• anomalous aortic origin of a coronary artery
• congenital heart disease
• coronary artery anomalies
• exercise
• sudden death

• Humans
• Coronary Vessel Anomalies/surgery
• Coronary Vessel Anomalies/complications
• Athletes
• Death, Sudden, Cardiac/prevention & control
• Death, Sudden, Cardiac/etiology
• Risk Assessment
• Adolescent

• CMR
• Coronary artery bypass grafting
• Dobutamine
• Safety

• Humans
• Male
• Female
• Retrospective Studies
• Aged
• Coronary Artery Bypass/adverse effects
• Dobutamine/administration & dosage
• Coronary Artery Disease/diagnostic imaging
• Coronary Artery Disease/physiopathology
• Coronary Artery Disease/surgery
• Middle Aged
• Predictive Value of Tests
• Risk Factors
• Risk Assessment
• Treatment Outcome
• Magnetic Resonance Imaging, Cine
• Adrenergic beta-1 Receptor Agonists/administration & dosage
• Patient Safety

• Cardiac magnetic resonance imaging
• Coronary artery anomalies
• Dobutamine stress
• Pediatric cardiac imaging

• Advanced imaging
• Anomalous aortic origin of a coronary artery
• Cardiac catheterization
• Coronary artery anomalies
• Sudden cardiac death

• Humans
• Coronary Vessel Anomalies/epidemiology
• Aorta
• Exercise

• Adenosine
• CMR
• Cardiovascular imaging
• Dobutamine
• LV thrombus
• Stroke

• Humans
• Male
• Dobutamine/adverse effects
• Adenosine
• Magnetic Resonance Imaging, Cine
• Retrospective Studies
• Magnetic Resonance Imaging
• Vasodilator Agents/adverse effects
• Thrombosis/diagnosis
• Thrombosis/etiology
• Thrombosis/pathology

• D.10021788 Deutsches Zentrum für Herz-Kreislaufforschung

• Advanced imaging
• Anomalous aortic origin of a coronary artery
• Cardiac catheterization
• Coronary artery anomalies
• Sudden cardiac death

• Humans
• Coronary Vessel Anomalies/diagnosis
• Coronary Vessel Anomalies/surgery
• Aorta

• AAOCA
• Anomalous aortic origin of a coronary artery
• Assessment of hemodynamic relevance
• Dynamic stenosis
• Fixed stenosis
• Multimodality imaging

• Humans
• Coronary Vessels/diagnostic imaging
• Coronary Vessel Anomalies/diagnostic imaging
• Aorta
• Tomography, X-Ray Computed
• Myocardial Ischemia/complications
• Coronary Artery Disease/diagnostic imaging
• Coronary Artery Disease/complications

• CAD
• CMR
• cardiovascular imaging
• chronic kidney disease
• dialysis
• dobutamine

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

• CMR
• CMR perfusion
• cCTA
• cardiovascular imaging
• coronary artery disease
• stress test

Background: Cardiac magnetic resonance (CMR) pharmacological stress-testing is a well-established technique for detecting myocardial ischemia. Although stressors and contrast agents seem relatively safe, contraindications and side effects must be considered. Substantial costs are further limiting its applicability. Dynamic handgrip exercise (DHE) may have the potential to address these shortcomings as a physiological stressor. We therefore evaluated the feasibility and physiologic stress response of DHE in relation to pharmacological dobutamine-stimulation within the context of CMR examinations.

Methods: Two groups were prospectively enrolled: (I) volunteers without relevant disease and (II) patients with known CAD referred for stress-testing. A both-handed, metronome-guided DHE was performed over 2 min continuously with 80 contractions/minute by all participants, whereas dobutamine stress-testing was only performed in group (II). Short axis strain by fast-Strain-ENCoded imaging was acquired at rest, immediately after DHE and during dobutamine infusion.

Results: Eighty middle-aged individuals (age 56 ± 17 years, 48 men) were enrolled. DHE triggered significant positive chronotropic (HR_rest: 68 ± 10 bpm, HR_DHE: 91 ± 13 bpm, p < 0.001) and inotropic stress response (GLS_rest: −19.4 ± 1.9%, GLS_DHE: −20.6 ± 2.1%, p < 0.001). Exercise-induced increase of longitudinal strain was present in healthy volunteers and patients with CAD to the same extent, but in general more pronounced in the midventricular and apical layers (p < 0.01). DHE was aborted by a minor portion (7%) due to peripheral fatigue. The inotropic effect of DHE appears to be non-inferior to intermediate dobutamine-stimulation (GLS_DHE= −19.5 ± 2.3%, GLS_Dob= −19.1 ± 3.1%, p = n.s.), whereas its chronotropic effect was superior (HR_DHE= 89 ± 14 bpm, HR_Dob= 78 ± 15 bpm, p < 0.001).

Conclusions: DHE causes positive ino- and chronotropic effects superior to intermediate dobutamine-stimulation, suggesting a relevant increase of myocardial oxygen demand. DHE appears to be safe and timesaving with broad applicability. The data encourages further studies to determine its potential to detect obstructive CAD.

• CMR
• fSENC
• handgrip
• longitudinal strain
• stress-test

• Cardiovascular magnetic resonance
• Feasibility
• Regadenoson
• Registry
• Safety

• Cardiovascular magnetic resonance
• Dipyridamole
• IRM cardiovasculaire
• IRM de stress
• Ischaemia
• Ischémie
• Safety
• Stress perfusion CMR
• Tolérance

• Anomalous aortic origin of a coronary artery
• Dobutamine stress perfusion cardiac magnetic resonance imaging
• First pass perfusion
• Myocardial ischemia
• Pediatric patients
• Sudden cardiac death

• Adult
• Aorta
• Child
• Coronary Artery Disease/diagnostic imaging
• Coronary Artery Disease/epidemiology
• Coronary Vessel Anomalies
• Dobutamine
• Humans
• Magnetic Resonance Imaging
• Young Adult

• acquired coronary artery disease
• congenital heart disease
• magnetic resonance imaging
• perfusion
• pharmacologic stress imaging

Introduction: Exercise testing has become a diagnostic standard in the evaluation and management of heart disease. While different methods of exercise and pharmacological stress testing exist, only little is known about their comparability. We aimed to assess hemodynamic changes during dynamic exercise, isometric exercise, and dobutamine stress testing at different stress intensities in healthy subjects and patients with aortic stenosis (AS) and aortic coarctation (CoA).

Methods: A systematic literature search (PROSPERO 2017:CRD42017078608) in MEDLINE of interventional trials was conducted to identify eligible studies providing evidence of changes in hemodynamic parameters under different stress conditions acquired by MRI or echocardiography. A random effects model was used to estimate pooled mean changes in hemodynamics.

Results: One hundred and twenty-eight study arms with a total of 3,139 stress-examinations were included. In healthy subjects/(where available) in AS, pooled mean changes (95% CIs) during light dynamic stress were 31.78 (27.82–35.74) bpm in heart rate (HR) and 6.59 (2.58–10.61) ml in stroke volume (SV). Changes during light pharmacological stress were 13.71 (7.87–19.56)/14.0 (9.82–18.18) bpm in HR, and 5.47 (0.3–10.63)/8.0 (3.82–12.18) ml in SV. Changes during light isometric stress were 18.44 (10.74–26.14)/5.0 (−1.17–11.17) bpm in HR and −4.17 (−14.37–6.03)/−4.0 (−16.43–8.43) ml in SV. Changes during moderate dynamic stress were 49.57 (40.03–59.1)/46.45 (42.63–50.27) bpm in HR and 11.64 (5.87–17.42) ml in SV. During moderate pharmacological stress, changes in HR were 42.83 (36.94–48.72)/18.66 (2.38–34.93) bpm and in SV 6.29 (−2.0–14.58)/13.11 (7.99–18.23) ml. During high intensity dynamic stress changes in HR were 89.31 (81.46–97.17)/55.32 (47.31–63.33) bpm and in SV 21.31 (13.42–29.21)/−0.96 (−5.27–3.35) ml. During high pharmacological stress, changes in HR were 53.58 (36.53–70.64)/42.52 (32.77–52.28) bpm, and in SV 0.98 (−9.32–11.27)/14.06 (−1.62–29.74) ml. HR increase and age were inversely correlated at high stress intensities. In CoA, evidence was limited to single studies.

Conclusion: This systematic review and meta-analysis presents pooled hemodynamic changes under light, moderate and high intensity exercise and pharmacological stress, while considering the potential influence of age. Despite limited availability of comparative studies, the reference values presented in this review allow estimation of the expected individual range of a circulatory response in healthy individuals and patients with AS and may contribute to future study planning and patient-specific models even when stress testing is contraindicated.

• aortic coarctation
• aortic stenosis
• dobutamine stress
• exercise testing
• healthy subjects
• hemodynamics
• meta-analysis
• systematic review

The aim of this study was to compare the feasibility of 640-slice with 64-slice computed tomography (CT) coronary angiography for diagnosing coronary lesions in patients with pacemakers.

Forty-five and 50 patients with pacemakers and with suspected or known coronary artery disease underwent 64-slice (64 group) and 640-slice (640 group) CT scans, respectively. All segments of the vessels were evaluated according to the 15-segment model recommended by the American Heart Association.

The incidence of moderate or severe artifacts was significantly lower (7.27% vs. 32.17%) and the diagnosable rate for coronary lesions was higher (98.91% vs. 94.19%) in the 640 compared with the 64 group. In the 64 group, the incidence of artifacts in patients with a heart rate >65 bpm (20.98%) was higher than in those with a heart rate <65 bpm (15.67%), although the difference was not significant, while the incidence of artifacts was significantly higher in patients with heart arrhythmia (21.40%) compared with in those with normal heart rhythm (15.09%).

Among patients with pacemakers and a higher heart rate or heart arrhythmia, 640-slice CT may be more effective than 64-slice CT for diagnosing coronary lesions, by reducing moderate and severe artifacts.

• 640-slice computed tomography
• Cardiac pacemaker
• cardiac imaging
• computed tomography
• coronary artery disease
• imaging artifacts

• cardiac magnetic resonance imaging
• contrast imaging

Coronary artery disease (CAD) is a leading cause of death and disability worldwide. Cardiovascular magnetic resonance (CMR) is established in clinical practice guidelines with a growing evidence base supporting its use to aid the diagnosis and management of patients with suspected or established CAD. CMR is a multi-parametric imaging modality that yields high spatial resolution images that can be acquired in any plane for the assessment of global and regional cardiac function, myocardial perfusion and viability, tissue characterisation and coronary artery anatomy, all within a single study protocol and without exposure to ionising radiation. Advances in technology and acquisition techniques continue to progress the utility of CMR across a wide spectrum of cardiovascular disease, and the publication of large scale clinical trials continues to strengthen the role of CMR in daily cardiology practice. This article aims to review current practice and explore the future directions of multi-parametric CMR imaging in the investigation of stable CAD.

• Cardiovascular magnetic resonance
• Coronary heart disease
• Myocardial perfusion
• Viability
• Prognosis

• Cardiovascular magnetic resonance
• Dipyridamole
• Dobutamine
• Feasibility
• Registry
• Safety

• Cardiac magnetic resonance imaging
• Coronary artery disease
• Coronary flow reserve
• Fractional flow reserve
• Ischemia
• Myocardial flow reserve
• Myocardial infarction
• Perfusion
• Quantitative myocardial perfusion

• Coronary Circulation
• Fractional Flow Reserve, Myocardial
• Heart Diseases/diagnosis
• Heart Diseases/physiopathology
• Humans
• Image Processing, Computer-Assisted
• Imaging, Three-Dimensional
• Magnetic Resonance Imaging/trends
• Myocardial Perfusion Imaging/methods
• Myocardial Perfusion Imaging/trends
• Predictive Value of Tests
• Prognosis

• Cardiac magnetic resonance imaging
• Ischemic heart disease
• Myocardial infarction
• Myocardial perfusion

Cardiac magnetic resonance (CMR) imaging is now widely used in several fields of cardiovascular disease assessment due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there is no guideline which is suitable for Korean people for the use of CMR. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates and patients to improve the overall medical system performances. By addressing CMR usage and creating these guidelines we hope to contribute towards the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.

• Appropriateness criteria
• Evidence-based medicine
• Guideline
• Heart
• Magnetic resonance imaging

• Cardiovascular magnetic resonance (CMR)
• acute coronary syndromes (ACS)
• coronary heart disease (CHD)
• prognosis

Cardiac magnetic resonance (CMR) imaging is now widely used in several fields of cardiovascular disease assessment due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there is no guideline which is suitable for Korean people for the use of CMR. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates and patients to improve the overall medical system performances. By addressing CMR usage and creating these guidelines we hope to contribute towards the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.

• Appropriateness criteria
• Evidence-based medicine
• Guideline
• Heart
• Magnetic resonance imaging

• Cardiac magnetic resonance imaging
• Coronaropathie
• Coronary artery disease
• Imagerie cardiaque par résonance magnétique
• Ischémie myocardique
• Late gadolinium enhancement
• Myocardial ischemia
• Rehaussement tardif
• Stress

• Adenosine
• Contrast Media
• Coronary Angiography/methods
• Coronary Artery Disease/diagnosis
• Coronary Artery Disease/therapy
• Coronary Stenosis/diagnosis
• Coronary Stenosis/therapy
• Dipyridamole
• Echocardiography, Stress/methods
• Electrocardiography/methods
• Exercise Test/methods
• Gadolinium
• Humans
• Magnetic Resonance Angiography/methods
• Myocardial Ischemia/diagnosis
• Myocardial Ischemia/therapy
• Risk Factors
• Sensitivity and Specificity
• Tomography, Emission-Computed, Single-Photon

• AHA Scientific Statements
• cardiac imaging techniques
• coronary disease
• heart disease
• ischemic heart disease
• noninvasive testing
• risk assessment
• women

• Algorithms
• Chest Pain/etiology
• Coronary Stenosis/diagnosis
• Coronary Stenosis/physiopathology
• Decision Making
• Diagnostic Techniques, Cardiovascular/adverse effects
• Evidence-Based Medicine
• Exercise Test
• Exercise Tolerance
• Female
• Humans
• Myocardial Ischemia/diagnosis
• Myocardial Ischemia/physiopathology
• Neoplasms, Radiation-Induced/etiology
• Neoplasms, Radiation-Induced/prevention & control
• Radiation Dosage
• Risk
• Symptom Assessment