Feasibility of dobutamine stress cardiovascular magnetic resonance imaging in children.
OBJECTIVE
To evaluate the feasibility of dobutamine stress magnetic resonance (DSMR) in pediatric patients.


METHODS
The medical records of all DSMR studies performed on patients < or =22 years old at a single institution were retrospectively reviewed. The DSMR protocol included dobutamine doses up to 40 microg/kg/minute and atropine to attain the target heart rate [0.85 . (220 - age)].


RESULTS
Thirty-two DSMR studies were performed in 28 patients (median age = 7.3 years; range = 0.8-22 years). Twenty of the studies were performed under general anesthesia. The protocol was completed in 26 studies, technical problems and interruptions were few, and image quality scores (1-5) for all ventricular wall segments were high (mean = 4.2). A heart rate > or =160 bpm was attained in 84% of the studies, a rate pressure product > or =20,000 beats . mm Hg in 87%, and a heart rate greater than or equal to the target heart rate in 19%. No serious adverse events occurred. One patient had an inducible wall motion abnormality. Interobserver agreement was 100% (kappa = 1.0) for test positivity and 92% (kappa = 0.72) for wall motion scores.


CONCLUSIONS
DSMR in pediatric patients is feasible and provides high-quality imaging of all ventricular wall segments with low interobserver variability. Further exploration of DSMR in pediatric patients is warranted, particularly for those children who are unable to cooperate sufficiently for exercise stress or have poor acoustic windows.
Strigl
Sebastian
S
Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts, USA.
Beroukhim
Rebecca
R
Valente
Anne Marie
AM
Annese
David
D
Harrington
James S
JS
Geva
Tal
T
Powell
Andrew J
AJ
D000293:Adolescent; D002316:Cardiotonic Agents; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003330:Coronary Vessel Anomalies / Q000175:diagnosis*; D004280:Dobutamine; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult
D002316:Cardiotonic Agents; D004280:Dobutamine