- Poster presentation
- Open Access
Early clinical experience with ‘splenic switch-off' in adenosine stress CMR
https://doi.org/10.1186/1532-429X-17-S1-P91
© Bryant et al; licensee BioMed Central Ltd. 2015
- Published: 3 February 2015
Keywords
- Perfusion Imaging
- Haemodynamic Response
- Adenosine Stress
- Symptomatic Response
- Dual Response
Background
MRI Adenosine stress perfusion is a well-established method of evaluating myocardial ischaemia but we know from a number of studies that false negatives are a potential weakness of this modality. Assessment of splenic perfusion at stress and rest (splenic switch-off) has recently been suggested as a means of identifying true pharmacological stress response to adenosine[1]. This is a promising technique but can only be assessed after the stress procedure. The aim of this study was to compare symptomatic and haemodynamic response with visual assessment of splenic perfusion during stress and rest perfusion imaging to see if we could accurately predict those who would have absent splenic switch-off.
Methods
We retrospectively reviewed all patients who completed a standard adenosine perfusion CMR over 2 months at a single centre. Adenosine was administered at a standard dose of 140 μg/kg/min for at least 3 minutes prior to perfusion imaging. Adequate haemodynamic response was considered as a heartrate increase ≥ 10bpm and/or SBP decrease ≥ 10 mmHg. Appropriate symptomatic response included facial flushing, breathlessness and chest tightness. According to current clinical practice concurrent haemodynamic and symptomatic response was taken to indicate adequate physiological stress. Splenic switch-off was assessed by visual comparison between stress and rest images.
Results
Splenic switch-off related to adenosine response
Response to adenosine | |||||
---|---|---|---|---|---|
Single | Dual | Total | |||
Splenic switch-off | NO | Number (%) | 12 (41.4%) | 7 (6.3%) | 19 (13.5%) |
YES | Number (%) | 17 (58.6%) | 105 (93.8%) | 122 (86.5%) | |
Total | Number (% of total) | 29 (20.6%) | 112 (79.4%) | 141 (100%) |
Conclusions
Using splenic switch-off as the gold standard assessment for adequate pharmacological response there was a good correlation with those who experienced both a haemodynamic and symptomatic response. We should consider increasing adenosine dose when patients show only a single haemodynamic or symptomatic response.
Funding
N/A.
Authors’ Affiliations
References
- Manisty C, Ripley D, Captur G, Peebles C, Wong T, Schelbert E, Herrey A, Greenwood J, Moon J: ‘Splenic switch-off' to detect adenosine understress; a novel method to improve test sensitivity. Journal of Cardiovascular Magnetic Resonance. 2014, 16 (Suppl 1): O1-10.1186/1532-429X-16-S1-O1.PubMed CentralView ArticleGoogle Scholar
Copyright
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/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.