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Safety profile of adenosine stress cardiac MRI in a tertiary hospital in India
BACKGROUND: Coronary artery disease (CAD) is a major cause of morbidity and mortality in India. Stress Cardiac Magnetic Resonance (CMR) using vasodilator agent is well established in assessing the functional significance of CAD. Adenosine is the preferred agent, but can have severe side effects incl...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7954153/ https://www.ncbi.nlm.nih.gov/pubmed/33737775 http://dx.doi.org/10.4103/ijri.IJRI_283_20 |
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author | Raj, Vimal Pudhiavan, A Hrishikesh, VJ Ali, Asik Kothari, Richa |
author_facet | Raj, Vimal Pudhiavan, A Hrishikesh, VJ Ali, Asik Kothari, Richa |
author_sort | Raj, Vimal |
collection | PubMed |
description | BACKGROUND: Coronary artery disease (CAD) is a major cause of morbidity and mortality in India. Stress Cardiac Magnetic Resonance (CMR) using vasodilator agent is well established in assessing the functional significance of CAD. Adenosine is the preferred agent, but can have severe side effects including dyspnoea, chest pain, atrioventricular block or bronchospasm. The stress CMR examination is not routinely performed in many of the clinical imaging departments in India. OBJECTIVE: The aim of this study was to establish safety of adenosine as a pharmacological stressor agent for CMR in a tertiary care radiology department in India. METHODS: A review of all patients undergoing stress CMR in our institution from May 2018 to May 2019 was made. Records were reviewed to collect response parameters and documented adverse reactions. RESULTS: A total of 1057 patients underwent stress CMR during this period. No death, myocardial infarction or atrio-ventricular block related complications were seen. Transient hypotension was seen in 20 patients (1.8') with spontaneous recovery after stopping infusion. Chest pain and breathlessness severe enough to discontinue the scan were seen in 6 (0.5') and 10 (0.9') patients, respectively. All patients with breathlessness recovered on low flow oxygen therapy with three requiring bronchodilator. Out of six patients with chest pain, three had immediate relief with sublingual nitroglycerin, and three required hospital admission for unstable angina. Of the latter three, 1 underwent revascularization on the same day and other two later in the week. CONCLUSION: Stress CMR using adenosine in appropriately selected patients is a highly safe procedure with significant side effects seen in less than 1’ of patients. Therefore, it is safe to perform stress CMR studies in a fully equipped and well-trained radiology department in India. |
format | Online Article Text |
id | pubmed-7954153 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-79541532021-03-17 Safety profile of adenosine stress cardiac MRI in a tertiary hospital in India Raj, Vimal Pudhiavan, A Hrishikesh, VJ Ali, Asik Kothari, Richa Indian J Radiol Imaging Cardiac Imaging BACKGROUND: Coronary artery disease (CAD) is a major cause of morbidity and mortality in India. Stress Cardiac Magnetic Resonance (CMR) using vasodilator agent is well established in assessing the functional significance of CAD. Adenosine is the preferred agent, but can have severe side effects including dyspnoea, chest pain, atrioventricular block or bronchospasm. The stress CMR examination is not routinely performed in many of the clinical imaging departments in India. OBJECTIVE: The aim of this study was to establish safety of adenosine as a pharmacological stressor agent for CMR in a tertiary care radiology department in India. METHODS: A review of all patients undergoing stress CMR in our institution from May 2018 to May 2019 was made. Records were reviewed to collect response parameters and documented adverse reactions. RESULTS: A total of 1057 patients underwent stress CMR during this period. No death, myocardial infarction or atrio-ventricular block related complications were seen. Transient hypotension was seen in 20 patients (1.8') with spontaneous recovery after stopping infusion. Chest pain and breathlessness severe enough to discontinue the scan were seen in 6 (0.5') and 10 (0.9') patients, respectively. All patients with breathlessness recovered on low flow oxygen therapy with three requiring bronchodilator. Out of six patients with chest pain, three had immediate relief with sublingual nitroglycerin, and three required hospital admission for unstable angina. Of the latter three, 1 underwent revascularization on the same day and other two later in the week. CONCLUSION: Stress CMR using adenosine in appropriately selected patients is a highly safe procedure with significant side effects seen in less than 1’ of patients. Therefore, it is safe to perform stress CMR studies in a fully equipped and well-trained radiology department in India. Wolters Kluwer - Medknow 2020 2021-01-13 /pmc/articles/PMC7954153/ /pubmed/33737775 http://dx.doi.org/10.4103/ijri.IJRI_283_20 Text en Copyright: © 2021 Indian Journal of Radiology and Imaging http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Cardiac Imaging Raj, Vimal Pudhiavan, A Hrishikesh, VJ Ali, Asik Kothari, Richa Safety profile of adenosine stress cardiac MRI in a tertiary hospital in India |
title | Safety profile of adenosine stress cardiac MRI in a tertiary hospital in India |
title_full | Safety profile of adenosine stress cardiac MRI in a tertiary hospital in India |
title_fullStr | Safety profile of adenosine stress cardiac MRI in a tertiary hospital in India |
title_full_unstemmed | Safety profile of adenosine stress cardiac MRI in a tertiary hospital in India |
title_short | Safety profile of adenosine stress cardiac MRI in a tertiary hospital in India |
title_sort | safety profile of adenosine stress cardiac mri in a tertiary hospital in india |
topic | Cardiac Imaging |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7954153/ https://www.ncbi.nlm.nih.gov/pubmed/33737775 http://dx.doi.org/10.4103/ijri.IJRI_283_20 |
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