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Stress imaging in congenital cardiac disease

Published online by Cambridge University Press:  23 October 2009

Daniëlle Robbers-Visser
Affiliation:
Department of Paediatrics, Division of Cardiology, Erasmus MC – Sophia Children’s Hospital, Rotterdam, the Netherlands Department of Radiology, Erasmus MC, Rotterdam, the Netherlands
Saskia E. Luijnenburg
Affiliation:
Department of Paediatrics, Division of Cardiology, Erasmus MC – Sophia Children’s Hospital, Rotterdam, the Netherlands Department of Radiology, Erasmus MC, Rotterdam, the Netherlands
Jochem van den Berg
Affiliation:
Department of Paediatrics, Division of Cardiology, Erasmus MC – Sophia Children’s Hospital, Rotterdam, the Netherlands Department of Radiology, Erasmus MC, Rotterdam, the Netherlands
Adriaan Moelker
Affiliation:
Department of Radiology, Erasmus MC, Rotterdam, the Netherlands
Willem A. Helbing*
Affiliation:
Department of Paediatrics, Division of Cardiology, Erasmus MC – Sophia Children’s Hospital, Rotterdam, the Netherlands Department of Radiology, Erasmus MC, Rotterdam, the Netherlands
*
Correspondence to: W.A. Helbing, MD, PhD, Erasmus MC – Sophia Children’s Hospital, Department of Paediatrics, Division of Cardiology, Sp-2429, PO box 2060, 3000 CB Rotterdam, The Netherlands. Tel: +31-10-7036264; Fax: +31-10-7036772; E-mail: w.a.helbing@erasmusmc.nl

Abstract

In patients with coronary arterial disease, stress imaging is able to demonstrate abnormalities in the motion of the ventricular walls, and abnormalities in coronary arterial perfusion not apparent at rest. It can also provide information on prognostic factors. In patients with congenitally malformed hearts, stress imaging is used to determine contractile reserve, abnormalities of mural motion, and global systolic function, but also to assess diastolic and vascular function. In most of these patients, stress is usually induced using pharmacological agents, mainly dobutamine given in varying doses. The clinical usefulness of abnormal responses to the stress induced in such patients has to be addressed in follow-up studies. The abnormal stress might serve as surrogate endpoints, predicting primary endpoints at an early stage, which are useful for stratification of risk in this population of growing patients. We review here the stress imaging studies performed to date in patients with congenitally malformed hearts, with a special emphasis on echocardiography and cardiac magnetic resonance imaging.

Type
Review
Copyright
Copyright © Cambridge University Press 2009

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