Prognostic value of normal regadenoson stress perfusion cardiovascular magnetic resonance

Journal of Cardiovascular Magnetic Resonance

Research

Benjamin H Freed¹  Sonal Chandra¹  Peter Czobor²  Akhil Narang²  Sara M Tanaka²  Michael H Davidson²  Kevin P Cavanaugh²  Emily R Zaran²  Victor Mor-Avi²  Kristen M Turner²  Roberto M Lang³  Amit R Patel³  Nicole M Bhave⁴ 

[1] Department of Medicine, Northwestern University, Chicago, IL, USA;Department of Medicine, University of Chicago, Chicago, IL, USA;Department of Medicine, University of Chicago, Chicago, IL, USA;Department of Radiology, University of Chicago, MC 5084, 5841 S Maryland Ave., 60637, Chicago, IL, USA;Department of Medicine, University of Michigan, Ann Arbor, MI, USA;

关键词: Cardiovascular magnetic resonance;    Myocardial perfusion;    Regadenoson;   

DOI  :  10.1186/1532-429X-15-108

 received in 2013-02-11, accepted in 2013-12-10,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundRegadenoson is a vasodilator stress agent that selectively activates the A2A receptor. Compared to adenosine, regadenoson is easier to administer and results in fewer side effects. Although extensively studied in patients undergoing nuclear perfusion imaging (MPI), its use for perfusion cardiovascular magnetic resonance (CMR) is not well described. The aim of this study was to determine the prognostic value of a normal regadenoson perfusion CMR in patients with known or suspected coronary artery disease.MethodsPatients with known or suspected coronary artery disease were prospectively enrolled to receive perfusion CMR (Philips 1.5 T) with regadenoson. Three short-axis slices of the left ventricle (LV) were obtained during first pass of contrast using a hybrid GRE-EPI pulse sequence (0.075 mmol/kg Gadolinium-DTPA-BMA at 4 ml/sec). Imaging was performed 1 minute after injection of regadenoson (0.4 mg) and repeated 15 minutes after reversal of hyperemia with aminophylline (125 mg). Perfusion defects were documented if they persisted for ≥2 frames after peak enhancement of the LV cavity. CMR was considered abnormal if there was a resting wall motion abnormality, decreased LVEF (<40%), presence of LGE, or the presence of a perfusion defect during hyperemia. All patients were followed for a minimum of 1 year for major adverse cardiovascular event (MACE) defined as coronary revascularization, non-fatal myocardial infarction, and cardiovascular death.Results149 patients were included in the final analysis. Perfusion defects were noted in 43/149 (29%) patients; 59/149 (40%) had any abnormality on CMR. During the mean follow-up period of 24 ± 9 months, 17/149 (11.4%) patients experienced MACE. The separation in the survival distributions for those with perfusion defects and those without perfusion defects was highly significant (log-rank p = 0.0001). When the absence of perfusion defects was added to the absence of other resting CMR abnormalities, the negative predictive value improved from 96% to 99%.ConclusionRegadenoson perfusion CMR provides high confidence for excellent prognosis in patients with normal perfusion.

【 授权许可】

Unknown   
© Freed et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.