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Dobutamine Stress Magnetic Resonance Imaging for the Detection of Coronary Artery Disease in Women
  1. Rolf Gebker (gebker{at}dhzb.de)
  1. German Heart Institute Berlin, Germany
    1. Cosima Jahnke
    1. German Heart Institute Berlin, Germany
      1. Thomas Hucko
      1. German Heart Institute Berlin, Germany
        1. Robert Manka
        1. German Heart Institute Berlin, Germany
          1. Jesus G Mirelis
          1. German Heart Institute Berlin, Germany
            1. Ashraf Hamdan
            1. German Heart Institute Berlin, Germany
              1. Bernhard Schnackenburg
              1. German Heart Institute Berlin, Germany
                1. Eckart Fleck
                1. German Heart Institute Berlin, Germany
                  1. Ingo Paetsch
                  1. German Heart Institute Berlin, Germany

                    Abstract

                    Background: Dobutamine stress magnetic resonance (DSMR) imaging represents an excellent imaging approach for the detection of coronary artery disease (CAD). However, most studies predominantly reported the utility of DSMR in men. Thus, we performed a comparative study to evaluate the diagnostic value of DSMR in men and women.

                    Methods and results: High dose dobutamine/atropine stress magnetic resonance imaging was performed and evaluated regarding new or worsening wall motion abnormalities in 745 consecutive patients (204 women, 541 men). Invasive coronary angiography was performed within 30 days and served as the reference standard (≥70% stenosis). DSMR was technically successful and had diagnostic image quality in all patients except 2 women and 5 men (P=ns). In the absence of ischemia target heart rate was not reached in 9.3% of women and 8.5% of men (P ns) despite maximum pharmacologic infusion (1% and 2.2%, respectively, P=ns) or due to limiting side effects (8.3% and 6.3%, respectively, P=ns). Diagnostic values (sensitivity/specificity/accuracy) for the detection of significant coronary stenoses were similar for men (86%/83%/85%) and women (85%/86%/85%). There was no gender-based difference in regional diagnostic accuracy of DSMR for all 3 coronary vascular territories in patients with single-vessel CAD (81% vs. 81%, P=ns, respectively).

                    Conclusion: The diagnostic capability of DSMR regarding the detection of hemodynamically relevant, obstructive CAD is gender-independent.

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