Copyright © 1993 by the European Society of Cardiology.
© 1993 The European Society of Cardiology
Quantitation of global and regional left ventricular function by cine magnetic resonance imaging during dobutamine stress in normal human subjects
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*Department of Cardiology, University Hospital Leiden, The Netherlands
Interuniversity Cardiology institute of The Netherlands
Department Radiology, University Hospital Leiden, The Netherlands
Received 8 June 1992; revised 22 September 1992; .
Correspondence: Ernst E. van der wall, MD, FESC. Department of Cardiology, University Hospital Leiden, Building 1, C5-P25. Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands.
Abstract
Magnetic resonance imaging (MRI) provides high-resolution images of the heart. However, physical exercise during MRI is difficult due to space restriction and motion artefacts. To evaluate the feasibility of MRI during stress conditions, dobutamine was used as an alternative to exercise. Haemodynamics, ventricular volumes and wall thickening were measured at rest and during peak dobutamine infusion (15 µg . kg–1 . min–1) in 23 normal human subjects. To calculate left ventricular volumes, eight short-axis views were obtained encompassing the left ventricle from base to apex. At six levels, percent systolic wall thickening (% WTh) was measured in 18 segments (20° intervals). Heart rate, systolic and diastolic blood pressures, stroke index, cardiac output and left ventricular ejection fraction increased significantly during dobutamine infusion (all P values <0.001). In addition, % WTh increased significantly (P < 0.001 during dobutamine compared to the control state at all levels except in the apical and low-left ventricular levels. Both in control conditions and during dobutamine, segmental wall motion analysis showed the highest % WTh at the posterolateral area and the lowest % WTh at the septal region (P <0.05).
MRI clearly identifies wall motion dynamics and provides calculations of segmental wall thickening and haemodynamic parameters. Dobutamine is a useful stress agent by virtue of its safety, operator control and its effects which resemble physical exercise.
Key Words: Magnetic resonance imaging • dobutamine stress • wall thickening dynamics • left ventricular function • non-invasive cardiac imaging
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