Diagnostic Performance of Treadmill Exercise Cardiac Magnetic Resonance: The Prospective, Multicenter Exercise CMR's Accuracy for Cardiovascular Stress Testing (EXACT) Trial

Abstract

Background--Stress cardiac magnetic resonance (CMR) has typically involved pharmacologic agents. Treadmill CMR has shown utility in single-center studies but has not undergone multicenter evaluation.

Exercise cardiovascular magnetic resonance: development, current utility and future applications

“…Varying transfer times have been achieved in treadmill Ex-CMR studies (Table 2) [27,31,33,34,[42][43][44][45]. Since progression to a CMR compatible treadmill adjacent to the scanner, all studies demonstrate scan initiation in under 30 s, as shown in Video 1 (with the exception of La Fountain et al in which removal of the face mask assessing oxygen uptake prolonged transfer time [44]) and cine imaging completion in under 60 s [42,43,45]. [45].…”

“…Since progression to a CMR compatible treadmill adjacent to the scanner, all studies demonstrate scan initiation in under 30 s, as shown in Video 1 (with the exception of La Fountain et al in which removal of the face mask assessing oxygen uptake prolonged transfer time [44]) and cine imaging completion in under 60 s [42,43,45]. [45]. This protocol is compared with adenosine/dobutamine pharmacological stress CMR imaging in Fig.…”

Updates on Stress Imaging Testing and Myocardial Viability With Advanced Imaging Modalities

“…The exercise stress using MRI compatible treadmill testing is another newer development in the field of stress CMR. The EXACT trial showed excellent diagnostic value and agreement with invasive coronary angiography [61]. The setup, however, poses many technical challenges and is currently limited to a few research centers.…”

Moving Toward the Optimal Test for the Assessment of Myocardial Ischemia

“…The multicenter EXACT trial presented in this issue10 adds to this information. Raman et al examined 94 patients with a sophisticated dual‐imaging exercise stress protocol.…”