title: Stress cardiovascular magnetic resonance imaging: current and future perspectives.
abstract: Vasodilator and dobutamine are the main pharmacological agents used in current stress cardiovascular magnetic resonance (CMR). Exercise stress has well-established advantages and it is commonly used in other stress imaging, but the technical considerations have limited its use in stress CMR. In this review, we will describe the diagnostic performance, prognostic value, strengths and challenges of current stress CMR techniques. We will also discuss future perspectives of exercise stress CMR. Areas covered: Despite notable mechanistic differences, vasodilator and dobutamine stress CMR offer similar diagnostic and prognostic value in coronary artery disease. Combined perfusion and wall motion assessment has been explored with dobutamine stress CMR: diagnostic sensitivity improved at the expense of reduced specificity. However, a combined assessment may provide additional prognostic value in selected patients. There is emerging interest and promising data in exercise stress CMR because of the availability of CMR-compatible stress equipment and development of novel real-time sequences that allow imaging during exercise with adequate spatiotemporal resolution. Expert commentary: Exercise stress CMR is able to assess wall motion abnormalities, perfusion defects, exercise capacity and viability in a single examination. This holds important clinical potential in a variety of cardiovascular conditions.
authors.affiliation: a Department of cardiovascular medicine , National Heart Centre Singapore , Singapore , Singapore.
authors.forename: Thu-Thao
authors.initials: TT
authors.lastname: Le
authors.affiliation: a Department of cardiovascular medicine , National Heart Centre Singapore , Singapore , Singapore.
authors.forename: Weiting
authors.initials: W
authors.lastname: Huang
authors.affiliation: a Department of cardiovascular medicine , National Heart Centre Singapore , Singapore , Singapore.
authors.forename: Jennifer Ann
authors.initials: JA
authors.lastname: Bryant
authors.affiliation: a Department of cardiovascular medicine , National Heart Centre Singapore , Singapore , Singapore.|b Duke-NUS Medical School , Singapore , Singapore.
authors.forename: Stuart Alexander
authors.initials: SA
authors.lastname: Cook
authors.affiliation: a Department of cardiovascular medicine , National Heart Centre Singapore , Singapore , Singapore.|b Duke-NUS Medical School , Singapore , Singapore.
authors.forename: Calvin Woon-Loong
authors.initials: CW
authors.lastname: Chin
mesh_terms: D003324:Coronary Artery Disease / Q000175:diagnosis / Q000000981:diagnostic imaging*; D004280:Dobutamine / Q000008:administration & dosage*; D005080:Exercise Test; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D012680:Sensitivity and Specificity; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents; D004280:Dobutamine
keywords: Cardiovascular magnetic resonance; Perfusion stress CMR; dobutamine stress CMR; exercise stress; supine cycle ergometer