Aims: Dobutamine and adenosine stress cardiac magnetic resonance imaging (CMR) are relatively contraindicated in patients with moderate to severe AS. We aimed to determine the safety of dobutamine and adenosine stress CMR in patients with moderate to severe AS.
Methods: In this retrospective study patients with AS who underwent either dobutamine or adenosine stress CMR between January 2009 and December 2021 for exclusion of obstructive CAD were enrolled. We recorded clinical data, CMR and echocardiography findings and side effects (major complications, minor complications and complaints). Patients with AS were compared to matched individuals without AS.
Results: 187 patients with AS were identified and compared to age-, gender- and BMI-matched 187 patients without AS. No major complications were reported in the study nor the control group. The reported frequency of complaints and minor complications were similar between the study and the control groups.
Nineteen patients with AS experienced side effects during dobutamine stress CMR compared to eighteen patients without AS (p=0.855). One patient with AS and two patients without AS undergoing adenosine stress CMR experienced side effects (p=0.562). Four examinations were aborted because of severe chest pain, paroxysmal atrial fibrillation and third-degree atrioventricular block. Age, prior coronary artery bypass grafting, prior stroke and inducible ischaemia were associated with a higher incidence of complications.
Conclusion: Moderate to severe AS was not associated with side effects of complications during CMR stress test. The data suggest CMR stress testing to be safe in patients with AS.