{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,31]],"date-time":"2024-08-31T05:53:40Z","timestamp":1725083620725},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2021,7,14]],"date-time":"2021-07-14T00:00:00Z","timestamp":1626220800000},"content-version":"vor","delay-in-days":286,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Indian Journal of Radiology and Imaging"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          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\u2019) with spontaneous recovery after stopping infusion. Chest pain and breathlessness severe enough to discontinue the scan were seen in 6 (0.5\u2019) and 10 (0.9\u2019) 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\u2019 of patients. Therefore, it is safe to perform stress CMR studies in a fully equipped and well-trained radiology department in India.<\/jats:p>","DOI":"10.4103\/ijri.ijri_283_20","type":"journal-article","created":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T18:26:02Z","timestamp":1610562362000},"page":"459-464","source":"Crossref","is-referenced-by-count":4,"title":["Safety profile of adenosine stress cardiac MRI in a tertiary hospital in India"],"prefix":"10.1055","volume":"30","author":[{"given":"Vimal","family":"Raj","sequence":"additional","affiliation":[{"name":"Cardiothoracic Imaging Unit, Narayana Institute of Cardiac Sciences, Narayana Health City, Hosur Road, Bommasandra Industrial Estate, Bangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Pudhiavan","sequence":"additional","affiliation":[{"name":"Cardiothoracic Imaging Unit, Narayana Institute of Cardiac Sciences, Narayana Health City, Hosur Road, Bommasandra Industrial Estate, Bangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"VJ","family":"Hrishikesh","sequence":"additional","affiliation":[{"name":"Cardiothoracic Imaging Unit, Narayana Institute of Cardiac Sciences, Narayana Health City, Hosur Road, Bommasandra Industrial Estate, Bangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asik","family":"Ali","sequence":"additional","affiliation":[{"name":"Cardiothoracic Imaging Unit, Narayana Institute of Cardiac Sciences, Narayana Health City, Hosur Road, Bommasandra Industrial Estate, Bangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richa","family":"Kothari","sequence":"additional","affiliation":[{"name":"Cardiothoracic Imaging Unit, Narayana Institute of Cardiac Sciences, Narayana Health City, Hosur Road, Bommasandra Industrial Estate, Bangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,7,14]]},"reference":[{"key":"ref2","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1136\/hrt.2007.132951","article-title":"Epidemiology and causation of coronary heart disease and stroke in India","volume":"94","author":"R Gupta","year":"2008","journal-title":"Heart"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"806","DOI":"10.4103\/2230-8210.117212","article-title":"Emerging risk factors for cardiovascular diseases: Indian context","volume":"17","author":"S Gupta","year":"2013","journal-title":"Indian J Endocrinol Metab"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1016\/S0140-6736(96)07492-2","article-title":"Alternative projections of mortality and disability by cause 1990-2020: Global burden of disease study","volume":"349","author":"C J Murray","year":"1997","journal-title":"Lancet"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.1016\/j.jacc.2019.07.074","article-title":"Cardiac magnetic resonance stress perfusion imaging for evaluation of patients with chest pain","volume":"74","author":"R Y Kwong","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1093\/eurheartj\/ehm617","article-title":"MR-IMPACT: Comparison of perfusion-cardiac magnetic resonance with single-photon emission computed tomography for the detection of coronary artery disease in a multicentre, multivendor, randomized trial","volume":"29","author":"J Schwitter","year":"2008","journal-title":"Eur Heart J"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1093\/eurheartj\/ehs022","article-title":"MR-IMPACT II: Magnetic resonance imaging for myocardial perfusion assessment in coronary artery disease trial: Perfusion-cardiac magnetic resonance vs. single-photon emission computed tomography for the detection of coronary artery disease: A comparative multicentre, multivendor trial","volume":"34","author":"J Schwitter","year":"2013","journal-title":"Eur Heart J"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/S0140-6736(11)61335-4","article-title":"Cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary heart disease (CE-MARC): A prospective trial","volume":"379","author":"J P Greenwood","year":"2012","journal-title":"Lancet"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1161\/CIRCULATIONAHA.109.907659","article-title":"Incremental prognostic significance of combined cardiac magnetic resonance imaging, adenosine stress perfusion, delayed enhancement, and left ventricular function over preimaging information for the prediction of adverse events","volume":"123","author":"S E Bingham","year":"2011","journal-title":"Circulation"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1016\/j.jacc.2007.06.016","article-title":"Prognostic value of dipyridamole stress cardiovascular magnetic resonance imaging in patients with known or suspected coronary artery disease","volume":"50","author":"V Bodi","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1016\/j.jacc.2013.03.080","article-title":"Prognostic value of stress cardiac magnetic resonance imaging in patients with known or suspected coronary artery disease: A systematic review and meta-analysis","volume":"62","author":"M J Lipinski","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1161\/CIRCULATIONAHA.113.001430","article-title":"Stress cardiac magnetic resonance imaging provides effective cardiac risk reclassification in patients with known or suspected stable coronary artery disease","volume":"128","author":"R Shah","year":"2013","journal-title":"Circulation"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.jacc.2013.11.009","article-title":"ACCF\/AHA\/ASE\/ASNC\/HFSA\/HRS\/SCAI\/SCCT\/SCMR\/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons","volume":"63","author":"M J Wolk","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/0735-1097(94)90424-3","article-title":"Safety profile of adenosine stress perfusion imaging: Results from the Adenoscan Multicenter Trial Registry","volume":"23","author":"M D Cerqueira","year":"1994","journal-title":"J Am Coll Cardiol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s10554-008-9392-3","article-title":"Tolerance and safety of adenosine stress perfusion cardiovascular magnetic resonance imaging in patients with severe coronary artery disease","volume":"25","author":"T D Karamitsos","year":"2009","journal-title":"Int J Cardiovasc Imaging"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"e851","DOI":"10.1259\/bjr\/14829242","article-title":"Stress cardiovascular MR in routine clinical practice: Referral patterns, accuracy, tolerance, safety and incidental findings","volume":"85","author":"J P Khoo","year":"2012","journal-title":"Br J Radiol"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"424","DOI":"10.3348\/kjr.2011.12.4.424","article-title":"The adverse events and hemodynamic effects of adenosine-based cardiac MRI","volume":"12","author":"T Voigtlander","year":"2011","journal-title":"Korean J Radiol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s12968-020-00607-1","article-title":"Standardized cardiovascular magnetic resonance imaging (CMR) protocols: 2020 update","volume":"22","author":"C M Kramer","year":"2020","journal-title":"J Cardiovasc Magn Reson"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1186\/1532-429X-15-91","article-title":"Society for cardiovascular magnetic resonance board of trustees task force on standardized P. 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