title: Pharmacological stress cardiovascular magnetic resonance: feasibility and safety in a large multicentre prospective registry.
abstract: OBJECTIVE
  To assess the feasibility and incidence of immediate complications of stress cardiovascular magnetic resonance (CMR) and to determine associated factors.
  
  
  RESULTS
  This was a large multicentre, prospective registry of pharmacologic stress CMR in a referral population. We used dipyridamole when no contraindication was present and dobutamine in the remaining patients. Stress CMR was performed at 1.5 T. We recorded the clinical and demographic data, quality of test, CMR findings, haemodynamic data, and complications. Stress CMR was performed in 11 984 patients (98.2% of requested), using dipyridamole in 95.4% and dobutamine in 4.6%. The study could not be performed due to claustrophobia in 0.2%. Quality was optimal in 93.4%, suboptimal in 6.2%, and poor in 0.4% of studies. Images were diagnostic in 97.6% of patients (98.7% with dipyridamole and 75.1% with dobutamine, P < 0.0001). No patient died or had acute myocardial infarction during the test. Ten patients (0.08%) had severe immediate complications, seven after dipyridamole and two after dobutamine (P = 0.062), and one anaphylactic shock post-gadolinium. The only factor significantly associated with higher incidence of serious complications was the detection of inducible ischaemia. Incidence of non-severe complications was low (1.5%), severe controlled chest pain being the most frequent. Minor symptoms occurred frequently (24.8%). Both were significantly more frequent when dobutamine was used.
  
  
  CONCLUSIONS
  Performance of stress CMR is safe in a referral population. Inducible ischaemia was the only factor identified which was associated with serious complications. The incidence of non-severe complications and minor symptoms was greater with dobutamine.
authors.affiliation: Cardiac Imaging Unit, ERESA Medical Center, Valencia, Spain jmonmeneu@eresa.com.
authors.forename: Jose V
authors.initials: JV
authors.lastname: Monmeneu Menadas
authors.affiliation: Cardiac Imaging Unit, ERESA Medical Center, Valencia, Spain.
authors.forename: Maria P
authors.initials: MP
authors.lastname: Lopez-Lereu
authors.affiliation: Cardiac Imaging Unit, ERESA Medical Center, Valencia, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Estornell Erill
authors.affiliation: Cardiac Imaging Unit, ERESA Medical Center, Valencia, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Garcia Gonzalez
authors.affiliation: Cardiac Imaging Unit, ERESA Medical Center, Valencia, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Igual Muñoz
authors.affiliation: Cardiac Imaging Unit, ERESA Medical Center, Valencia, Spain.
authors.forename: Alicia
authors.initials: A
authors.lastname: Maceira Gonzalez
mesh_terms: D002316:Cardiotonic Agents / Q000009:adverse effects*; D004176:Dipyridamole / Q000009:adverse effects*; D004280:Dobutamine / Q000009:adverse effects*; D005080:Exercise Test / Q000009:adverse effects*; D005240:Feasibility Studies; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013030:Spain; D014665:Vasodilator Agents / Q000009:adverse effects*
chemical_list: D002316:Cardiotonic Agents; D014665:Vasodilator Agents; D004280:Dobutamine; D004176:Dipyridamole
keywords: Cardiovascular magnetic resonance; Dipyridamole; Dobutamine; Feasibility; Registry; Safety