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Assessment of perfusion and wall-motion abnormalities and transient ischemic dilation in regadenoson stress cardiac magnetic resonance perfusion imaging

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Abstract

Vasodilator first-pass stress cardiac magnetic resonance perfusion imaging [stress cardiac magnetic resonance (CMR)] is a reliable, noninvasive method for evaluating myocardial ischemia; however, it does not routinely evaluate metrics such as wall-motion abnormality (WMA) and transient ischemic dilation (TID). Using the new selective A2A adenosine receptor agonist regadenoson, we tested a novel protocol for assessing perfusion defects, WMA, and TID in a single stress CMR session. We evaluated 29 consecutive patients who presented for clinically indicated regadenoson stress CMR. Immediately before and after the regadenoson stress perfusion sequence, we obtained baseline and post-stress cine images in the short-axis orientation to detect worsening or newly developed WMAs. This approach also allowed evaluation of TID. Delayed-enhancement imaging was performed in the standard orientations. All patients tolerated the procedure well. Thirteen patients (45 %) had perfusion abnormalities, and four patients developed TID. Seven patients had WMAs, and three of them also had TID. Patients with TID ± WMAs had multivessel disease documented by coronary angiography. By using regadenoson to assess myocardial ischemia during stress CMR, perfusion defects, WMAs, and TID can be evaluated in a single imaging session. To our knowledge, we are the first to describe this novel approach in a vasodilator stress CMR study.

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Acknowledgments

We are grateful to Virginia C. Fairchild and Nicole Stancel, Ph.D., ELS, of the Section of Scientific Publications at the Texas Heart Institute, Houston, Texas, for providing editorial assistance.

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Authors and Affiliations

  1. Department of Cardiology, Texas Heart Institute, Houston, TX, USA

    Mohammad R. Hojjati & James M. Wilson

  2. Department of Diagnostic and Interventional Radiology, St. Luke’s Medical Center, Texas Heart Institute, Houston, TX, USA

    Raja Muthupillai & Benjamin Y. C. Cheong

  3. Department of Radiology, Baylor College of Medicine, 6720 Bertner Avenue, MC 2-270, Houston, TX, 77030, USA

    Raja Muthupillai & Benjamin Y. C. Cheong

  4. Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    James M. Wilson & Benjamin Y. C. Cheong

  5. Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA

    Ourania A. Preventza

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  1. Mohammad R. Hojjati
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  2. Raja Muthupillai
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  5. Benjamin Y. C. Cheong
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Correspondence to Benjamin Y. C. Cheong.

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Hojjati, M.R., Muthupillai, R., Wilson, J.M. et al. Assessment of perfusion and wall-motion abnormalities and transient ischemic dilation in regadenoson stress cardiac magnetic resonance perfusion imaging. Int J Cardiovasc Imaging 30, 949–957 (2014). https://doi.org/10.1007/s10554-014-0415-y

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  • DOI: https://doi.org/10.1007/s10554-014-0415-y

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