Resonancia magnética cardíaca con perfusión stress: Utilidad clínica y relación con coronariografía convencional

background: cardiovascular magnetic resonance (cmr) is a non invasive and non ionizing imaging tool that allows a complete cardiovascular evaluation. one of its advantages is the ability to analyze myocardial perfusión with and without stress. aim: to show our experience using stress perfusión cmr (spcmr), its correlation with conventional coronary angiography (cca) and cardiovascular events. methods: we retrospectively included in the analysis all patients referred to our institution to undergo a spcmr since january 2007 to april 2009. in all patients we performed a complete evaluation including anatomic, left ventricular function, adenosine stress perfusión and viability study. all the studies were performed in a 1.5 t scanner and 10 seconds breath-hold. stress perfusión was performed alter iv adenosine bolus (140 ug/kg/min). eight minutes after the stress, the rest phase was performed. viability analysis was done after the iv injection of gadolinium based contrast (0.15 mmol/ kg). a positive spcmr was considered in those with mismatch areas between stress and rest phases. in those patients who underwent a cca, we correlated the sp-cmr findings with the presence and location of stenoses equal or greater than 70% as significant. results: we included 71 patients during the mentioned period. indication for spcmr were heart failure and viability study (64%); coronary ischemia (36%). main baseline characteristics were: male 7%; age 9 ±7 years; diabetes 17%; hypertension 13%; previous family history for cad 15%; and tobacco 20%. mean left ventricular ejection fraction was 53±7 %. mean time to complete the exam was 50±5 minutes. there were not adverse reactions to contrast or adenosine. thirty one patients (42%) underwent cca. all patients with stenoses greater than 70% had a positive spcmr. agreement between cca and spcmr for ischemia location was 90%. conclusion: spcmr is feasible, safe and reliable in patients with suspected ischemia. sensitivity, specificity and pred