Exercise stress cardiac magnetic resonance imaging in cardiac patients

Introduction: Cardiac magnetic resonance imaging testing protocols used in combination with exercise (Ex-CMR) facilitate the characterization of the heart by differentiating between normal cardiac remodeling and pathological cardiac remodeling. Studies have reported challenges when using Ex-CMR, limiting its clinical use. Hence, this review provides an overview of existing Ex-CMR studies focusing on cardiac remodeling in cardiac patients. Methods: This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A total of 24 studies were included in this review. Results: A total of 538 patients (265 males and 200 females) underwent an Ex-CMR procedure. Ex-CMR testing protocols included cycle ergometer (N=20), isometric handgrip exercise (N=3) and stepper ergometer (N=1). Exercise-induced cardiovascular responses were evaluated in both the left and right ventricles. This review reports the advantages and limitations of Ex-CMR testing. Conclusions: This scoping review identified existing Ex-CMR protocols that assess cardiovascular responses among cardiac patients, highlighting their advantages and limitations. Both cycle ergometer and isometric handgrip protocols have been used to induce cardiovascular responses in cardiac patients. Nevertheless, it appears that developing an effective Ex-CMR protocol is necessary and may improve early detection of abnormal cardiovascular responses in cardiac patients. Registration: This study was registered as a protocol as ‘Exercise stress cardiac magnetic resonance imaging in the assessment of induced cardiovascular responses in cardiac patients: a scoping review protocol’ (https://journals.lww.com/jbisrir/fulltext/2023/09000/exercise_stress_cardiac_magnetic_resonance_imaging.10.aspx) with the protocol prospectively registered with the Open Science Framework (https://osf.io/hvn75/overview?view_only = f6cf8fc2112e498d89c39639dbce70d1).