Functional MRI in ischemic heart disease based on detection of contraction abnormalities

Nagel, Eike; Fleck, Eckart

doi:10.1002/(sici)1522-2586(199909)10:3<411::aid-jmri24>3.0.co;2-#

Cited by 17 publications

(4 citation statements)

References 40 publications

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“…MRI has become an alternative method for the assessment of wall motion, proving particularly beneficial in patients where suboptimal image quality is obtained during echocardiographic assessment 12 . These findings are confirmed by comparative studies between echocardiography and MRI conducted at rest, 13 in conjunction with stress imaging, 14 and with the addition of echocardiographic contrast agents 15 …”

Section: Discussionmentioning

confidence: 89%

Imagent Improves Endocardial Border Delineation, Inter‐reader Agreement, and the Accuracy of Segmental Wall Motion Assessment

et al. 2003

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Section: Discussionmentioning

confidence: 89%

Imagent Improves Endocardial Border Delineation, Inter‐reader Agreement, and the Accuracy of Segmental Wall Motion Assessment

et al. 2003

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“…Therefore, myocardial tagging is an ideal tool to analyze myocardial deformation (circumferential shortening, radial thickening, and longitudinal compression) throughout the cardiac cycle and thus to unravel the mechanisms of myocardial contraction in normal and pathological conditions [64][65][66][67]. Kuijpers et al [42] reported that myocardial tagging in combination with a high-dose dobutamine stress protocol detected more stress-induced wall-motion abnormalities than high-dose dobutamine stress testing alone.…”

Section: Risk Stratificationmentioning

confidence: 99%

Cardiac stress MR imaging with dobutamine

et al. 2006

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Stress testing for detection of ischemia-induced wall-motion abnormalities has become a mainstay for noninvasive diagnosis and risk stratification of patients with suspected coronary artery disease (CAD). Recent technical developments in magnetic resonance imaging (MRI), including the adoption of balanced steady-state free precession (b-SSFP) sequences-preferentially in combination with parallel imaging techniques-have led to a significant reduction of imaging time and improved patient safety. The stress protocol includes application of high-dose dobutamine (up to 40 microg/kg/min) combined with fractionated atropine (up to a maximal dose of 1.0 mg). High-dose dobutamine stress MRI revealed good sensitivity (83-96%) and specificity (80-100%) for detection of significant CAD. Myocardial tagging methods have been shown to further increase sensitivity for CAD detection. Severe complications (sustained tachycardia, ventricular fibrillation, myocardial infarction, cardiogenic shock) are rare but may be expected in 0.1-0.3% of patients. Dobutamine stress MRI has emerged as a reliable and safe clinical alternative for noninvasive assessment of CAD. New pulse sequences, such as real-time imaging, might obviate the need for breath holding and electrocardiogram (ECG) triggering in patients with severe dyspnoea and cardiac arrhythmias, which may further improve the clinical impact and acceptance of stress MRI in the future.

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“…In addition, the diagnostic utility of ECG monitoring is diminished within the magnetic field. Published efficacy studies have reported safety of dobutamine MRI both at low and high doses (20, 57, 58), however, data recently presented at the Society of Cardiovascular Magnetic Resonance Annual Meeting in 2003 from Wahl et al (59) found that limiting side effects occurred in 7.4% of 1000 consecutive patients having (high‐dose) dobutamine stress MRI.…”

Section: Magnetic Resonance Viability Imagingmentioning

confidence: 99%

Magnetic resonance imaging for the assessment of myocardial viability

Thomson

Kim

Judd

2004

Magnetic Resonance Imaging

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The identification of myocardial viability in the setting of left ventricular (LV) dysfunction is crucial for the prediction of functional recovery following revascularization. Although echocardiography, positron emission tomography (PET), and nuclear imaging have validated roles, recent advances in cardiac magnetic resonance (CMR) technology and availability have led to increased experience in CMR for identification of myocardial viability. CMR has unique advantages in the ability of magnetic resonance spectroscopy (MRS) to measure subcellular components of myocardium, and in the image resolution of magnetic resonance proton imaging. As a result of excellent image resolution and advances in pulse sequences and coil technology, magnetic resonance imaging (MRI) can be used to identify the transmural extent of myocardial infarction (MI) in vivo for the first time. This review of the role of CMR in myocardial viability imaging describes the acute and chronic settings of ventricular dysfunction and concepts regarding the underlying pathophysiology. Recent advances in MRS and MRI are discussed, including the potential for dobutamine MRI to identify viable myocardium and a detailed review of the technique of delayed gadolinium (Gd) contrast hyperenhancement for visualization of viable and nonviable myocardium. IN THE LAST FIVE years, there have been multiple technological advances in noninvasive cardiac imaging that are now being translated into new clinical options for the diagnosis and management of cardiac disease. Echocardiography, nuclear imaging, computed tomography (CT), and magnetic resonance imaging (MRI) have established and emerging roles in noninvasive cardiac imaging. Of the clinical applications for cardiac imaging, assessment of cardiac viability has experienced significant growth as a reflection of the rising number of patients with coronary artery disease (CAD)-related left ventricular (LV) dysfunction (1). Despite its relatively recent addition to the cardiac imaging armory, cardiac magnetic resonance (CMR) viability imaging has established a clinical role and is serving to provide new insights into the natural history of myocardial damage and myocardial dysfunction in patients with CAD. CMR can provide morphological, functional (MRI) and metabolic (magnetic resonance spectroscopy, MRS) information about the heart, and offers detailed viability information that cannot be obtained from any other modality. KeyThroughout the Western world there has been a decline in the number of deaths from myocardial infarction MI) but a dramatic increase in the incidence of congestive cardiac failure. In the United States between 1970 and 2000, cardiovascular disease death rates decreased overall by 50%, however mortality rates for congestive heart failure more than doubled and hospitalizations for congestive heart failure more than tripled (1). Palliative treatment options for heart failure are numerous (2), however the ideal treatment is the restoration of myocardial systolic function through revascularization of d...

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Functional MRI in ischemic heart disease based on detection of contraction abnormalities

Cited by 17 publications

References 40 publications

Imagent Improves Endocardial Border Delineation, Inter‐reader Agreement, and the Accuracy of Segmental Wall Motion Assessment

Imagent Improves Endocardial Border Delineation, Inter‐reader Agreement, and the Accuracy of Segmental Wall Motion Assessment

Cardiac stress MR imaging with dobutamine

Magnetic resonance imaging for the assessment of myocardial viability

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