Related Experiment Video
Updated: Jun 19, 2026
Cardiac Stress Test Induced by Dobutamine and Monitored by Cardiac Catheterization in Mice
Published on: February 10, 2013
Prognostic value of negative dobutamine-stress cardiac magnetic resonance imaging
Sebastian Kelle1, Christina Egnell, Juliane Vierecke
1Department of Internal Medicine/Cardiology, German Heart Institute Berlin, Berlin, Germany. kelle@dhzb.de
Insights
Dobutamine-stress magnetic resonance (DSMR) effectively guides clinical decisions for patients with suspected coronary artery disease (CAD). A negative DSMR indicates an excellent prognosis, while a positive DSMR identifies patients who benefit from invasive angiography.
Area of Science:
- Cardiovascular Imaging
- Cardiac MRI
- Myocardial Perfusion Imaging
Background:
- Dobutamine-stress magnetic resonance (DSMR) is established for identifying myocardial ischemia.
- Integration of DSMR into clinical decision-making for suspected coronary artery disease (CAD) requires further validation.
Purpose of the Study:
- To evaluate the clinical utility of DSMR in guiding patient management for suspected CAD.
- To assess the prognostic value of a DSMR-guided strategy.
Main Methods:
- Retrospective review of 123 patients with suspected CAD undergoing high-dose DSMR.
- DSMR results directly influenced clinical decisions, including referral for invasive angiography.
- Median follow-up of 23 months to assess clinical outcomes.
Main Results:
- 27.6% of patients showed inducible ischemia; 91.2% proceeded to angiography with significant findings.
- Vascularization in 15 patients with positive DSMR resulted in only 2 myocardial infarctions.
- 72.4% had no inducible ischemia; those not catheterized had a 0% annual event rate.
Conclusions:
- DSMR is a valuable tool for clinical decision-making in patients with suspected CAD.
- A DSMR-guided approach leads to a high prevalence of significant CAD in patients undergoing angiography.
- Patients with negative DSMR results demonstrate an excellent long-term prognosis.
Background:
Assessment of left ventricular wall motion during dobutamine-stress magnetic resonance (DSMR) is well established for the identification of myocardial ischemia. However, the integration of DSMR into the process of clinical decision-making in patients with suspected CAD is not well established. The aim of this study was to assess the value of DSMR used for clinical decision-making and to stratify the prognosis following this strategy.
Material/Methods:
Medical records of 123 consecutive patients suspected of having CAD who underwent high-dose DSMR were reviewed and followed for a median of 23+/-12 months. DSMR results were used for decision-making, for example in favor of catheterization by the referring physician.
Results:
Thirty-four (27.6%) patients had inducible ischemia, of whom 31 (91.2%) underwent invasive angiography, 25 (80.6%) having stenoses of >50% in a vessel of > or =2 mm in diameter. Fifteen of these patients received vascularization (PCI/CABG); only two events (myocardial infarction) were observed during follow-up in this group. Eighty-nine (72.4%) patients had no inducible ischemia; 21 of them (23.6%) had invasive angiography resulting in 0 (0%) significant findings. In the remaining 68 (76.4%) patients with negative DSMR and who were not catheterized, an annual event rate of 0% was observed.
Conclusions:
DSMR can be used for clinical decision-making in patients suspected of having CAD. This strategy results in a high prevalence of CAD in patients referred for invasive angiography due to a positive DSMR and an excellent prognosis in all patients with a negative DSMR.
Related Concept Videos
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:26Exercise Stress Test
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes