Feasibility and results of acute cardiac stress MRI with regadenoson for risk stratification of COPD-patients with NSTEMI

Background Patients with chronic obstructive pulmonary disease (COPD) often present with symptoms equivalent to an acute coronary syndrome (ACS) and slightly elevated high sensitive troponine in the observational range (hsTnT 14-53 ng/l). While this cannot differentiate between coronary or pulmonary origin of myocardial damage it necessitates further investigation since it has prognostic impact. Comorbidity of COPD and coronary heart disease is frequent and risk factors are also congruent. In this acute setting, a safe, and reliable test to identify coronary problems is of great value. Non-invasive assessment of these patients is hampered by low echocardiographic imaging quality due to pulmonary emphysema and by the bronchospasmic effect of adenosine. With the new vasodilatator regadenoson, stress-MRI is possible in patients with COPD. The aim of this study was to evaluate the value of regadenoson stress MRI in patients with known COPD and low troponine values.