Safety of adenosine stress perfusion cardiac MRI in patients undergoing lung transplantation evaluation
© Chang et al. 2016
Published: 27 January 2016
Assessment of coronary artery disease in lung disease patients is frequently challenging because of physical limitations for exercise and poor echocardiographic windows. Vasodilator stress perfusion cardiac magnetic resonance imaging (CMR) does not require physical exercise and may provide good images. However, fear of aggravating bronchoconstriction limits the use of adenosine stress testing in patients with severe lung disease. We are unaware of any published study testing the use and/or safety of adenosine stress testing in patients undergoing lung transplantation evaluation.
Patients undergoing stress perfusion CMR for lung transplantation evaluation were consented and enrolled in a prospective CMR registry from February 2006 to April 2015. Patients with asthma or bronchospastic disease who required daily bronchodilator use were not considered for stress testing. Serious adverse events (SAEs) were defined as death, myocardial infarction, or cardiopulmonary instability requiring treatment and stopping the examination. Adverse events (AEs) included SAEs and any transient symptom/signs which did not require stopping the CMR examination.
271 patients were consecutively enrolled. Mean age was 64 ± 9 years old (84% male). Idiopathic pulmonary fibrosis and chronic obstructive lung disease were the leading cause of lung disease (67% and 18%). Spirometry finding demonstrated that 80% (n = 218) of patients met criteria of moderate or severe restrictive lung disease, and 85% showed moderate or severe obstructive disease. All patients were on home oxygen therapy or supplemental oxygen therapy.
Adverse Events During Stress CMR
Adverse Events During Stress CMR (271 patients)
Transient heart block
Paroxysmal atrial fibrillation
Serious Adverse Event
Cardiopulmonary instability / requiring treatment or early scan termination
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