J Cardiovasc Imaging.  2023 Jan;31(1):26-38. 10.4250/jcvi.2022.0063.

Safety of Stress Cardiac Magnetic Resonance in Patients With Moderate to Severe Aortic Valve Stenosis

• Salatzki J
• Ochs A
• Kirchgäßner N
• Heins J
• Seitz S
• Hund H
• Mereles D
• Friedrich MG
• Katus HA
• Frey N
• André F
• Ochs MM

• KMID: 2539242
• DOI: http://doi.org/10.4250/jcvi.2022.0063

Abstract

BACKGROUND
Dobutamine and adenosine stress cardiac magnetic resonance (CMR) imaging is relatively contraindicated in patients with moderate to severe aortic valve stenosis (AS). We aimed to determine the safety of dobutamine and adenosine stress CMR in patients with moderate to severe AS.
METHODS
In this retrospective study patients with AS who underwent either dobutamine or adenosine stress CMR for exclusion of obstructive coronary artery disease were enrolled. We recorded clinical data, CMR and echocardiography findings, and complications as well as minor symptoms. Patients with AS were compared to matched individuals without AS.
RESULTS
A total of 187 patients with AS were identified and compared to age-, gender- and body mass index-matched 187 patients without AS. No severe complications were reported in the study nor the control group. The reported frequency of non-severe complications and minor symptoms were similar between the study and the control groups. Nineteen patients with AS experienced non-severe complications or minor symptoms during dobutamine stress CMR compared to eighteen patients without AS (p = 0.855). One patient with AS and two patients without AS undergoing adenosine stress CMR experienced minor symptoms (p = 0.562). Four examinations were aborted because of chest pain, paroxysmal atrial fibrillation and third-degree atrioventricular block. Inducible ischaemia, prior coronary artery bypass grafting, prior stroke and age were associated with a higher incidence of complications and minor symptoms.
CONCLUSIONS
Moderate to severe AS was not associated with complications during CMR stress test. The incidence of non-severe complications and minor symptoms was greater with dobutamine.

Keyword

Aortic valve stenosis; Magnetic resonance imaging; Safety; Adenosine; Dobutamine