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Dynamic handgrip exercise for the detection of myocardial ischemia using fast Strain-ENCoded cardiovascular magnetic resonance

Background - Previous data suggest dynamic handgrip exercise (DHE) as a potential physiological, needle-free stressor feasible for cardiovascular magnetic resonance (CMR) examinations. DHE-fast Strain-ENCoded imaging (fSENC) is potentially cost-saving, ultra-fast and avoids pharmacological side effe...

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Main Authors: Ochs, Andreas (Author) , Nippes, Michael (Author) , Salatzki, Janek (Author) , Weberling, Lukas D. (Author) , Osman, Nael (Author) , Riffel, Johannes (Author) , Katus, Hugo (Author) , Friedrich, Matthias (Author) , Frey, Norbert (Author) , Ochs, Marco (Author) , André, Florian (Author)
Format: Article (Journal)
Language:English
Published: Sum 2025
In: Journal of cardiovascular magnetic resonance
Year: 2025, Volume: 27, Issue: 1, Pages: 1-10
ISSN:1532-429X
DOI:10.1016/j.jocmr.2025.101879
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.jocmr.2025.101879
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S1097664725000419
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Author Notes:Andreas Ochs, Michael Nippes, Janek Salatzki, Lukas D. Weberling, Nael Osman, Johannes Riffel, Hugo A. Katus, Matthias G. Friedrich, Norbert Frey, Marco M. Ochs, Florian André
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Summary:Background - Previous data suggest dynamic handgrip exercise (DHE) as a potential physiological, needle-free stressor feasible for cardiovascular magnetic resonance (CMR) examinations. DHE-fast Strain-ENCoded imaging (fSENC) is potentially cost-saving, ultra-fast and avoids pharmacological side effects thereby targeting the drawbacks of conventional pharmacological stress CMR. - Objectives - To assess the diagnostic accuracy of DHE-fSENC for detecting ischemia-related wall motion abnormalities in suspected obstructive coronary artery disease (CAD). - Methods - Patients with known or suspected obstructive CAD referred for CMR stress testing were prospectively enrolled. Diagnostic accuracy was assessed in comparison to pharmacological stress CMR and in a subgroup, compared to invasive coronary angiography (ICA). The CMR protocol was extended by both-handed DHE with 80 repetitions per minute over 2 min followed by fSENC short-axis acquisition before pharmacological stress testing. Stress-induced impairment of regional longitudinal strain was graded suspicious for obstructive CAD. - Results - Two-hundred sixty individuals with cardiovascular high-risk profile (64±13years, 75% male) were enrolled. DHE-fSENC provided a sensitivity of 79% (95% CI: 64-89) and specificity of 87% (95% CI 82-91) compared to pharmacological stress CMR. In a subgroup of 105 patients with recent ICA, high diagnostic accuracy was found for the detection of obstructive CAD (sensitivity 82% [95% CI: 67-92], specificity 89% [95% CI: 78-95]). Exam duration of DHE-fSENC was significantly reduced compared to conventional CMR stress protocols (DHE-fSENC 207±69 s vs. adenosine-perfusion 287±82 s vs. dobutamine-cine 1132±294 s, all p<0.001). - Conclusion - DHE-fSENC allows for a reliable and fast detection of obstructive CAD, thereby expanding the applicability of needle-free CMR stress testing.
Item Description:Gesehen am 20.10.2025
Physical Description:Online Resource
ISSN:1532-429X
DOI:10.1016/j.jocmr.2025.101879

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