Document Detail

Prognostic value of high-dose dobutamine stress magnetic resonance imaging in 1,493 consecutive patients: assessment of myocardial wall motion and perfusion.
MedLine Citation:
PMID:  20883929     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study sought to determine the prognostic value of wall motion and perfusion assessment during high-dose dobutamine stress (DS) cardiac magnetic resonance imaging (MRI) in a large patient cohort.
BACKGROUND: DS-MRI offers the possibility to integrate myocardial perfusion and wall motion analysis in a single examination for the detection of coronary artery disease (CAD).
METHODS: A total of 1,493 consecutive patients with suspected or known CAD underwent DS-MRI, using a standard protocol in a 1.5-T magnetic resonance scanner. Wall motion and perfusion were assessed at baseline and during stress, and outcome data including cardiac death, nonfatal myocardial infarction ("hard events"), and "late" revascularization performed >90 days after the MR scans were collected during a 2 ± 1 year follow-up period.
RESULTS: Fifty-three hard events, including 14 cardiac deaths and 39 nonfatal infarctions, occurred during the follow-up period, whereas 85 patients underwent "late" revascularization. Using multivariable regression analysis, an abnormal result for wall motion or perfusion during stress yielded the strongest independent prognostic value for both hard events and late revascularization, clearly surpassing that of clinical and baseline magnetic resonance parameters (for wall motion: adjusted hazard ratio [HR] of 5.9 [95% confidence interval (CI): 2.5 to 13.6] for hard events and of 3.1 [95% CI: 1.7 to 5.6] for late revascularization, and for perfusion: adjusted HR of 5.4 [95% CI: 2.3 to 12.9] for hard events and of 6.2 [95% CI: 3.3 to 11.3] for late revascularization, p < 0.001 for all).
CONCLUSIONS: DS-MRI can accurately identify patients who are at increased risk for cardiac death and myocardial infarction, separating them from those with normal findings, who have very low risk for future cardiac events. (Prognostic Value of High Dose Dobutamine Stress Magnetic Resonance Imaging; NCT00837005).
Grigorios Korosoglou; Yacine Elhmidi; Henning Steen; Dieter Schellberg; Nina Riedle; Johannes Ahrens; Stephanie Lehrke; Constanze Merten; Dirk Lossnitzer; Jannis Radeleff; Christian Zugck; Evangelos Giannitsis; Hugo A Katus
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  56     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2010-10-22     Revised Date:  2011-05-11    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1225-34     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, Germany.
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MeSH Terms
Aged, 80 and over
Cohort Studies
Coronary Artery Disease / diagnosis*,  physiopathology*
Dobutamine / administration & dosage*,  diagnostic use*
Dose-Response Relationship, Drug
Exercise Test / drug effects*,  methods
Follow-Up Studies
Magnetic Resonance Angiography / methods
Middle Aged
Myocardial Ischemia / diagnosis,  physiopathology
Myocardial Perfusion Imaging / methods*
Prospective Studies
Reg. No./Substance:
Comment In:
J Am Coll Cardiol. 2010 Oct 5;56(15):1244-6   [PMID:  20883931 ]
Rev Cardiovasc Med. 2011;12(1):52-4   [PMID:  21546892 ]

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