- Meeting abstract
- Open Access
1007 Tolerance and safety of adenosine stress perfusion cardiovascular magnetic resonance imaging in patients with coronary artery disease
© Karamitsos et al; licensee BioMed Central Ltd. 2008
- Published: 22 October 2008
- Cardiovascular Magnetic Resonance
- Cardiac Magnetic Resonance
- Significant Coronary Artery Disease
- Adenosine Stress
Cardiac magnetic resonance (CMR) stress perfusion imaging with either adenosine or dipyridamole is increasingly used both in clinical and research practice. In nuclear Cardiology, the safety of adenosine stress has been confirmed in large-scale studies, although the data is more limited in the CMR setting. In theory, use of these stress agents in the CMR environment might be more risky due to the reduced robustness of ECG monitoring and the need for remote resuscitation in case of emergency, especially for patients with high likelihood of significant coronary artery disease (CAD). In this study, we sought to determine the safety and tolerability of adenosine stress CMR in patients with CAD.
We retrospectively examined all adenosine CMR perfusion scans performed in our centre between May 2003 and September 2007 in patients with suspected or documented CAD. These comprised both clinical and research scans, and were undertaken at either 1.5 Tesla (Sonata, Siemens Medical Solutions, Erlangen, Germany; n = 160) or 3 Tesla (Trio, Siemens Medical Solutions; n = 152). All subjects were screened for the presence of contraindications to adenosine (asthma, significant conduction abnormalities greater than first degree atrioventricular node [AV] block), and an ECG was performed prior to the scan. Information on safety and adverse events during and after adenosine infusion were routinely recorded, together with haemodynamic data. The dose of adenosine infused was 140 μg/kg/min for all subjects. Safety precautions included the provision of resuscitation facilities with availability of aminophylline and glyceryl trinitrate. All scans were undertaken by staff familiar with and trained in the evacuation and resuscitation protocols of the unit. Significant CAD was defined angiographically as the presence of at least one stenosis of > 50% diameter.
Haemodynamic data at rest and during adenosine infusion.
Heart rate (beats/min)
62 ± 11
81 ± 13
Systolic Blood Pressure (mmHg)
132 ± 18
129 ± 19
Diastolic Blood Pressure (mmHg)
76 ± 11
73 ± 12
Rate-Pressure Product (mmHg × beats/min)
8190 ± 2022
10451 ± 2554
In a large series, the use of intravenous adenosine in CMR perfusion imaging is safe and well tolerated in patients with even severe CAD. If a careful screening policy for contraindications to adenosine is followed, serious adverse events in the CMR scanner are relatively rare and most symptoms resolve following termination of the infusion without the need for aminophylline.
This article is published under license to BioMed Central Ltd.