Cardiology, 6550 Fannin, SM 677, Houston, TX 77030. E-mail wzoghbi@bcm.tmc.edu
Key Words: Editorials • coronary disease • echocardiography • stress • magnetic resonance imaging
Noninvasive techniques for assessing coronary artery disease (CAD) have improved dramatically over the past 20 years. This is particularly true with the advent of pharmacological stress testing in patients who are unable to exercise. Because myocardial perfusion and function are closely coupled, state-of-the-art stress imaging modalities have involved assessment of myocardial perfusion with radionuclide techniques or wall motion with echocardiography. Echocardiography is currently the preferred method for ascertaining regional ventricular function during stress because of its high diagnostic accuracy, feasibility, versatility, and relatively low cost. Echocardiography has been combined with various stress modalities besides exercise. Of the various agents that can produce cardiovascular stress, dobutamine has been the most widely used. Results from dobutamine stress echocardiography (DSE) have been consistent with those of exercise echo and radionuclide imaging.1 2 In addition to detecting CAD, current clinical applications of DSE include risk stratification and assessment of residual myocardial viability in patients with ventricular dysfunction.1 2 3 One of the main limitations of stress echocardiography has been the suboptimal visualization of myocardial segments in 5% to 10% of patients and the need for considerable technical aptitude to acquire the images. However, DSE requires less technical prowess than does exercise echo. Image quality and delineation of endocardial motion have been greatly improved by advances in transducer technology. More recently, the discovery of harmonic imaging and the availability of intravenous contrast agents that can opacify the left ventricle4 5 6 have further enhanced the efficacy of this technique.
Parallel to this evolution of echocardiography
into the stress arena has
This article has been cited by other articles:
 |
|
 |
|
  American College of Cardiology Foundation, American Heart Association Task Force on Practice, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interve, Society for Vascular Medicine, Society for Vascular Surgery, L. A. Fleisher, et al. 2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery J. Am. Coll. Cardiol., November 24, 2009; 54(22): e13 - e118. [Full Text] [PDF]
|
|
|
|
 |
|
 2007 WRITING COMMITTEE MEMBERS, L. A. Fleisher, J. A. Beckman, K. A. Brown, H. Calkins, E. L. Chaikof, K. E. Fleischmann, W. K. Freeman, J. B. Froehlich, E. K. Kasper, et al. 2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Circulation, November 24, 2009; 120(21): e169 - e276. [Full Text] [PDF]
|
|
|
|
|
|
L. A. Fleisher, J. A. Beckman, K. A. Brown, H. Calkins, E. L. Chaikof, K. E. Fleischmann, W. K. Freeman, J. B. Froehlich, E. K. Kasper, J. R. Kersten, et al. ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) Developed in Collaboration With the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery J. Am. Coll. Cardiol., October 23, 2007; 50(17): e159 - e242. [Full Text] [PDF]
|
|
|
|
|
|
L. A. Fleisher, J. A. Beckman, K. A. Brown, H. Calkins, E. L. Chaikof, K. E. Fleischmann, W. K. Freeman, J. B. Froehlich, E. K. Kasper, J. R. Kersten, et al. ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) Circulation, October 23, 2007; 116(17): e418 - e500. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Wahl, I. Paetsch, S. Roethemeyer, C. Klein, E. Fleck, and E. Nagel High-Dose Dobutamine-Atropine Stress Cardiovascular MR Imaging after Coronary Revascularization in Patients with Wall Motion Abnormalities at Rest Radiology, October 1, 2004; 233(1): 210 - 216. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A.C. Lima and M. Y. Desai Cardiovascular magnetic resonance imaging: Current and emerging applications J. Am. Coll. Cardiol., September 15, 2004; 44(6): 1164 - 1171. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Schalla, C. Klein, I. Paetsch, H. Lehmkuhl, A. Bornstedt, B. Schnackenburg, E. Fleck, and E. Nagel Real-Time MR Image Acquisition during High-Dose Dobutamine Hydrochloride Stress for Detecting Left Ventricular Wall-Motion Abnormalities in Patients with Coronary Arterial Disease Radiology, September 1, 2002; 224(3): 845 - 851. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.J. Bax and E.E. Van der Wall Assessment of myocardial viability: guide to prognosis and clinical management Eur. Heart J., June 2, 2000; 21(12): 961 - 963. [PDF]
|
|
|
|
 |
|
 A. J. Duerinckx Myocardial Viability Using MR Imaging: Is It Ready for Clinical Use? Am. J. Roentgenol., June 1, 2000; 174(6): 1741 - 1743. [Full Text]
|
|
|
|
|
|
W. G. Hundley, C. A. Hamilton, M. S. Thomas, D. M. Herrington, T. B. Salido, D. W. Kitzman, W. C. Little, and K. M. Link 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, October 19, 1999; 100(16): 1697 - 1702. [Abstract] [Full Text] [PDF]
|
|