title: Strain-encoded cardiac MR during high-dose dobutamine stress testing: comparison to cine imaging and to myocardial tagging.
abstract: OBJECTIVE
  To investigate regional strain response during high-dose dobutamine stress cardiac magnetic resonance imaging (DS-CMR) using myocardial tagging and Strain-Encoded MR (SENC).
  
  
  METHODS
  Stress induced ischemia was assessed by wall motion analysis, by tagged CMR and by SENC in 65 patients with suspected or known CAD who underwent DS-CMR in a clinical 1.5 Tesla scanner. Coronary angiography deemed as the standard reference for the presence or absence of CAD (> or =50% diameter stenosis) in all patients.
  
  
  RESULTS
  SENC and conventional tagging detected abnormal strain response in six and five additional patients, respectively, who were missed by cine images and proved to have CAD by angiography (P < 0.05 for SENC versus cine, P = 0.06 for tagging versus cine and p = NS for SENC versus tagging). On a per-vessel level, wall motion analysis on cine images showed high specificity (95%) but moderate sensitivity (70%) for the detection of CAD. Tagging and SENC yielded significantly higher sensitivity of 81% and 89%, respectively (P < 0.05 for tagging and P < 0.01 for SENC versus wall motion analysis, and p = NS for SENC versus tagging), while specificity was equally high (96% and 94%, respectively, P = NS for all).
  
  
  CONCLUSIONS
  Both the direct color-coded visualization of strain on CMR images and the generation of additional visual markers within the myocardium with tagged CMR represent useful adjuncts for DS-CMR, which may provide incremental value for the detection of CAD in humans. J. Magn. Reson.
authors.affiliation: University of Heidelberg, Department of Cardiology, Heidelberg, Germany. bkorosoglou@hotmail.com
authors.forename: Grigorios
authors.initials: G
authors.lastname: Korosoglou
authors.forename: Simon
authors.initials: S
authors.lastname: Futterer
authors.forename: Per M
authors.initials: PM
authors.lastname: Humpert
authors.forename: Nina
authors.initials: N
authors.lastname: Riedle
authors.forename: Dirk
authors.initials: D
authors.lastname: Lossnitzer
authors.forename: Birgit
authors.initials: B
authors.lastname: Hoerig
authors.forename: Henning
authors.initials: H
authors.lastname: Steen
authors.forename: Evangelos
authors.initials: E
authors.lastname: Giannitsis
authors.forename: Nael F
authors.initials: NF
authors.lastname: Osman
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
mesh_terms: D000465:Algorithms; D003324:Coronary Artery Disease / Q000175:diagnosis*; D004280:Dobutamine; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013194:Staining and Labeling; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D004280:Dobutamine