Tolerance, safety and accuracy of stress cardiovascular magnetic resonance in routine clinical practice
© Khoo et al; licensee BioMed Central Ltd. 2011
Published: 2 February 2011
The use of stress cardiac magnetic resonance (CMR) as a clinical tool to evaluate myocardial ischaemia has increased significantly over recent years, but large-scale audit data is lacking. We therefore aimed to assess the tolerance, safety and accuracy of stress CMR in routine clinical practice.
We retrospectively examined all stress CMR studies performed at our tertiary referral centre over a 20-month period, since the service was started in 2007. Patients were scanned in a 1.5T magnet (Avanto, Siemens), using a standardised protocol with routine imaging for late gadolinium enhancement (LGE). They were screened for contraindications to adenosine, and routine anti-anginal therapies, including beta-blockers, were not discontinued. Dobutamine stress was given in small number of patients in whom adenosine was contraindicated. Angiograms of patients who also had cardiac catheterization within 6 months of their CMR scan, were reassessed by an interventional cardiologist, blinded to the CMR data. For receiver-operator curve (ROC) analysis, CMR stress perfusion defects were graded into 5 categories (normal, probably normal, possibly abnormal, probably abnormal, abnormal).
Minor symptoms (e.g. mild chest pain, breathlessness)
Number of patients where adenosine was discontinued prematurely
Transient heart block
Significant sinus bradycardia
Severe chest pain
Transient Heart Block
Medical intervention (bronchodilators) needed
Myocardial Infarction or Death
We conclude that stress CMR, with adenosine as the main stress agent, is well-tolerated, safe and accurate in routine clinical practice.
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