Acute regadenoson stress prefusion testing using cardiac MRI is a valuable test of high predictive value for risk stratification of COPD-patients with NSTEM

Background The diagnostic dilemma of patients suffering from chronic obstructive pulmonary disease (COPD) presenting with symptoms equivalent to an acute coronary syndrome (ACS) and slightly elevated high sensitive troponine in the observational range (hsTnT 14-53 ng/l) is complex. Prognostic impact of elevated hsTnT demand further investigation. Comorbidities of COPD and coronary artery disease are frequent, risk factors congruent. The acute setting demands a safe and easily conductible test to identify coronary problems reliably. Echocardiographic imaging quality is often low due to emphysema. Adenosine is contraindicated due to its bronchospasmic effect. The new vasodilatator regadenoson does not bear this limitation. This study aims to evaluate feasibility and prognostic power of regadenoson stress cMRI in the above described population.