Cardiovascular magnetic resonance and the role of adenosine pharmacologic stress.

As an advanced imaging modality, cardiovascular magnetic resonance (CMR) offers high spatial resolution and produces unsurpassed images of the heart and its function. Clinically, CMR is well established in the assessment of congenital heart disease, the aorta, tumors, the pericardium, cardiac mass and function, flow measurement, and the structure and function of the right ventricle. CMR has demonstrated a high interstudy reproducibility of left ventricular volumes, ejection fraction, and mass, making it the ideal noninvasive technique for serial measurements. CMR growth areas that are nearing routine clinical application are the evaluation of myocardial perfusion, infarction, and viability. In perfusion CMR studies, pharmacologic stress is used to increase differences in the first-pass delivery of the contrast agent between myocardial regions perfused by normal and diseased arteries. The most widely used stress modality for CMR perfusion studies is adenosine.