Exercise Cardiovascular Magnetic Resonance: A Review

Abstract

While pharmacologic stress cardiovascular magnetic resonance imaging (MRI) is a robust noninvasive tool in the diagnosis and prognostication of epicardial coronary artery disease, clinical guidelines recommend exercise-based testing in those patients who can exercise. This review describes the development of exercise cardiovascular MRI protocols, summarizes the insights across various patient populations, and highlights future research initiatives.

Cardiac and intramuscular adaptations following short-term exercise prehabilitation in unfit patients scheduled to undergo hepatic or pancreatic surgery: study protocol of a multinuclear MRI study

“…Other strengths of this study are the additional pre-intervention and post-intervention in-magnet exercise tests, next to the conventional CPET, to acquire objective information on the adaptations in cardiac and skeletal muscle function. With exCMRI the effective cardiac output can be assessed, as patients reach their near-maximum effort during exercise, magnifying the insights in the physiological process with a non-invasive approach 17 31. Moreover, due to the precision of exCMRI, it is highly reproducible and therefore only small sample sizes are required to detect small changes over time after short-term exercise interventions 17 24 32.…”

“…With exCMRI the effective cardiac output can be assessed, as patients reach their near-maximum effort during exercise, magnifying the insights in the physiological process with a non-invasive approach 17 31. Moreover, due to the precision of exCMRI, it is highly reproducible and therefore only small sample sizes are required to detect small changes over time after short-term exercise interventions 17 24 32. Also, exCMRI has previously been successfully used to assess cardiac function and determine beneficial effects of exercise training programmes, including in the field of oncology 33–35.…”

“…17 31 Moreover, due to the precision of exCMRI, it is highly reproducible and therefore only small sample sizes are required to detect small changes over time after short-term exercise interventions. 17 24 32 Also, exCMRI has previously been successfully used to assess cardiac function and determine beneficial effects of exercise training programmes, including in the field of oncology. [33][34][35] Lastly, 31…”

“…Using in vivo exercise cardiac MRI (exCMRI) and musculoskeletal phosphorus 31 exercise multinuclear magnetic resonance spectroscopy ( 31 P-exMMRS) of the quadriceps femoris muscle, it is possible to interrogate the cardiac and skeletal muscle function. [16][17][18] Therefore, in the current explorative study with a pretest-posttest design, unfit patients approaching HPB surgery will undergo magnetic resonance (MR) measurements next to CPET before and after a 4-week prehabilitation programme. The primary aim of this study is to assess the central (cardiac function) and peripheral (skeletal muscle function) physiological adaptations in response to short-term exercise prehabilitation.…”

Cardiac MRI assessment of anthracycline-induced cardiotoxicity

“…Moreover, CMR can be used to assess cardiac function during exercise testing ( 72 ) and has even been utilized in hematologic cancer survivors by placing an exercise bike in the magnetic resonance imaging (MRI) scanner ( Figure 10 ). Cine images at rest and during exercise are depicted ( Figures 11 , 12 ), as this technology allows for myocardial function to be compared at baseline and during exercise ( 73 ).…”