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Assessment of perfusion and wall-motion abnormalities and transient ischemic dilation in regadenoson stress cardiac magnetic resonance perfusion imaging

  • Mohammad R. Hojjati
  • Raja Muthupillai
  • James M. Wilson
  • Ourania A. Preventza
  • Benjamin Y. C. Cheong
Original Paper

Abstract

Vasodilator first-pass stress cardiac magnetic resonance perfusion imaging [stress cardiac magnetic resonance (CMR)] is a reliable, noninvasive method for evaluating myocardial ischemia; however, it does not routinely evaluate metrics such as wall-motion abnormality (WMA) and transient ischemic dilation (TID). Using the new selective A2A adenosine receptor agonist regadenoson, we tested a novel protocol for assessing perfusion defects, WMA, and TID in a single stress CMR session. We evaluated 29 consecutive patients who presented for clinically indicated regadenoson stress CMR. Immediately before and after the regadenoson stress perfusion sequence, we obtained baseline and post-stress cine images in the short-axis orientation to detect worsening or newly developed WMAs. This approach also allowed evaluation of TID. Delayed-enhancement imaging was performed in the standard orientations. All patients tolerated the procedure well. Thirteen patients (45 %) had perfusion abnormalities, and four patients developed TID. Seven patients had WMAs, and three of them also had TID. Patients with TID ± WMAs had multivessel disease documented by coronary angiography. By using regadenoson to assess myocardial ischemia during stress CMR, perfusion defects, WMAs, and TID can be evaluated in a single imaging session. To our knowledge, we are the first to describe this novel approach in a vasodilator stress CMR study.

Keywords

Magnetic resonance imaging Myocardial perfusion imaging Coronary artery disease Wall-motion abnormalities Transient ischemic dilation Regadenoson Adenosine A2A receptor antagonists 

Notes

Acknowledgments

We are grateful to Virginia C. Fairchild and Nicole Stancel, Ph.D., ELS, of the Section of Scientific Publications at the Texas Heart Institute, Houston, Texas, for providing editorial assistance.

Conflict of interest

None.

Supplementary material

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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Mohammad R. Hojjati
    • 1
  • Raja Muthupillai
    • 2
    • 3
  • James M. Wilson
    • 1
    • 4
  • Ourania A. Preventza
    • 5
  • Benjamin Y. C. Cheong
    • 2
    • 3
    • 4
  1. 1.Department of CardiologyTexas Heart InstituteHoustonUSA
  2. 2.Department of Diagnostic and Interventional RadiologySt. Luke’s Medical Center, Texas Heart InstituteHoustonUSA
  3. 3.Department of RadiologyBaylor College of MedicineHoustonUSA
  4. 4.Department of MedicineBaylor College of MedicineHoustonUSA
  5. 5.Division of Cardiothoracic Surgery, Michael E. DeBakey Department of SurgeryBaylor College of MedicineHoustonUSA

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