Use of cardiac MRI for low gradient aortic stenosis
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BioMed Central
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Poster presentation
Use of cardiac MRI for low gradient aortic stenosis Stamatios Lerakis*, Patrick Willis, Zahid Junagadhwalla, Arthur Stillman, Edward Chen and Vasilis Babaliaros Address: Emory, Atlanta, GA, USA * 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):P109
doi:10.1186/1532-429X-12-S1-P109
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/P109 © 2010 Lerakis et al; licensee BioMed Central Ltd.
Introduction Low gradient aortic stenosis (AS) is a challenging problem. Low dose dobutamine (LDD) to seperate low gradient AS with myopathic etiology from true severe aortic stenosis is the gold standard practice today.
that do not respond to LDD since the presence of myocardial reserve may affect the management of these pts and has prognositic implications.
Purpose This initial small cohort will try to compare LDD to cardiac MRI with delayed enhancement (CMR-DE) imaging for the evaluation of contractile reserve.
Methods 7 patients (pts) with mean gradient < 30 mm Hg and LVEF < 30% underwent LDD and CMR-DE before aortic valve replacement (AVR). Increase in stroke volume > 20% by LDD up to 20 micrograms/kg/min was considered indication of the presence of myocardial reserve.
Results From the CMR-DE images: 3 pts had completely viable myocardium, 1 pt had intra-myocardial scar and 3 had subendocardial scar suggestive of concomitant coronary artery disease. Only 3 pts had evidence of contractile reserve by LDD. 2 pts with viable myocardium by CMRDE did not show response to dobutamine. Pts with scar had mixed response.
Conclusion The absence of response to dobutamine may not be enough to preclude the presence of myocardial reserve in low flow/low gradient aortic stenosis. This small cohort raises the question that CMR-DE may be needed in pts Page 1 of 1 (page number not for citation purposes)
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