Dobutamine stress magnetic resonance imaging for the detection of coronary artery disease in women.
BACKGROUND
Dobutamine stress magnetic resonance (DSMR) imaging represents an excellent imaging approach for the detection of coronary artery disease (CAD). However, most studies have predominantly reported the utility of DSMR in men.


OBJECTIVE
To evaluate the diagnostic value of DSMR in men and women.


RESULTS
High-dose dobutamine/atropine stress magnetic resonance imaging was performed and new or worsening wall motion abnormalities evaluated in 745 consecutive patients (204 women, 541 men). Invasive coronary angiography was performed within 30 days and served as the reference standard (> or =70% stenosis). DSMR was technically successful and had diagnostic image quality in all patients except one woman and three men (p=NS). In the absence of ischaemia, target heart rate was not reached in 9.3% of women and 8.5% of men (P=NS) despite maximum pharmacological infusion (1% and 2.2%, respectively, p=NS) or owing to limiting side effects (8.3% and 6.3%, respectively, p=NS). Diagnostic values (sensitivity/specificity/accuracy) for the detection of significant coronary stenoses were similar for men (86%/83%/85%) and women (85%/86%/85%). There was no gender-based difference in regional diagnostic accuracy of DSMR for all three coronary vascular territories in patients with single-vessel CAD (81% vs 81%, p=NS, respectively).


CONCLUSIONS
The diagnostic capability of DSMR for the detection of haemodynamically relevant, obstructive CAD is independent of gender.
Gebker
R
R
Deutsches Herzzentrum Berlin, Augustenburger Platz 1, Berlin, Germany. gebker@dhzb.de
Jahnke
C
C
Hucko
T
T
Manka
R
R
Mirelis
J G
JG
Hamdan
A
A
Schnackenburg
B
B
Fleck
E
E
Paetsch
I
I
D002316:Cardiotonic Agents; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis*; D004280:Dobutamine; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012737:Sex Factors
D002316:Cardiotonic Agents; D004280:Dobutamine