Absolute Quantification of Coronary Flow Reserve by Stress Perfusion MRI
Myocardial Ischemia
About this trial
This is an interventional diagnostic trial for Myocardial Ischemia focused on measuring Magnetic Resonance Imaging, regadenoson
Eligibility Criteria
Inclusion Criteria:
Under an Institutional Committee on Human Research board approved protocol, 20 patients with a suspected myocardial ischemic disease with positive stress nuclear medicine test laboratory will be recruited in this prospective study. All subjects will be screened for GFR within 24 hours before the exam. All patients must have a GFR > 30 mL/min/1.73m2 to be included in the study.
All subjects will be selected following the Nephrogenic Systemic Fibrosis (NSF) guidelines. All dialysis patients or end-stage renal disease patients with a creatinine clearance of < 30mL/min will not be selected for the study to avoid NSF.
Exclusion Criteria:
- Age 18 to 89 years;
- Known contraindication to MR imaging (such as pacemaker placement, magnetic implants, etc);
- Claustrophobia;
- Inability to perform an adequate breath-hold for imaging,
- Inability to provide informed consent;
- all subjects will be will be screened for GFR within 24 hours before the exam and subjects presenting with GFR < 60 ml/min will be excluded;
- Pregnant and lactating women;
- Patients with hypersensitivity to gadolinium contrast agents, metoprolol, adenosine, or nitroglycerin;
10) Contra indication for Regadenoson
- 2nd- or 3rd-degree AV block (except in patients with a functioning artificial pacemaker)
- Sinus node disease (except in patients with a functioning artificial pacemaker)
- Unstable angina
- Acute myocardial infarction
- Known or suspected bronchoconstrictive or bronchospastic lung disease (e.g., asthma)
- Hypersensitivity to adenosine
- Caffeine within 12-24 hours
- Theophylline and Dipyridamole products within 24 hours
Sites / Locations
- Northwestern University
Arms of the Study
Arm 1
Experimental
coronary artery disease patients
Patients with suspected coronary artery disease prospectively recruited for myocardial perfusion MRI. All subjects to receive 5 ml IV gadofoveset trisodium contrast (Ablavar, Lantheus) at both stress and rest. Stress to be induced using 5 ml intravenous (IV) regadenoson (Lexiscan, Astellas US LLC), and the effects of regadenoson were reversed with 50 mg IV aminophylline following the completion of stress imaging.