Real-time cine and myocardial perfusion with treadmill exercise stress cardiovascular magnetic resonance in patients referred for stress SPECT

Journal of Cardiovascular Magnetic Resonance

Research

Subha V Raman¹  Jennifer A Dickerson¹  Mihaela Jekic²  Eric L Foster² 

[1] Division of Cardiovascular Medicine, The Ohio State University, Columbus, Ohio, USA;Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio, USA;Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio, USA;

关键词: Single Photon Emission Compute Tomography;    Cardiovascular Magnetic Resonance;    Exercise Stress;    Cardiovascular Magnetic Resonance Imaging;    Perfusion Cardiovascular Magnetic Resonance;   

DOI  :  10.1186/1532-429X-12-41

 received in 2010-03-22, accepted in 2010-07-12,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundTo date, stress cardiovascular magnetic resonance (CMR) has relied on pharmacologic agents, and therefore lacked the physiologic information available only with exercise stress.Methods43 patients age 25 to 81 years underwent a treadmill stress test incorporating both Tc99m SPECT and CMR. After rest Tc99m SPECT imaging, patients underwent resting cine CMR. Patients then underwent in-room exercise stress using a partially modified treadmill. 12-lead ECG monitoring was performed throughout. At peak stress, Tc99m was injected and patients rapidly returned to their prior position in the magnet for post-exercise cine and perfusion imaging. The patient table was pulled out of the magnet for recovery monitoring. The patient was sent back into the magnet for recovery cine and resting perfusion followed by delayed post-gadolinium imaging. Post-CMR, patients went to the adjacent SPECT lab to complete stress nuclear imaging. Each modality's images were reviewed blinded to the other's results.ResultsPatients completed on average 9.3 ± 2.4 min of the Bruce protocol. Stress cine CMR was completed in 68 ± 14 sec following termination of exercise, and stress perfusion CMR was completed in 88 ± 8 sec. Agreement between SPECT and CMR was moderate (κ = 0.58). Accuracy in eight patients who underwent coronary angiography was 7/8 for CMR and 5/8 for SPECT (p = 0.625). Follow-up at 6 months indicated freedom from cardiovascular events in 29/29 CMR-negative and 33/34 SPECT-negative patients.ConclusionsExercise stress CMR including wall motion and perfusion is feasible in patients with suspected ischemic heart disease. Larger clinical trials are warranted based on the promising results of this pilot study to allow comparative effectiveness studies of this stress imaging system vs. other stress imaging modalities.

【 授权许可】

CC BY   
© Raman et al; licensee BioMed Central Ltd. 2010