Ces radiol. 2007, 61(1):85-90

Dobutamine-atropine myocardial stress test using magnetic resonance imagingOriginal article

Jiří Ferda¹, Kateřina Linhartová²

¹ Radiodiagnostická klinika LF UK a FN, Plzeň

² I. interní klinika LF UK a FN, Plzeň

Aim: This study assesses the feasibility, safety, and diagnostic experience with MRI dobutamine-atropine stress test.

Method: Fifty cardiac stress MRI examinations were performed during 12 months due to proved or suspected coronary heart disease, including 12 patients with renal insufficiency. All examinations were performed by a radiologist on 1.5 Tesla system (Magnetom Avanto, Siemens, Germany) using body matrix coil and wireless gating system. Protocol contained balanced echo sequences (trueFISP retrogated) in four-chamber, two-chamber, and short axis projections, with additional double outlet projection in selected cases. Dobutamine was dosed by experienced cardiologist in steps 5-10-20-30-40 μg/kg/min, one step of 4-5 min duration. If the chronotropic response was insufficient, additional application of atropine was used in partial doses of 0.5 mg up to total dose of 2 mg. Systolic blood pressure was measured between steps, heart rate and ECG was registered online during whole procedure.

Results: No acute myocardial infarction was noted. Developed in one patient, ventricular tachycardia requiring immediate cardioversion represented single serious complication (2 %). No complication occurred in patients with renal insufficiency. Stress dependent kinetic disorders and changes were assessed and viable myocardium was found in 22 %, non-viable scar in 28 %, stress induced ischemia in 18 %, and normal finding (without any kinetic disorder) in 32 % of cases. Valvular vitium was noted in 6 %.

Conclusion: Our experience shows that dobutamine-atropine stress test performed by an interdisciplinary team is safe and feasible procedure and is an alternative to dobutamine echocardiography in depiction of stress induced disorders of myocardial kinetics.

Keywords: dobutamine-atropine stress test, coronary heart disease, magnetic resonance

Grants and funding:

Práce byla podpořena výzkumným projektem MSM 0021620819.

Accepted: September 20, 2006; Published: March 1, 2007  Show citation