IMAJ 2013-05-01

Dobutamine stress MRI for the assessment of coronary artery disease: initial clinical experience in Israel.

Ashraf Hamdan, Orly Goitein, Shlomi Matetzky, Salem Yishay, Elio Di Segni, Dmitry Yakubovitch, Daniel Silverberg, Moshe Halak, Michael Eldar, Eli Konen

Index: Isr. Med. Assoc. J. 15(5) , 205-9, (2013)

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Abstract

Over the past few years dobutamine stress magnetic resonance (DSMR) has proven its efficacy as an integral part of the diagnosis of coronary artery disease (CAD).To present the feasibility and safety of DSMR in Israel.Thirty patients with suspected or known CAD were studied. DSMR images were acquired during short breath-holds in three short axis views and four-, two-, and three-chamber views. Patients were examined at rest and during a standard dobutamine-atropine protocol. Regional wall motion was assessed in a 16-segment model and the image quality was evaluated using a four-point scale for the visibility of the endocardial border.In 28 patients (93.4%) DSMR was successfully performed and completed within an average of 55 +/- 6 minutes. One patient could not be examined because of claustrophobia and another patient, who was on beta-blockers, did not reach the target heart rate. Image quality was excellent and there was no difference between the rest and stress images in short axis (3.91 +/- 0.29 vs. 3.88 +/- 0.34, P = 0.13, respectively) and long axis (3.83 +/- 0.38 vs. 3.70 +/- 0.49, P = 0.09, respectively) views. Segmental intra-observer agreement for wall motion contractility at rest and stress cine images was almost perfect (K = 0.88, 95% confidence interval = 0.93-0.84, and K = 0.82, 95% CI = 0.88-0.76) respectively. No serious side effects were observed during DSMR.The present study confirms the feasibility, safety and excellent image quality of DSMR for the diagnosis of coronary artery diseases.