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Pharmacologic stress testing with cardiac magnetic resonance (CMR) may use either dobutamine to assess contractility or adenosine to assess perfusion. Certain clinical factors may preclude the use of adenosine, such as severe obstructive pulmonary disease or high-grade conduction system disease. Using current techniques for ECG-gated acquisition that require breathhold may be difficult at peak inotropic stress due to both poor ECG signal detection and patient factors. We report successful implementation of a hybrid approach to dobutamine stress CMR using real-time cine imaging with parallel acquisition and first-pass perfusion imaging at peak stress to provide both wall motion and perfusion assessment for ischemia that is feasible in a broad spectrum of cardiovascular patients.

1111 Combined use of real-time cine and first-pass perfusion with dobutamine stress