Pharmacologic stress cardiovascular magnetic resonance in the pediatric population: A review of the literature, proposed protocol, and two examples in patients with Kawasaki disease

Fares, Maan; Critser, Paul J.; Arruda, Maria J; Wilhelm, Carolyn M.; Rattan, Mantosh S.; Lang, Sean M.; Alsaied, Tarek

doi:10.1111/chd.12840

Cited by 3 publications

(5 citation statements)

References 55 publications

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“…The choice of pharmacological stress agents in children is the same as in adults, but the dosage and infusion rates may vary depending on circumstances (see Table 2). Stress CMR with an adenosine infusion can be performed using the same infusion rates as in adults, and the dose is dependent on weight (i.e., 140 µg/kg/min) [131]. For patients under general anesthesia, some units have used lower adenosine infusion rates and titrated upwards (i.e., start with 110 µg/kg/min, increase stepwise to 125 µg/kg/min and then 140 µg/kg/min based on hemodynamic changes) [125].…”

Section: Childrenmentioning

confidence: 99%

“…Thus, this is widely used in pediatrics [126,128,132]. For pediatric patients weighing less than 40 kg, a dose of 6-10 µg/kg is recommended for safety concerns [126,128,131,133]; those ≥ 40 kg can receive the usual adult dose of 400 mcg of regadenoson [128,132]. Lastly, dobutamine can also be utilised with typical doses of 5-10 µg/kg/min with an increase every 3-5 min to a maximum dose of 40 µg/kg/min [131].…”

Section: Childrenmentioning

confidence: 99%

“…For pediatric patients weighing less than 40 kg, a dose of 6-10 µg/kg is recommended for safety concerns [126,128,131,133]; those ≥ 40 kg can receive the usual adult dose of 400 mcg of regadenoson [128,132]. Lastly, dobutamine can also be utilised with typical doses of 5-10 µg/kg/min with an increase every 3-5 min to a maximum dose of 40 µg/kg/min [131]. Additional atropine bolus up to 0.01 mg/kg can be given to reach 80% of maximal age predicted heart rate [134][135][136].…”

Section: Childrenmentioning

confidence: 99%

“…Additional atropine bolus up to 0.01 mg/kg can be given to reach 80% of maximal age predicted heart rate [134][135][136]. Dipyridamole is far less used in children, and only a few early studies have reported its feasibility [131,137]. During the entire period of pharmacological stress, close monitoring for adverse events such as heart block, bronchospasm, and hypotension should be performed.…”

Section: Childrenmentioning

confidence: 99%

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Qualitative and Quantitative Stress Perfusion Cardiac Magnetic Resonance in Clinical Practice: A Comprehensive Review

et al. 2023

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Stress cardiovascular magnetic resonance (CMR) imaging is a well-validated non-invasive stress test to diagnose significant coronary artery disease (CAD), with higher diagnostic accuracy than other common functional imaging modalities. One-stop assessment of myocardial ischemia, cardiac function, and myocardial viability qualitatively and quantitatively has been proven to be a cost-effective method in clinical practice for CAD evaluation. Beyond diagnosis, stress CMR also provides prognostic information and guides coronary revascularisation. In addition to CAD, there is a large body of literature demonstrating CMR’s diagnostic performance and prognostic value in other common cardiovascular diseases (CVDs), especially coronary microvascular dysfunction (CMD). This review focuses on the clinical applications of stress CMR, including stress CMR scanning methods, practical interpretation of stress CMR images, and clinical utility of stress CMR in a setting of CVDs with possible myocardial ischemia.

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Section: Childrenmentioning

confidence: 99%

Section: Childrenmentioning

confidence: 99%

Section: Childrenmentioning

confidence: 99%

Section: Childrenmentioning

confidence: 99%

See 2 more Smart Citations

Qualitative and Quantitative Stress Perfusion Cardiac Magnetic Resonance in Clinical Practice: A Comprehensive Review

et al. 2023

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“…Importantly, CMR can perform tissue characterization such as late gadolinium enhancement or T1 mapping (Fig. 1) aiding in the management of cardiomyopathies and acquired paediatric heart disease [17][18][19].…”

Section: When To Consider Advanced Imaging Modalitiesmentioning

confidence: 99%

Use of advanced cardiac imaging in congenital heart disease: growth, indications and innovations

Steele

Moore

Lang

2021

Current Opinion in Pediatrics

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Purpose of review Significant improvements in the diagnosis and management of patients with congenital heart disease (CHD) have led to improved survival. These patients require life-long noninvasive evaluation. The use of advanced imaging such as cardiac magnetic resonance imaging (CMR) and cardiac computed tomography (CCT) has increased to support this need. The purpose of this review is to discuss the basics of advanced cardiac imaging, indications and review the recent innovations. Recent findings Recent literature has demonstrated the increasing reliance of advanced imaging for CHD patients. In addition, research is focusing on CMR techniques to shorten scan time and address previous limitations that made imaging younger and sicker patients more challenging. CCT research has involved demonstrating high-quality images with low radiation exposure. Advances in digital technology have impacted the interactivity of 3D imaging through the use of virtual and augmented reality platforms. With the increased reliance of advanced imaging, appropriate use criteria have been developed to address possible under or over utilization. Summary The utilization of advanced cardiac imaging continues to increase. As CMR and CCT continue to grow, increased knowledge of these modalities and their usage will be necessary for clinicians caring for CHD patients.

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Tolerability and efficacy of a reduced dose adenosine stress cardiac magnetic resonance protocol under general anesthesia in infants and children

Ganigara,

Sharma,

Doctor

et al. 2023

Pediatr Radiol

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Pharmacologic stress cardiovascular magnetic resonance in the pediatric population: A review of the literature, proposed protocol, and two examples in patients with Kawasaki disease

Cited by 3 publications

References 55 publications

Qualitative and Quantitative Stress Perfusion Cardiac Magnetic Resonance in Clinical Practice: A Comprehensive Review

Qualitative and Quantitative Stress Perfusion Cardiac Magnetic Resonance in Clinical Practice: A Comprehensive Review

Use of advanced cardiac imaging in congenital heart disease: growth, indications and innovations

Tolerability and efficacy of a reduced dose adenosine stress cardiac magnetic resonance protocol under general anesthesia in infants and children

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