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Exercise and Dobutamine Stress CMR

  • Karolina M. Zareba
  • Subha V. RamanEmail author
Chapter
Part of the Contemporary Cardiology book series (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.

Keywords

Dobutamine stress cardiac magnetic resonance Wall motion abnormalities First-pass perfusion Exercise Ischemia Prognosis Women 

References

  1. 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.CrossRefGoogle Scholar
  2. 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.CrossRefGoogle Scholar
  3. 3.
    Charoenpanichkit C, Hundley WG. The 20 year evolution of dobutamine stress cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2010;12:59.CrossRefGoogle Scholar
  4. 4.
    Raman SV. Color atlas and synopsis of cardiovascular mr and ct. New York: McGraw-Hill; 2014.Google Scholar
  5. 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.CrossRefGoogle Scholar
  6. 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.CrossRefGoogle Scholar
  7. 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.CrossRefGoogle Scholar
  8. 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.CrossRefGoogle Scholar
  9. 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.CrossRefGoogle Scholar
  10. 10.
    Braunwald E. Control of myocardial oxygen consumption: physiologic and clinical considerations. Am J Cardiol. 1971;27:416–32.CrossRefGoogle Scholar
  11. 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.CrossRefGoogle Scholar
  12. 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 S8-9PubMedGoogle Scholar
  13. 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.CrossRefGoogle Scholar
  14. 14.
    Ruffolo RR Jr. The pharmacology of dobutamine. Am J Med Sci. 1987;294:244–8.CrossRefGoogle Scholar
  15. 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.CrossRefGoogle Scholar
  16. 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.CrossRefGoogle Scholar
  17. 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.CrossRefGoogle Scholar
  18. 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.CrossRefGoogle Scholar
  19. 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. 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.CrossRefGoogle Scholar
  21. 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.CrossRefGoogle Scholar
  22. 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.CrossRefGoogle Scholar
  23. 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.CrossRefGoogle Scholar
  24. 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.PubMedGoogle Scholar
  25. 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.CrossRefGoogle Scholar
  26. 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.CrossRefGoogle Scholar
  27. 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.CrossRefGoogle Scholar
  28. 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.CrossRefGoogle Scholar
  29. 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.CrossRefGoogle Scholar
  30. 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.CrossRefGoogle Scholar
  31. 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.CrossRefGoogle Scholar
  32. 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.CrossRefGoogle Scholar
  33. 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.CrossRefGoogle Scholar
  34. 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.CrossRefGoogle Scholar
  35. 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.CrossRefGoogle Scholar
  36. 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.CrossRefGoogle Scholar
  37. 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.CrossRefGoogle Scholar
  38. 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.CrossRefGoogle Scholar
  39. 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.CrossRefGoogle Scholar
  40. 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.CrossRefGoogle Scholar
  41. 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. 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.CrossRefGoogle Scholar
  43. 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.CrossRefGoogle Scholar
  44. 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.CrossRefGoogle Scholar
  45. 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.CrossRefGoogle Scholar
  46. 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.CrossRefGoogle Scholar
  47. 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.CrossRefGoogle Scholar
  48. 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.CrossRefGoogle Scholar
  49. 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.CrossRefGoogle Scholar
  50. 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.CrossRefGoogle Scholar
  51. 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. 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.CrossRefGoogle Scholar
  53. 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

Copyright information

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

Authors and Affiliations

  1. 1.The Ohio State University Wexner Medical CenterDepartment of Internal Medicine/Cardiovascular MedicineColumbusUSA

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