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Feasibility of dobutamine stress cardiovascular magnetic resonance imaging in children
Author(s) -
Strigl Sebastian,
Beroukhim Rebecca,
Valente Anne Marie,
Annese David,
Harrington James S.,
Geva Tal,
Powell Andrew J.
Publication year - 2009
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.21639
Subject(s) - medicine , dobutamine , heart rate , magnetic resonance imaging , kappa , stress testing (software) , cardiology , blood pressure , radiology , nuclear medicine , hemodynamics , linguistics , philosophy , computer science , programming language
Purpose To evaluate the feasibility of dobutamine stress magnetic resonance (DSMR) in pediatric patients. Materials and Methods The medical records of all DSMR studies performed on patients ≤22 years old at a single institution were retrospectively reviewed. The DSMR protocol included dobutamine doses up to 40 μg/kg/minute and atropine to attain the target heart rate [0.85 · (220 – age)]. Results Thirty‐two DSMR studies were performed in 28 patients (median age = 7.3 years; range = 0.8–22 years). Twenty of the studies were performed under general anesthesia. The protocol was completed in 26 studies, technical problems and interruptions were few, and image quality scores (1–5) for all ventricular wall segments were high (mean = 4.2). A heart rate ≥160 bpm was attained in 84% of the studies, a rate pressure product ≥20,000 beats · mm Hg in 87%, and a heart rate greater than or equal to the target heart rate in 19%. No serious adverse events occurred. One patient had an inducible wall motion abnormality. Interobserver agreement was 100% (kappa = 1.0) for test positivity and 92% (kappa = 0.72) for wall motion scores. Conclusion DSMR in pediatric patients is feasible and provides high‐quality imaging of all ventricular wall segments with low interobserver variability. Further exploration of DSMR in pediatric patients is warranted, particularly for those children who are unable to cooperate sufficiently for exercise stress or have poor acoustic windows. J. Magn. Reson. Imaging 2009;29:313–319. © 2009 Wiley‐Liss, Inc.