OBJECTIVES: The aim of this study was to assess the long-term value of high-dose dobutamine cardiac magnetic resonance (DCMR) for the prediction of cardiac events in a large cohort of patients with known or suspected coronary artery disease. BACKGROUND: High-dose DCMR has been shown to be a useful technique for diagnosis and intermediate-term prognostic stratification. METHODS: Clinical data and DCMR results were analyzed in 1,463 consecutive patients undergoing DCMR between 2000 and 2004. Ninety-four patients were lost to follow-up. The remaining 1,369 patients were followed up for a mean of 44 ± 24 months. Cardiac events, defined as cardiac death and nonfatal myocardial infarction, were related to clinical and DCMR results. RESULTS: Three-hundred fifty-two patients underwent early revascularization (≤ 3 months of DCMR) and were excluded from analysis. Of the remaining 1,017 patients, 301 patients (29.6%) experienced inducible wall motion abnormalities (WMA). Forty-six cardiac events were reported. In those with and without inducible WMA, the proportion of patients with cardiac events was 8.0% versus 3.1%, respectively, p = 0.001 (hazard ratio: 3.3; 95% confidence interval: 1.8 to 5.9 for the presence of inducible WMA; p < 0.001). A DCMR without inducible WMA carried an excellent prognosis, with a 6-year cardiac event-free survival of 96.8%. In all 1,369 patients in the patient group with stress-inducible WMA, those patients with medical therapy demonstrated a trend to a higher cardiac event rate (8.0%) than those with early revascularization (5.4%) (p = 0.234). Patients with normal DCMR and medical therapy or early revascularization demonstrated similar cumulative cardiac event rates (3.1% vs. 3.2%, p = 0.964). CONCLUSIONS: In a large cohort of patients, DCMR has an added value for predicting cardiac events during long-term follow-up, improving the differentiation between high-risk and low-risk patients. Patients with inducible WMA and following early revascularization, demonstrate lower cardiac event rates than patients with medical therapy alone.
OBJECTIVES: The aim of this study was to assess the long-term value of high-dose dobutamine cardiac magnetic resonance (DCMR) for the prediction of cardiac events in a large cohort of patients with known or suspected coronary artery disease. BACKGROUND: High-dose DCMR has been shown to be a useful technique for diagnosis and intermediate-term prognostic stratification. METHODS: Clinical data and DCMR results were analyzed in 1,463 consecutive patients undergoing DCMR between 2000 and 2004. Ninety-four patients were lost to follow-up. The remaining 1,369 patients were followed up for a mean of 44 ± 24 months. Cardiac events, defined as cardiac death and nonfatal myocardial infarction, were related to clinical and DCMR results. RESULTS: Three-hundred fifty-two patients underwent early revascularization (≤ 3 months of DCMR) and were excluded from analysis. Of the remaining 1,017 patients, 301 patients (29.6%) experienced inducible wall motion abnormalities (WMA). Forty-six cardiac events were reported. In those with and without inducible WMA, the proportion of patients with cardiac events was 8.0% versus 3.1%, respectively, p = 0.001 (hazard ratio: 3.3; 95% confidence interval: 1.8 to 5.9 for the presence of inducible WMA; p < 0.001). A DCMR without inducible WMA carried an excellent prognosis, with a 6-year cardiac event-free survival of 96.8%. In all 1,369 patients in the patient group with stress-inducible WMA, those patients with medical therapy demonstrated a trend to a higher cardiac event rate (8.0%) than those with early revascularization (5.4%) (p = 0.234). Patients with normal DCMR and medical therapy or early revascularization demonstrated similar cumulative cardiac event rates (3.1% vs. 3.2%, p = 0.964). CONCLUSIONS: In a large cohort of patients, DCMR has an added value for predicting cardiac events during long-term follow-up, improving the differentiation between high-risk and low-risk patients. Patients with inducible WMA and following early revascularization, demonstrate lower cardiac event rates than patients with medical therapy alone.
Authors: Gianluca Pontone; Daniele Andreini; Erika Bertella; Monica Loguercio; Marco Guglielmo; Andrea Baggiano; Giovanni Donato Aquaro; Saima Mushtaq; Sara Salerni; Paola Gripari; Carmen Rossi; Chiara Segurini; Edoardo Conte; Virginia Beltrama; Marta Giovannardi; Fabrizio Veglia; Andrea Igoren Guaricci; Antonio L Bartorelli; Piergiuseppe Agostoni; Mauro Pepi; Pier Giorgio Masci Journal: Eur Radiol Date: 2015-10-29 Impact factor: 5.315
Authors: Leslee J Shaw; Daniel S Berman; Michael H Picard; Matthias G Friedrich; Raymond Y Kwong; Gregg W Stone; Roxy Senior; James K Min; Rory Hachamovitch; Marielle Scherrer-Crosbie; Jennifer H Mieres; Thomas H Marwick; Lawrence M Phillips; Farooq A Chaudhry; Patricia A Pellikka; Piotr Slomka; Andrew E Arai; Ami E Iskandrian; Timothy M Bateman; Gary V Heller; Todd D Miller; Eike Nagel; Abhinav Goyal; Salvador Borges-Neto; William E Boden; Harmony R Reynolds; Judith S Hochman; David J Maron; Pamela S Douglas Journal: JACC Cardiovasc Imaging Date: 2014-06
Authors: Michael J Lipinski; Courtney M McVey; Jeffrey S Berger; Christopher M Kramer; Michael Salerno Journal: J Am Coll Cardiol Date: 2013-05-30 Impact factor: 24.094