Berger, Alexander

Chiribiri, Amedeo

Fleck, Eckart

Gebker, Rolf

Giannitsis, Evangelos

Katus, Hugo A

Kelle, Sebastian

Korosoglou, Grigorios

Nagel, Eike

Schneeweis, Christopher

Journal of Cardiovascular Magnetic Resonance

English

PubMed

Sebastian Kelle

Eike Nagel

Amedeo Chiribiri

Rolf Gebker

Christopher Schneeweis

Alexander Berger

Evangelos Giannitsis

Eckart Fleck

Hugo A Katus

Grigorios Korosoglou

Springer - Publisher Connector

ORAL PRESENTATION Open Access
Assessment of warranty time for dobutamine
stress magnetic resonance imaging in 3138
consecutive patients: a bi-center study
Sebastian Kelle1*, Eike Nagel2, Amedeo Chiribiri2, Rolf Gebker1, Christopher Schneeweis1, Alexander Berger1,
Evangelos Giannitsis3, Eckart Fleck1, Hugo A Katus3, Grigorios Korosoglou3
From 15th Annual SCMR Scientific Sessions
Orlando, FL, USA. 2-5 February 2012
Summary
We aimed to determine the prognostic value of wall
motion assessment during high-dose dobutamine stress
cardiac magnetic resonance imaging (DCMR) for the
prediction of hard cardiac events in a large patient
cohort and within a long follow-up duration. DCMR
can accurately identify between patients with inducible
ischemia who are at increased risk for future hard car-
diac events and revascularization procedures. Within the
‘primary warranty time’ of 3 years after DCMR excellent
outcomes (annual hard cardiac event rate <1%) are
recorded in patients with normal findings.
Background
We aimed to determine the prognostic value of wall
motion assessment during high-dose dobutamine stress
cardiac magnetic resonance imaging (DCMR) for the
prediction of hard cardiac events in a large patient
cohort and within a long follow-up duration.
Methods
Consecutive patients with suspected or known coronary
artery disease underwent DCMR at two experienced car-
diac-MRI centers (German Heart Institute Berlin and
Heidelberg University Hospital), using a standard proto-
col with a 1.5T Philips MR-scanner. Wall motion was
assessed at rest and during maximum stress, and out-
come data including cardiac death and non-fatal myo-
cardial infarction (defined as hard cardiac events) and
‘late’ revascularization (percutaneous coronary interven-
tion or coronary artery bypass grafting) performed >90
days after the MR-scans were prospectively collected at
least 6 months after DCMR.
Results
Follow-up data were available in 3138 consecutive
patients (mean follow-up 3.3±1.7 years, range 0.5 and
9.7 years). Hard cardiac events occurred in 183 (5.8%)
patients during the follow-up period. Patients with an
inducible wall motion abnormality (WMA) experienced
hard cardiac events and late revascularization at signifi-
cantly higher rates (hazard ratio (HR): 6.9; 95%; confi-
dence interval (CI): 4.9-9.7, and HR=3.8; 95%CI=2.9-5.0,
respectively, p<0.001 for both) (Figure 1) compared to
those with normal findings. Within the first 3 years of
follow-up excellent outcomes were recorded for patients
with normal wall motion during stress in regard to hard
cardiac events and late revascularization procedures
(annual hard cardiac event rate of 0.6% and revasculari-
zation rate of 1.6%). Over the following 3 years of follow
up, annual event rates rose for both hard events and
revascularization to 1.6% and 3.2%, respectively.
Using multivariate regression analysis, inducible WMA
during stress, yielded the strongest independent prog-
nostic value for both, hard cardiac events and late revas-
cularization, clearly surpassing that of clinical and
baseline MR-parameters (HR=7.4, 95%CI=3.3-16.7 for
hard cardiac events and HR=3.1, 95%CI=1.7-5.5 for late
revascularization, p<0.001).
Interestingly, patients without inducible ischemia who
underwent early revascularization yielded similar hard
cardiac event rates, compared to those who were contin-
ued on medical treatment. Conversely, patients with
inducible ischemia and early revascularization yielded
significantly improved prognosis compared to patients
1Cardiology, German Heart Institute Berlin, Berlin, Germany
Full list of author information is available at the end of the article
Kelle et al. Journal of Cardiovascular Magnetic Resonance 2012, 14(Suppl 1):O14
http://www.jcmr-online.com/content/14/S1/O14
© 2012 Kelle et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.
with inducible ischemia who were continued on medical
treatment (Figure 2).
Conclusions
DCMR can accurately identify between patients with
inducible ischemia who are at increased risk for future
hard cardiac events and revascularization procedures.
Within the ‘primary warranty time’ of 3 years after
DCMR excellent outcomes (annual hard cardiac event
rate <1%) are recorded in patients with normal findings.
Funding
None.
Author details
1Cardiology, German Heart Institute Berlin, Berlin, Germany. 2Division of
Imaging Sciences, Kings College London, London, UK. 3Cardiology, University
of Heidelberg, Heidelberg, Germany.
Published: 1 February 2012
doi:10.1186/1532-429X-14-S1-O14
Cite this article as: Kelle et al.: Assessment of warranty time for
dobutamine stress magnetic resonance imaging in 3138 consecutive
patients: a bi-center study. Journal of Cardiovascular Magnetic Resonance
2012 14(Suppl 1):O14.
Submit your next manuscript to BioMed Central
and take full advantage of: 
• Convenient online submission
• Thorough peer review
• No space constraints or color figure charges
• Immediate publication on acceptance
• Inclusion in PubMed, CAS, Scopus and Google Scholar
• Research which is freely available for redistribution
Submit your manuscript at 
www.biomedcentral.com/submit
Figure 1
Figure 2
Kelle et al. Journal of Cardiovascular Magnetic Resonance 2012, 14(Suppl 1):O14
http://www.jcmr-online.com/content/14/S1/O14
Page 2 of 2


Assessment of warranty time for dobutamine stress magnetic resonance imaging in 3138 consecutive patients: a bi-center study

Crossref

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3304949

Assessment of warranty time for dobutamine stress magnetic resonance imaging in 3138 consecutive patients: a bi-center study

Abstract

Similar works

Full text

Available Versions

Springer - Publisher Connector

Crossref