Key result
Moderate to severe AS is not linked to increased complications during stress CMR.
Why the study?
Dobutamine and adenosine stress CMR is relatively contraindicated in moderate to severe AS, prompting an evaluation of its safety in this population.
Does dobutamine or adenosine stress cardiac magnetic resonance imaging cause excess complications in patients with moderate to severe aortic valve stenosis compared to matched patients without aortic stenosis?
Cohort (n=374)
No
Does dobutamine or adenosine stress cardiac magnetic resonance imaging cause excess complications in patients with moderate to severe aortic valve stenosis compared to matched patients without aortic stenosis?
Absolute Event Rate: 20% vs 19%
p-value: p=0.855
Dobutamine and adenosine stress CMR appear safe in patients with moderate to severe aortic stenosis, with no severe complications observed and minor complication rates comparable to matched controls.
Comparable complication rates support considering stress CMR in moderate-severe AS; observational data leave open need for prospective confirmation.
BACKGROUND: Dobutamine and adenosine stress cardiac magnetic resonance (CMR) imaging is relatively contraindicated in patients with moderate to severe aortic valve stenosis (AS). We aimed to determine the safety of dobutamine and adenosine stress CMR in patients with moderate to severe AS. METHODS: In this retrospective study patients with AS who underwent either dobutamine or adenosine stress CMR for exclusion of obstructive coronary artery disease were enrolled. We recorded clinical data, CMR and echocardiography findings, and complications as well as minor symptoms. Patients with AS were compared to matched individuals without AS. RESULTS: A total of 187 patients with AS were identified and compared to age-, gender- and body mass index-matched 187 patients without AS. No severe complications were reported in the study nor the control group. The reported frequency of non-severe complications and minor symptoms were similar between the study and the control groups. Nineteen patients with AS experienced non-severe complications or minor symptoms during dobutamine stress CMR compared to eighteen patients without AS (p = 0.855). One patient with AS and two patients without AS undergoing adenosine stress CMR experienced minor symptoms (p = 0.562). Four examinations were aborted because of chest pain, paroxysmal atrial fibrillation and third-degree atrioventricular block. Inducible ischaemia, prior coronary artery bypass grafting, prior stroke and age were associated with a higher incidence of complications and minor symptoms. CONCLUSIONS: Moderate to severe AS was not associated with complications during CMR stress test. The incidence of non-severe complications and minor symptoms was greater with dobutamine.
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Salatzki et al. (2022) conducted a cohort in Moderate to severe aortic valve stenosis (n=374). Dobutamine and adenosine stress cardiac magnetic resonance (CMR) vs. Matched individuals without aortic valve stenosis was evaluated on Non-severe complications or minor symptoms during dobutamine stress CMR (p=0.855). Moderate to severe aortic valve stenosis was not associated with increased complications during dobutamine (20% vs 19%, p=0.855) or adenosine (1.1% vs 2.2%, p=0.562) stress CMR compared to controls.
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