MRI Heart with Function and Inotropic Stress MRI Heart with Function and Inotropic Stress Although early ACS approaches of CMR included high-risk patients and tended to use rest-only CMR, more recent studies have demonstrated high negative predictive value and excellent diagnostic performance in a low- to intermediate-risk cohort when compared with nuclear MPI or stress echocardiography [110,111]. Multiple studies have shown that a vasodilator stress CMR strategy for chest pain patients can allow safe discharge and show similar Chest Pain-Possible Acute Coronary Syndrome clinical performance to other stress perfusion techniques [45,112-114]. However, inotropic stress agents like dobutamine, although useful for the characterization of stable ischemic heart disease [115,116], are relatively contraindicated in patients with recent or active chest pain, and so limited literature exists on the use of inotropic stress MRI for the evaluation of ACS. MRI Heart with Function and Vasodilator Stress Perfusion Although early ACS approaches of CMR included high-risk patients and tended to use rest-only CMR, more recent studies have demonstrated high negative predictive value and excellent diagnostic performance in a low- to intermediate-risk cohort when compared with nuclear MPI or stress echocardiography [110,111]. Multiple studies have shown that a stress CMR strategy for chest pain patients can allow safe discharge and show similar clinical performance to other stress-perfusion techniques [45,112-114]. In particular, CMR has been shown to have similar or better performance to nuclear MPI in determining the degree of ischemic myocardium, which may be an important predictor of outcomes after revascularization [117,118].
Chest Pain Possible Acute Coronary Syndrome PCAs. MRI Heart with Function and Inotropic Stress MRI Heart with Function and Inotropic Stress Although early ACS approaches of CMR included high-risk patients and tended to use rest-only CMR, more recent studies have demonstrated high negative predictive value and excellent diagnostic performance in a low- to intermediate-risk cohort when compared with nuclear MPI or stress echocardiography [110,111]. Multiple studies have shown that a vasodilator stress CMR strategy for chest pain patients can allow safe discharge and show similar Chest Pain-Possible Acute Coronary Syndrome clinical performance to other stress perfusion techniques [45,112-114]. However, inotropic stress agents like dobutamine, although useful for the characterization of stable ischemic heart disease [115,116], are relatively contraindicated in patients with recent or active chest pain, and so limited literature exists on the use of inotropic stress MRI for the evaluation of ACS. MRI Heart with Function and Vasodilator Stress Perfusion Although early ACS approaches of CMR included high-risk patients and tended to use rest-only CMR, more recent studies have demonstrated high negative predictive value and excellent diagnostic performance in a low- to intermediate-risk cohort when compared with nuclear MPI or stress echocardiography [110,111]. Multiple studies have shown that a stress CMR strategy for chest pain patients can allow safe discharge and show similar clinical performance to other stress-perfusion techniques [45,112-114]. In particular, CMR has been shown to have similar or better performance to nuclear MPI in determining the degree of ischemic myocardium, which may be an important predictor of outcomes after revascularization [117,118].