title: Magnetic resonance stress tagging in ischemic heart disease.
abstract: High-dose dobutamine magnetic resonance stress testing has been shown to be superior to dobutamine stress echocardiography for diagnosis of coronary artery disease (CAD). We determined the feasibility of quantitative myocardial tagging during low- and high-dose dobutamine stress and tested the ability of global systolic and diastolic quantitative parameters to identify patients with significant CAD. Twenty-five patients suspected of having significant CAD were examined with a standard high-dose dobutamine/atropine stress magnetic resonance protocol (1.5-T scanner, Philips). All patients underwent invasive coronary angiography as the standard of reference for the presence (n = 13) or absence (n = 12) of significant CAD. During low-dose dobutamine stress, systolic (circumferential shortening, systolic rotation, and systolic rotation velocity) and diastolic (velocity of circumferential lengthening and diastolic rotation velocity) parameters changed significantly in patients without CAD (all P < 0.05 vs. rest) but not in patients with CAD. Identification of patients without and with CAD during low-dose stress was possible using the diastolic parameter of "time to peak untwist." At high-dose stress, none of the global systolic or diastolic parameters showed the potential to identify the presence of significant CAD. With myocardial tagging, a quantitative analysis of systolic and diastolic function was feasible during low- and high-dose dobutamine stress. In our study, the diastolic parameter of time to peak untwist as assessed during low-dose dobutamine stress was the most promising global parameter for identification of patients with significant CAD. Thus quantitative myocardial tagging may become a tool that reduces the need for high-dose dobutamine stress.
authors.affiliation: German Heart Institute Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Paetsch
authors.forename: Daniela
authors.initials: D
authors.lastname: Föll
authors.forename: Adam
authors.initials: A
authors.lastname: Kaluza
authors.forename: Roger
authors.initials: R
authors.lastname: Luechinger
authors.forename: Matthias
authors.initials: M
authors.lastname: Stuber
authors.forename: Axel
authors.initials: A
authors.lastname: Bornstedt
authors.forename: Andreas
authors.initials: A
authors.lastname: Wahl
authors.forename: Eckart
authors.initials: E
authors.lastname: Fleck
authors.forename: Eike
authors.initials: E
authors.lastname: Nagel
mesh_terms: D000318:Adrenergic beta-Agonists; D000368:Aged; D003327:Coronary Disease / Q000503:physiopathology; D023903:Coronary Restenosis / Q000503:physiopathology; D003971:Diastole; D004280:Dobutamine; D005080:Exercise Test / Q000379:methods; D005260:Female; D006321:Heart / Q000503:physiopathology; D006334:Heart Function Tests; D006339:Heart Rate; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000503:physiopathology*; D013599:Systole
chemical_list: D000318:Adrenergic beta-Agonists; D004280:Dobutamine