From: Exercise cardiovascular magnetic resonance: development, current utility and future applications
Exercise type | Treadmill | Upright cycle ergometer | Supine Cycle ergometer | Supine stepper ergometer | Prone exercise | Isometric Handgrip |
---|---|---|---|---|---|---|
Outside MR scanner | Inside MR scanner | |||||
Dynamic | Dynamic | Dynamic | Dynamic | Dynamic | Static | |
Common applications | Ischaemia testing (Regional wall motion & perfusion) | Aortic/Pulmonary Flow | Ventricular volumes Aortic/pulmonary flow | Ventricular volumes Aortic/pulmonary flow | Spectroscopy | Spectroscopy Coronary endothelial function |
Max exercise intensitya | Maximal | Light | Maximal | Submaximal/ Vigorous | Light-Moderate | Very-light |
Benefits | -Patients more readily achieve maximal intensity exercise -Diagnostic 12 lead ECG performed during exercise -Treadmill test provides separate prognostic data - Maximal oxygen uptake during exercise on CMR adjacent treadmill feasible -Most natural and tolerated form of exercise | Allows imaging during exercise | ||||
Allows imaging at multpile exercise levels | ||||||
-Only modality with upright in-scanner exercise -Less claustrophobia in open magnet scanner | -Can be performed to maximal exercise intensity in MR bore. | -Less leg restriction than cycle ergometer | Â | -Stable stress heart rate -Minimal movement -No magnet bore restriction | ||
Weaknesses | - Post stress imaging allows heart rate recovery before imaging - Logistically difficult to image at multiple exercise intensities | Unable to perform 12 lead ECG or accurate ST segment monitoring during in-scanner exercise | ||||
-Uses open magnet scanner – low field strength (low SNR), limited availability, CMR feasible but non-standard. -Only published in minimal studies to light intensity exercise. | -Cycling can be restricted by magnet bore diameter | - Lower intensity exercise than cycle ergometer | - Uncomfortable form of exercise - Modest exercise feasible - Logistically difficult to increase resistance | -Atypical form of exercise - Limited increase in heart rate |