Document Detail


Dobutamine cardiac magnetic resonance results predict cardiac prognosis in women with known or suspected ischemic heart disease.
MedLine Citation:
PMID:  19356575     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to determine the prognostic utility of dobutamine cardiac magnetic resonance (DCMR) stress test results in women.
BACKGROUND: To date, the preponderance of studies reporting the utility of DCMR stress results for predicting cardiac prognosis have been performed in men. We sought to determine the utility of DCMR results for predicting cardiac prognosis in women.
METHODS: Two hundred sixty-six consecutively referred women underwent DCMR in which left ventricular wall motion (LVWM) was assessed at rest and after intravenous dobutamine and atropine. Inducible LVWM abnormalities were identified during testing. Women were contacted to determine the post-DCMR occurrence of a cardiac event. All events were substantiated according to defined criteria and then were verified after a thorough medical record review by individuals blinded to testing data.
RESULTS: Women were contacted an average of 6.2 +/- 1.6 (median 6.2, range 0.8 to 10.4) years after DCMR; 27% of the women experienced an inducible LVWM abnormality during testing. In those with and without inducible LVWM abnormalities, the proportion of women with cardiac events were 63% versus 30%, respectively, (hazard ratio [HR]: 2.7; 95% confidence interval [CI]: 1.8 to 4.3 for the presence of inducible LVWM abnormalities p < 0.0001). The proportion of women with myocardial infarction (MI) and cardiac death were 33.3% and 7.5%, respectively. This resulted in a HR for MI and cardiac death of 4.1 (95% CI: 2.2 to 9.4) for those with versus those without inducible LVWM abnormalities; p < 0.0001. A subgroup analysis was performed in women without a history of coronary artery disease and in those with LVWM abnormalities, DCMR remained an adverse predictor of cardiac events (HR: 4.0, 95% CI: 1.8 to 9.0, p = 0.003).
CONCLUSIONS: Inducible LVWM abnormalities during DCMR predict cardiac death and MI in women. Similar to men, these results indicate that DCMR is a valuable noninvasive stress imaging modality for identifying cardiac risk in women with known or suspected ischemic heart disease.
Authors:
Eric L Wallace; Timothy M Morgan; Thomas F Walsh; Erica Dall'Armellina; William Ntim; Craig A Hamilton; W Gregory Hundley
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  JACC. Cardiovascular imaging     Volume:  2     ISSN:  1876-7591     ISO Abbreviation:  JACC Cardiovasc Imaging     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-04-09     Completed Date:  2009-07-02     Revised Date:  2014-09-18    
Medline Journal Info:
Nlm Unique ID:  101467978     Medline TA:  JACC Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  299-307     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Atropine / diagnostic use
Cardiotonic Agents / diagnostic use*
Dobutamine / diagnostic use*
Humans
Kaplan-Meier Estimate
Magnetic Resonance Imaging, Cine*
Middle Aged
Myocardial Contraction*
Myocardial Infarction / etiology*,  mortality,  physiopathology
Myocardial Ischemia / complications,  diagnosis*,  mortality,  physiopathology
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Prospective Studies
Risk Assessment
Risk Factors
Time Factors
Ventricular Function, Left*
Women's Health Services*
Grant Support
ID/Acronym/Agency:
M01 RR007122/RR/NCRR NIH HHS; M01 RR007122/RR/NCRR NIH HHS; M01 RR007122-147159/RR/NCRR NIH HHS; P30 AG021332/AG/NIA NIH HHS; P30 AG021332-010003/AG/NIA NIH HHS; P30 AG21332/AG/NIA NIH HHS; R01 HL076438/HL/NHLBI NIH HHS; R01 HL076438/HL/NHLBI NIH HHS; R01 HL076438-03/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 3S12J47372/Dobutamine; 7C0697DR9I/Atropine
Comments/Corrections

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