{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T18:45:20Z","timestamp":1785782720722,"version":"3.56.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["PG\/18\/42\/33746"],"award-info":[{"award-number":["PG\/18\/42\/33746"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIHR Clinician Scientist Award","award":["CS-2018\u201318-ST2-007"],"award-info":[{"award-number":["CS-2018\u201318-ST2-007"]}]},{"DOI":"10.13039\/501100000272","name":"NIHR Research","doi-asserted-by":"publisher","award":["RP-2017-08-ST2-007"],"award-info":[{"award-number":["RP-2017-08-ST2-007"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020013","name":"NIHR Leicester BRC","doi-asserted-by":"publisher","award":["NIHR203327"],"award-info":[{"award-number":["NIHR203327"]}],"id":[{"id":"10.13039\/501100020013","id-type":"DOI","asserted-by":"publisher"}]},{"name":"BHF Leicester Centre of Research Excellence"},{"name":"BHF Research Professor","award":["F\/20\/90026"],"award-info":[{"award-number":["F\/20\/90026"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>In patients with heart failure with reduced ejection fraction (HFrEF), determining the aetiology of cardiac dysfunction has important therapeutic and prognostic implications. Cardiovascular magnetic resonance (CMR) enables comprehensive phenotyping of HFrEF; however, it remains uncertain whether the choice of pharmacological stress agent influences the hyperaemic response required for reliable ischaemia assessment. We sought to compare the hyperaemic effects of adenosine and dobutamine in patients with HFrEF using quantitative perfusion CMR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Patients with HFrEF [left ventricular ejection fraction (LVEF) \u226440%] prospectively underwent 3-Tesla CMR comprising functional cine imaging, late gadolinium enhancement (LGE), and first-pass perfusion imaging at rest and during pharmacological stress with (i) adenosine (140\u2013210 \u03bcg\/kg\/min) and (ii) dobutamine (10\u201330\u2005\u00b5g\/kg\/min). Perfusion maps were reconstructed inline with automated, pixel-wise quantification of myocardial blood flow (MBF). The hyperaemic response, defined by global myocardial perfusion reserve (MPR), was calculated as the quotient of stress and rest MBF and compared between stress protocols. Fifty-three patients with HFrEF (mean age 63 \u00b1 10 years, 77% male, mean LVEF 36 \u00b1 10%, infarction 59%, and non-ischaemic focal fibrosis 21%) with paired adenosine and dobutamine stress\u2013perfusion data were analysed. Compared with dobutamine, adenosine produced a higher global MPR [mean difference: +0.61 (95% CI: 0.35, 0.88); P &amp;lt; 0.001], which remained significant at the segmental level following adjustment for age, sex, type 2 diabetes, LVEF, and LGE presence [mean difference: +0.63 (95% CI: 0.55, 0.71); P &amp;lt; 0.001].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with HFrEF, adenosine induces a greater hyperaemic response than dobutamine; however, whether this impacts on the diagnostic assessment of ischaemia remains to be established (Trial registration: NCT03661827).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjimp\/qyag128","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:48:52Z","timestamp":1784116132000},"source":"Crossref","is-referenced-by-count":0,"title":["Hyperaemic effects of adenosine and dobutamine in heart failure with reduced ejection fraction: a quantitative perfusion CMR study"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4761-7297","authenticated-orcid":false,"given":"Simran","family":"Shergill","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Sciences, University of Leicester, the National Institute for Health and Care Research Biomedical Research Centre Leicester and British Heart Foundation Centre of Research Excellence, Glenfield Hospital , Groby Road, Leicester LE3 9QP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M S E K","family":"Abdelaty","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, University of Leicester, the National Institute for Health and Care Research Biomedical Research Centre Leicester and British Heart Foundation Centre of Research Excellence, Glenfield Hospital , Groby Road, Leicester LE3 9QP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunny R","family":"Sedani","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, University of Leicester, the National Institute for Health and Care Research Biomedical Research Centre Leicester and British Heart Foundation Centre of Research Excellence, Glenfield Hospital , Groby Road, Leicester LE3 9QP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida","family":"Moafi","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, University of Leicester, the National Institute for Health and Care Research Biomedical Research Centre Leicester and British Heart Foundation Centre of Research Excellence, Glenfield Hospital , Groby Road, Leicester LE3 9QP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lavanya","family":"Athithan","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, University of Leicester, the National Institute for Health and Care Research Biomedical Research Centre Leicester and British Heart Foundation Centre of Research Excellence, Glenfield Hospital , Groby Road, Leicester LE3 9QP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna M","family":"Bilak","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, University of Leicester, the National Institute for Health and Care Research Biomedical Research Centre Leicester and British Heart Foundation Centre of Research Excellence, Glenfield Hospital , Groby Road, Leicester LE3 9QP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8555-5141","authenticated-orcid":false,"given":"Mohamed","family":"Elshibly","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, University of Leicester, the National Institute for Health and Care Research Biomedical Research Centre Leicester and British Heart Foundation Centre of Research Excellence, Glenfield Hospital , Groby Road, Leicester LE3 9QP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iyare","family":"Nehikhare","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital , Leicester ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6174-8202","authenticated-orcid":false,"given":"Adeogo A","family":"Olusan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital , Leicester ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pharveen","family":"Jaspal","sequence":"additional","affiliation":[{"name":"Department of Medicine, South Warwickshire University NHS Foundation Trust , Warwick ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon L","family":"Hetherington","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kettering General Hospital , Kettering ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7277-5145","authenticated-orcid":false,"given":"Mohamed","family":"Alama","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kettering General Hospital , Kettering 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Institute , Melbourne ,","place":["Australia"]},{"name":"University of Melbourne , Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1112-3973","authenticated-orcid":false,"given":"Anvesha","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, University of Leicester, the National Institute for Health and Care Research Biomedical Research Centre Leicester and British Heart Foundation Centre of Research Excellence, Glenfield Hospital , Groby Road, Leicester LE3 9QP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iain B","family":"Squire","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, University of Leicester, the National Institute for Health and Care Research Biomedical Research Centre Leicester and British Heart Foundation Centre of Research Excellence, Glenfield Hospital , Groby Road, Leicester LE3 9QP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep S","family":"Hothi","sequence":"additional","affiliation":[{"name":"Heart and Lung Centre, Royal Wolverhampton NHS Trust , Wolverhampton ,","place":["UK"]},{"name":"Institute of Cardiovascular Sciences, University of Birmingham , Birmingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Khoo","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, University of Leicester, the National Institute for Health and Care Research Biomedical Research Centre Leicester and British Heart Foundation Centre of Research Excellence, Glenfield Hospital , Groby Road, Leicester LE3 9QP ,","place":["UK"]},{"name":"Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital , Leicester ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav S","family":"Gulsin","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, University of Leicester, the National Institute for Health and Care Research Biomedical Research Centre Leicester and British Heart Foundation Centre of Research Excellence, Glenfield Hospital , Groby Road, Leicester LE3 9QP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerry P","family":"McCann","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, University of Leicester, the National Institute for Health and Care Research Biomedical Research Centre Leicester and British Heart Foundation Centre of Research Excellence, Glenfield Hospital , Groby Road, Leicester LE3 9QP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Ranjit","family":"Arnold","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, University of Leicester, the National Institute for 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