title: Dobutamine stress MRI for the assessment of coronary artery disease: initial clinical experience in Israel.
abstract: BACKGROUND
  Over the past few years dobutamine stress magnetic resonance (DSMR) has proven its efficacy as an integral part of the diagnosis of coronary artery disease (CAD).
  
  
  OBJECTIVE
  To present the feasibility and safety of DSMR in Israel.
  
  
  METHODS
  Thirty patients with suspected or known CAD were studied. DSMR images were acquired during short breath-holds in three short axis views and four-, two-, and three-chamber views. Patients were examined at rest and during a standard dobutamine-atropine protocol. Regional wall motion was assessed in a 16-segment model and the image quality was evaluated using a four-point scale for the visibility of the endocardial border.
  
  
  RESULTS
  In 28 patients (93.4%) DSMR was successfully performed and completed within an average of 55 +/- 6 minutes. One patient could not be examined because of claustrophobia and another patient, who was on beta-blockers, did not reach the target heart rate. Image quality was excellent and there was no difference between the rest and stress images in short axis (3.91 +/- 0.29 vs. 3.88 +/- 0.34, P = 0.13, respectively) and long axis (3.83 +/- 0.38 vs. 3.70 +/- 0.49, P = 0.09, respectively) views. Segmental intra-observer agreement for wall motion contractility at rest and stress cine images was almost perfect (K = 0.88, 95% confidence interval = 0.93-0.84, and K = 0.82, 95% CI = 0.88-0.76) respectively. No serious side effects were observed during DSMR.
  
  
  CONCLUSIONS
  The present study confirms the feasibility, safety and excellent image quality of DSMR for the diagnosis of coronary artery diseases.
authors.affiliation: Heart Institute, Sheba Medical Center, Tel Hashomer, Israel. Ashraf.Hamdan@sheba.health.gov.il
authors.forename: Ashraf
authors.initials: A
authors.lastname: Hamdan
authors.forename: Orly
authors.initials: O
authors.lastname: Goitein
authors.forename: Shlomi
authors.initials: S
authors.lastname: Matetzky
authors.forename: Salem
authors.initials: S
authors.lastname: Yishay
authors.forename: Elio
authors.initials: E
authors.lastname: Di Segni
authors.forename: Dmitry
authors.initials: D
authors.lastname: Yakubovitch
authors.forename: Daniel
authors.initials: D
authors.lastname: Silverberg
authors.forename: Moshe
authors.initials: M
authors.lastname: Halak
authors.forename: Michael
authors.initials: M
authors.lastname: Eldar
authors.forename: Eli
authors.initials: E
authors.lastname: Konen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001285:Atropine; D002316:Cardiotonic Agents; D003324:Coronary Artery Disease / Q000175:diagnosis*; D004280:Dobutamine; D005080:Exercise Test / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007557:Israel; D019028:Magnetic Resonance Imaging, Cine / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D002316:Cardiotonic Agents; D018727:Muscarinic Antagonists; D004280:Dobutamine; D001285:Atropine