Moving Toward the Optimal Test for the Assessment of Myocardial Ischemia

Nagel, Eike

doi:10.1161/jaha.116.003266

Cited by 2 publications

(4 citation statements)

References 14 publications

(16 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Importantly, we demonstrated that CMR-FT is feasible and reproducible even when the temporal resolution is limited by a fast HR in a DSCMR. LV wall motion assessment is an important adjunct to perfusion imaging in assessing ischemic changes (7). The prognostic value of WMSI has been investigated in patients with acute STEMI and NSTEMI myocardial infarction as well as post-CABG, suggesting it provides incremental information in predicting infarct size and mortality (8,21,24,25).…”

Section: Discussionmentioning

confidence: 99%

“…It has been deemed safe and feasible in the pediatric population ( 6 ). The assessment for left ventricular (LV) wall motion abnormalities (WMA) is an important adjunct in assessing ischemic changes ( 7 ). It is conventionally performed by subjective visual examination, which is associated with considerable interobserver variability ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Wall motion assessment by feature tracking in pediatric patients with coronary anomalies undergoing dobutamine stress CMR

Sachdeva,

Molossi,

Reaves-O’Neal

et al. 2024

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundLeft ventricular (LV) wall motion assessment is an important adjunct in addition to perfusion defects in assessing ischemic changes. This study aims to investigate the feasibility and utility of performing feature tracking (FT) in pediatric patients with coronary anomalies undergoing dobutamine stress CMR to assess wall motion abnormalities (WMA) and perfusion defects.MethodThis is a retrospective study where 10 patients with an inducible first-pass perfusion (FPP) defect and 10 without were selected. Global LV circumferential strain/strain rate (GCS/GCSR) was measured at rest and at peak stress (systole and diastole) using a commercially available feature tracking software. Peak GCS and GCSR were compared to indexed wall motion score (WMSI) between groups with and without FPP defect and in subjects with and without WMA.ResultsThe median age of patients was 13.5 years (Q1, 11 years; Q3, 15 years). Five subjects had qualitatively WMA at peak stress. A moderate correlation of GCS with WMSI at peak stress (0.48, p = 0.026) and a significant difference between GCS at rest and stress in patients with no inducible WMA (p = 0.007) were seen. No significant difference was noted in GCS between rest and stress in patients with WMA (p = 0.13). There was a larger absolute GCS/GCSR at peak stress in subjects with no inducible FPP defect or WMA.ConclusionSmaller absolute GCS and a lack of significant change in GCS at peak stress in those with inducible WMA or perfusion defect are suggestive of compromised LV deformation in subjects with inducible WMA. Given these findings, GCS derived from CMR-FT may be used to objectively assess WMA in pediatric patients undergoing stress CMR.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Wall motion assessment by feature tracking in pediatric patients with coronary anomalies undergoing dobutamine stress CMR

Sachdeva,

Molossi,

Reaves-O’Neal

et al. 2024

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…A contrast‐free alternative to stress perfusion cardiac MRI is stress wall motion imaging, which allows detection of ischemia by qualitative evaluation of regional wall motion during infusion of increasing doses of pharmacological stress agents . In general, adenosine (a vasodilator) is used for the detection of stress‐inducible perfusion deficits, and dobutamine (a positive inotropic and positive chronotropic) for wall motion abnormalities …”

Section: Major Building Blocks Of Cardiac Mrimentioning

confidence: 99%

“…Most of the evidence regarding the diagnostic accuracy of stress perfusion and stress wall motion imaging is in individual studies, with various combinations in the studied image modality and stress agent, in different patient populations. Whether stress wall motion or stress perfusion imaging is preferable in under debate, and it is recommended that the method be used in which there is local expertise . Since stress imaging is typically combined with a LGE module, the patient will receive contrast material during the MR examination, even if stress wall motion imaging is chosen over stress perfusion imaging.…”

Section: Clinical Indicationsmentioning

confidence: 99%