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Methods We prospectively recruited 13 normal volunteers and 10 stable patients with known ischemic or nonischemic cardiomyopathy. All participants underwent cardiac MRI in a 1.5 T scanner (Siemens Avanto). Prior to exercise participants were fit tested to a modified supine ergometer (Lode, the Netherlands) attached to the scanner table to ensure that the body habitus was appropriate for exercising inside the bore. Exercise began outside the bore with workload set at 25 Watts which was increased every 3 minutes by 25 Watts or adjusted to subjects’ tolerance. Participants were slide into the bore while exercising when they reached near maximal capacity or at least 75% maximally predicted heart rate. Imaging took place while subjects were exercising. Real-time SSFP cine images of the short axis stack covering the whole heart were acquired with free breathing prior to exercise and again at peak exercise. Myocardial circumferential strain was analyzed using Feature Tracking software (CIM V8.1 by Auckland, New Zealand). Endocardial and epicardial contours were drawn in mid ventricle to assess strain of the whole myocardium and of the endocardium.

journal of cardiovascular magnetic resonance

Feasibility of performing in-scanner exercise testing and assessing myocardial mechanical reserve in normal volunteers and in patients with cardiomyopathy