Safety and diagnostic accuracy of stress cardiac magnetic resonance imaging vs exercise tolerance testing early after acute ST elevation myocardial infarction

Objective:To determine the safety and diagnostic accuracy of adenosine-stress cardiac magnetic resonance (CMR) perfusion imaging early after acute ST elevation myocardial infarction (STEMI) compared with standard exercise tolerance testing (ETT).Design and setting:Cross sectional observational study...

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Bibliographic Details
Published in:Heart (British Cardiac Society) 2007-11, Vol.93 (11), p.1363-1368
Main Authors: Greenwood, J P, Younger, J F, Ridgway, J P, Sivananthan, M U, Ball, S G, Plein, S
Format: Article
Language:English
Subjects:
Accuracy
Acute Coronary Syndromes
Adenosine
Aged
Biological and medical sciences
Cardiology. Vascular system
Cardiovascular disease
Clinical medicine
Coronary Angiography
Coronary heart disease
Coronary Stenosis - diagnosis
Coronary Stenosis - therapy
Coronary vessels
Cross-Sectional Studies
Electrocardiography
Exercise Test - methods
Exercise Tolerance
Female
Heart
Heart attacks
Humans
magnetic resonance imaging
Magnetic Resonance Imaging - adverse effects
Magnetic Resonance Imaging - methods
Male
Medical imaging
Medical sciences
Middle Aged
myocardial infarction
Myocardial Infarction - diagnosis
Myocardial Infarction - physiopathology
Myocardial Infarction - therapy
myocardial ischaemia
myocardial perfusion
Myocardial Revascularization
Myocarditis. Cardiomyopathies
Patient Selection
Patients
Studies
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Summary:Objective:To determine the safety and diagnostic accuracy of adenosine-stress cardiac magnetic resonance (CMR) perfusion imaging early after acute ST elevation myocardial infarction (STEMI) compared with standard exercise tolerance testing (ETT).Design and setting:Cross sectional observational study in a university teaching hospital.Patients:35 patients admitted with first acute STEMI.Interventions:All patients underwent a CMR imaging protocol which included rest and adenosine-stress perfusion, viability, and cardiac functional assessment. All patients also had an ETT (modified Bruce protocol) and x ray coronary angiography.Main outcome measures:Safety and diagnostic accuracy of adenosine-stress perfusion CMR vs ETT early after STEMI in identifying patients with significant coronary stenosis (⩾70%) and the need for coronary revascularisation. Also, to determine if CMR can distinguish between ischaemia in the peri-infarct zone and ischaemia in remote myocardium.Results:CMR imaging was well tolerated (all patients completed the protocol) and no complications occurred. CMR was more sensitive (86% vs 48%, p = 0.0074) and more specific than ETT (100% vs 50%, p
ISSN:1355-6037
1468-201X
DOI:10.1136/hrt.2006.106427