Dobutamine stress MR in Tetralogy of Fallot with significant pulmonary regurgitation, safety, feasibility and haemodynam
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Dobutamine stress MR in Tetralogy of Fallot with significant pulmonary regurgitation, safety, feasibility and haemodynamic effects Victoria Parish*1, Aaron Bell2, Catherine Head2, Eric Rosenthal1, Gerald Greil1, Reza Razavi1 and Philipp Beerbaum1 Address: 1King's College, London, UK and 2Guy's and St Thomas' NHS Trust, 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):P3
doi:10.1186/1532-429X-12-S1-P3
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/P3 © 2010 Parish et al; licensee BioMed Central Ltd.
Background In Tetralogy of Fallot (TOF), surgical repair is undertaken in childhood but standard repair techniques result in pulmonary regurgitation (PR). With time this induces right ventricular (RV) dilation and dysfunction and is associated with an increased risk of sudden death. Although pulmonary valve replacement (PVR) has been shown to improve symptoms, appropriate timing for this procedure continues to be debated. This study aims to evaluate the safety, feasibility and diagnostic potential of high dose dobutamine stress magnetic resonance imaging (DS-MR) in the assessment of right ventricular contractile reserve in post repair TOF with significant PR.
DS-MR. Five patients could not progress to Stage 2, due to either minor dobutamine side effects (nausea or headache) or achievement of maximum predicted heart rate. Nineteen patients went on to complete stage 2 stress with no severe adverse side effects. The heart rate (cardiac index) increased from 66 ± 6 bpm (2.9 ± 0.4 l/min/m2) at
Methods 26 patients with repaired TOF and PR referred for cardiac MRI were prospectively recruited. In addition to morphological assessment ventricular volumes (2D cine MRI) pulmonary artery and aortic flows (phase contrast) were obtained at baseline and during dobutamine infusion: Stage 1 DS-MR 10 mcg/kg/min an Stage 2 DS-MR 20 mcg/ kg/min. Data comparison was performed using the student t-test (p < 0.05).
Results Of the 26 patients, DS-MR imaging data is incomplete, in one patient due to claustrophobia and in the second due to failure of VECG triggering secondarily to frequent ventricular ectopics. Twenty-four patients completed stage 1
minbaseline Change at Figure in 1 end anddiastolic with dobutamine volume for stress the left at 10 andand right 20ventricle mcg/kg/ Change in end diastolic volume for the left and right ventricle at baseline and with dobutamine stress at 10 and 20 mcg/kg/min.
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Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):P3
http://jcmr-online.com/content/12/S1/P3
Table 1: Haemodynamic
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