Long-term prognostic value of dobutamine cardiovascular magnetic resonance in 1466 patients and its value for clinical d
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Long-term prognostic value of dobutamine cardiovascular magnetic resonance in 1466 patients and its value for clinical decision making Sebastian Kelle*1, Amedeo Chiribiri2, Christoph Klein1, Juliane Vierecke1, Christina Egnell1, Ingo Paetsch1, Rolf Gebker1, Ernst Wellnhofer1 and Eckart Fleck1 Address: 1German Heart Institute Berlin, Berlin, Germany and 2King's College, London, UK * Corresponding author
from 13th Annual SCMR Scientific Sessions Phoenix, AZ, USA. 21-24 January 2010 Published: 21 January 2010 Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):O9
doi:10.1186/1532-429X-12-S1-O9
Abstracts of the 13th Annual SCMR Scientific Sessions - 2010
Meeting abstracts - A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-infoThis abstract is available from: http://jcmr-online.com/content/12/S1/O9 © 2010 Kelle et al; licensee BioMed Central Ltd.
Introduction Current available reports about the prognostic value of dobutamine stress cardiovascular magnetic resonance (DCMR) are limited by the number of patients and cardiac events.
Purpose Aim of this study was to assess the long-term value of DCMR for prediction of late cardiac events in a large cohort of patients with known or suspected coronary artery disease.
Methods Clinical data and DCMR results were analyzed in 1466 consecutive patients undergoing DCMR between 2000 and 2004. Ninety four patients lost to follow-up and three hundred fifty five patients who underwent early revascularization within 3 months of DCMR were excluded from analysis. The remaining 1017 patients (median age, 62 years) were followed up for a mean of 44 ± 24 months (range: 1 to 116 months). Wall motion abnormalities (WMA) at rest and the presence of stress-induced WMA (ischemia) were assessed for each patient. Cardiac events, defined as cardiac death and non-fatal myocardial infarction, were related to clinical and DCMR results. Patients with inducible WMA were compared in regards to follow-
ing therapy (revascularization or medical therapy alone) and outcome.
Results Twenty nine percent of the patients experienced an inducible WMA during testing. Forty six cardiac events were reported, documented cardiac death in 33 and nonfatal myocardial infarction in 13 patients. In those with and without inducible WMA, the proportion of patients with cardiac events were 8.0% versus 3.1%, respectively, (hazard ratio: 3.3; 95% confidence interval: 1.8 to 5.9 for the presence of inducible WMA; p < 0.001). A normal DCMR carried a relatively good prognosis, with a 5-year eventfree survival of 97.1%. Patients who underwent revascularization within 3 months of DCMR due to inducible WMA demonstrated a significant lower rate of cardiac events (5.1%) compared to patients with inducible WMA and medical therapy only (8.0%), p < 0.001.
Conclusion In a large cohort of patients, DCMR has an added value for predicting cardiac events during long-term follow-u
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