Skip to main content
SpringerLink
Log in

Exercise and Dobutamine Stress CMR

  • Chapter
  • First Online:
Cardiovascular Magnetic Resonance Imaging

Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

Cardiovascular magnetic resonance (CMR) is becoming the test of choice for the comprehensive evaluation of cardiac structure and function. Numerous advances in CMR techniques have allowed the rapid acquisition of images required for stress CMR. Combined dobutamine/atropine stress CMR along with first-pass perfusion is a very attractive method for evaluating ischemia given its high diagnostic accuracy and significant prognostic value. Dobutamine stress CMR is particularly superior to other modalities at diagnosing significant obstructive disease and predicting outcome in women. The development of an MRI-compatible treadmill has allowed incorporation of physiologic exercise data into the ischemic evaluation, further providing prognostic information on the patient’s hemodynamic response and functional capacity. Dobutamine and exercise treadmill stress CMR are two feasible and highly accurate modalities which are becoming mainstay in the assessment of coronary artery disease.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Pennell DJ, Underwood SR, Manzara CC, Swanton RH, Walker JM, et al. Magnetic resonance imaging during dobutamine stress in coronary artery disease. Am J Cardiol. 1992;70:34–40.

    Article  CAS  Google Scholar 

  2. Jekic M, Foster EL, Ballinger MR, Raman SV, Simonetti OP. Cardiac function and myocardial perfusion immediately following maximal treadmill exercise inside the mri room. J Cardiovasc Magn Reson. 2008;10:3.

    Article  Google Scholar 

  3. Charoenpanichkit C, Hundley WG. The 20 year evolution of dobutamine stress cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2010;12:59.

    Article  Google Scholar 

  4. Raman SV. Color atlas and synopsis of cardiovascular mr and ct. New York: McGraw-Hill; 2014.

    Google Scholar 

  5. Schalla S, Klein C, Paetsch I, Lehmkuhl H, Bornstedt A, Schnackenburg B, et al. 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. 2002;224:845–51.

    Article  Google Scholar 

  6. Jahnke C, Paetsch I, Gebker R, Bornstedt A, Fleck E, Nagel E. Accelerated 4d dobutamine stress mr imaging with k-t blast: feasibility and diagnostic performance. Radiology. 2006;241:718–28.

    Article  Google Scholar 

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

    Article  Google Scholar 

  8. Paetsch I, Foll D, Kaluza A, Luechinger R, Stuber M, Bornstedt A, et al. Magnetic resonance stress tagging in ischemic heart disease. Am J Physiol Heart Circ Physiol. 2005;288:H2708–14.

    Article  CAS  Google Scholar 

  9. Korosoglou G, Lehrke S, Wochele A, Hoerig B, Lossnitzer D, Steen H, et al. Strain-encoded cmr for the detection of inducible ischemia during intermediate stress. JACC Cardiovasc Imaging. 2010;3:361–71.

    Article  Google Scholar 

  10. Braunwald E. Control of myocardial oxygen consumption: physiologic and clinical considerations. Am J Cardiol. 1971;27:416–32.

    Article  CAS  Google Scholar 

  11. Iskandrian AS, Verani MS, Heo J. Pharmacologic stress testing: mechanism of action, hemodynamic responses, and results in detection of coronary artery disease. J Nucl Cardiol. 1994;1:94–111.

    Article  CAS  Google Scholar 

  12. Pennell DJ, Underwood SR. The cardiovascular effects of dobutamine assessed by magnetic resonance imaging. Postgrad Med J. 1991;67(Suppl 1):S1–8; discussion S8-9

    PubMed  Google Scholar 

  13. Warltier DC, Zyvoloski M, Gross GJ, Hardman HF, Brooks HL. Redistribution of myocardial blood flow distal to a dynamic coronary arterial stenosis by sympathomimetic amines: comparison of dopamine, dobutamine and isoproterenol. Am J Cardiol. 1981;48:269–79.

    Article  CAS  Google Scholar 

  14. Ruffolo RR Jr. The pharmacology of dobutamine. Am J Med Sci. 1987;294:244–8.

    Article  Google Scholar 

  15. Kramer CM, Barkhausen J, Flamm SD, Kim RJ, Nagel E, Society for Cardiovascular Magnetic Resonance Board of Trustees Task Force on Standardized P. Standardized cardiovascular magnetic resonance (cmr) protocols 2013 update. J Cardiovasc Magn Reson. 2013;15:91.

    Article  Google Scholar 

  16. McNeill AJ, Fioretti PM, el-Said SM, Salustri A, Forster T, Roelandt JR. Enhanced sensitivity for detection of coronary artery disease by addition of atropine to dobutamine stress echocardiography. Am J Cardiol. 1992;70:41–6.

    Article  CAS  Google Scholar 

  17. 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  CAS  Google Scholar 

  18. Lubbers DD, Janssen CH, Kuijpers D, van Dijkman PR, Overbosch J, 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  Google Scholar 

  19. Hendel RC, Patel MR, Kramer CM, Poon M, Hendel RC, Carr JC, et al. American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working G, American College of R, Society of Cardiovascular Computed T, Society for Cardiovascular Magnetic R, American Society of Nuclear C, North American Society for Cardiac I, Society for Cardiovascular A, Interventions, Society of Interventional R. Accf/acr/scct/scmr/asnc/nasci/scai/sir 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: A report of the american college of cardiology foundation quality strategic directions committee appropriateness criteria working group, American College of radiology, society of cardiovascular computed tomography, society for cardiovascular magnetic resonance, american society of nuclear cardiology, North American society for cardiac imaging, society for cardiovascular angiography and interventions, and society of interventional radiology. J Am Coll Cardiol. 2006;48:1475–97.

    Google Scholar 

  20. Nagel E, Lorenz C, Baer F, Hundley WG, Wilke N, Neubauer S, et al. Stress cardiovascular magnetic resonance: consensus panel report. J Cardiovasc Magn Reson. 2001;3:267–81.

    Article  CAS  Google Scholar 

  21. Wahl A, Paetsch I, Gollesch A, Roethemeyer S, Foell D, Gebker R, 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(14):1230–6.

    Article  Google Scholar 

  22. Pedone C, Bax JJ, van Domburg RT, Rizzello V, Biagini E, Schinkel AF, et al. Long-term prognostic value of ejection fraction changes during dobutamine-atropine stress echocardiography. Coron Artery Dis. 2005;16:309–13.

    Article  Google Scholar 

  23. Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, et al. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the cardiac imaging committee of the council on clinical cardiology of the American Heart Association. Circulation. 2002;105:539–42.

    Article  Google Scholar 

  24. Baer FM, Theissen P, Smolarz K, Voth E, Sechtem U, et al. Dobutamine versus dipyridamole magnetic resonance tomography: safety and sensitivity in the detection of coronary stenoses. Z Kardiol. 1993;82:494–503.

    CAS  PubMed  Google Scholar 

  25. van Rugge FP, van der Wall EE, de Roos A, Bruschke AV. Dobutamine stress magnetic resonance imaging for detection of coronary artery disease. J Am Coll Cardiol. 1993;22:431–9.

    Article  Google Scholar 

  26. van Rugge FP, van der Wall EE, Spanjersberg SJ, de Roos A, Matheijssen NA, Zwinderman AH, et al. Magnetic resonance imaging during dobutamine stress for detection and localization of coronary artery disease. Quantitative wall motion analysis using a modification of the centerline method. Circulation. 1994;90:127–38.

    Article  Google Scholar 

  27. Nagel E, Lehmkuhl HB, Bocksch W, Klein C, Vogel U, Frantz E, 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.

    Article  CAS  Google Scholar 

  28. Bikiri E, Mereles D, Voss A, Greiner S, Hess A, Buss SJ, et al. Dobutamine stress cardiac magnetic resonance versus echocardiography for the assessment of outcome in patients with suspected or known coronary artery disease. Are the two imaging modalities comparable? Int J Cardiol. 2014;171:153–60.

    Article  Google Scholar 

  29. Hundley WG, Hamilton CA, Thomas MS, Herrington DM, Salido TB, Kitzman DW, 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.

    Article  CAS  Google Scholar 

  30. Wahl A, Paetsch I, Roethemeyer S, Klein C, Fleck E, Nagel E. High-dose dobutamine-atropine stress cardiovascular mr imaging after coronary revascularization in patients with wall motion abnormalities at rest. Radiology. 2004;233:210–6.

    Article  Google Scholar 

  31. Mordi I, Stanton T, Carrick D, McClure J, Oldroyd K, et al. Comprehensive dobutamine stress cmr versus echocardiography in lbbb and suspected coronary artery disease. JACC Cardiovasc Imaging. 2014;7:490–8.

    Article  Google Scholar 

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

    Article  CAS  Google Scholar 

  33. Nandalur KR, Dwamena BA, Choudhri AF, Nandalur MR, Carlos RC. Diagnostic performance of stress cardiac magnetic resonance imaging in the detection of coronary artery disease: a meta-analysis. J Am Coll Cardiol. 2007;50:1343–53.

    Article  Google Scholar 

  34. Paetsch I, Jahnke C, Ferrari VA, Rademakers FE, Pellikka PA, Hundley WG, 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  Google Scholar 

  35. Syed MA, Paterson DI, Ingkanisorn WP, Rhoads KL, Hill J, et al. Reproducibility and inter-observer variability of dobutamine stress cmr in patients with severe coronary disease: implications for clinical research. J Cardiovasc Magn Reson. 2005;7:763–8.

    Article  Google Scholar 

  36. Hundley WG, Morgan TM, Neagle CM, Hamilton CA, Rerkpattanapipat P, Link KM. Magnetic resonance imaging determination of cardiac prognosis. Circulation. 2002;106:2328–33.

    Article  Google Scholar 

  37. Hundley WG, Rerkpattanapipat P, Little WC, Link KM, Morgan TM. Relation of cardiac prognosis to segment location with apical left ventricular ischemia. Am J Cardiol. 2003;92:1206–8.

    Article  Google Scholar 

  38. Rerkpattanapipat P, Morgan TM, Neagle CM, Link KM, Hamilton CA, Hundley WG. Assessment of preoperative cardiac risk with magnetic resonance imaging. Am J Cardiol. 2002;90:416–9.

    Article  Google Scholar 

  39. Kuijpers D, van Dijkman PR, Janssen CH, Vliegenthart R, Zijlstra F, Oudkerk M. Dobutamine stress mri. Part ii. Risk stratification with dobutamine cardiovascular magnetic resonance in patients suspected of myocardial ischemia. Eur Radiol. 2004;14:2046–52.

    Article  Google Scholar 

  40. Jahnke C, Nagel E, Gebker R, Kokocinski T, Kelle S, Manka 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.

    Article  Google Scholar 

  41. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. American Heart Association Statistics C, Stroke Statistics S. Heart disease and stroke statistics – 2013 update: a report from the American Heart Association. Circulation 2013;127:e6–e245.

    Google Scholar 

  42. Shaw LJ, Bairey Merz CN, Pepine CJ, Reis SE, Bittner V, Kelsey SF, et al. Investigators W. Insights from the nhlbi-sponsored women’s ischemia syndrome evaluation (wise) study: part i: gender differences in traditional and novel risk factors, symptom evaluation, and gender-optimized diagnostic strategies. J Am Coll Cardiol 2006;47:S4–S20.

    Article  Google Scholar 

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

    Article  CAS  Google Scholar 

  44. Raman SV, Donnally MR, McCarthy B. Dobutamine stress cardiac magnetic resonance imaging to detect myocardial ischemia in women. Prev Cardiol. 2008;11:135–40.

    Article  Google Scholar 

  45. Wallace EL, Morgan TM, Walsh TF, Dall’Armellina E, Ntim W, 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  Google Scholar 

  46. Gebker R, Jahnke C, Manka R, Hamdan A, Schnackenburg B, 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  Google Scholar 

  47. Roest AA, Kunz P, Lamb HJ, Helbing WA, van der Wall EE, de Roos A. Biventricular response to supine physical exercise in young adults assessed with ultrafast magnetic resonance imaging. Am J Cardiol. 2001;87:601–5.

    Article  CAS  Google Scholar 

  48. Rerkpattanapipat P, Gandhi SK, Darty SN, Williams RT, Davis AD, Mazur W, et al. Feasibility to detect severe coronary artery stenoses with upright treadmill exercise magnetic resonance imaging. Am J Cardiol. 2003;92:603–6.

    Article  Google Scholar 

  49. Raman SV, Dickerson JA, Jekic M, Foster EL, Pennell ML, et al. Real-time cine and myocardial perfusion with treadmill exercise stress cardiovascular magnetic resonance in patients referred for stress spect. J Cardiovasc Magn Reson. 2010;12:41.

    Article  Google Scholar 

  50. Thavendiranathan P, Dickerson JA, Scandling D, Balasubramanian V, Pennell ML, Hinton A, et al. Comparison of treadmill exercise stress cardiac mri to stress echocardiography in healthy volunteers for adequacy of left ventricular endocardial wall visualization: a pilot study. J Magn Reson Imaging. 2014;39:1146–52.

    Article  Google Scholar 

  51. Gebker R, Berger A, Schneeweis C, Hucko T, Schnackenburg B, Klein C, et al. High-dose dobutamine stress magnetic resonance perfusion imaging at 3.0 tesla. Abstracts of the 16th Annual SCMR Scientific Sessions. 2013.

    Google Scholar 

  52. Thomas D, Meyer C, Strach K, Naehle CP, Mazraeh J, Gampert T, et al. Dobutamine stress tagging and gradient-echo imaging for detection of coronary heart disease at 3 t. Br J Radiol. 2011;84:44–50.

    Article  CAS  Google Scholar 

  53. Petry PG, Lossnitzer D, Haberkorn SM, aus dem Siepen F, Seitz SA, et al. Feasibility of high dose dobutamine stress and scar imaging in high field open mri in patients with suspected coronary artery disease. Abstracts of the 16th Annual SCMR Scientific Sessions. 2013.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Ohio State University Wexner Medical Center, Department of Internal Medicine/Cardiovascular Medicine, Columbus, OH, USA

    Karolina M. Zareba & Subha V. Raman

Authors
  1. Karolina M. Zareba
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Subha V. Raman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Subha V. Raman .

Editor information

Editors and Affiliations

  1. Cardiovascular Division, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA

    Raymond Y. Kwong

  2. Department of Radiology, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA

    Michael Jerosch-Herold

  3. Department of Cardiac Sciences, University of Calgary, Calgary, AB, Canada

    Bobak Heydari

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Science+Business Media, LLC, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Zareba, K.M., Raman, S.V. (2019). Exercise and Dobutamine Stress CMR. In: Kwong, R., Jerosch-Herold, M., Heydari, B. (eds) Cardiovascular Magnetic Resonance Imaging. Contemporary Cardiology. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-8841-9_11

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-8841-9_11

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-8839-6

  • Online ISBN: 978-1-4939-8841-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation