This study is directed at evaluating patients with "myocardial ischemia" or poor blood supply to the heart muscle due to coronary artery disease. The major objective of this study is to determine the level of safety and effectiveness of magnetic resonance imaging at diagnosing coronary artery disease.

In addition, this study will allow researchers at the National Institutes of Health to see a broad spectrum of disease, preserve clinical skills, and stimulate future ideas for clinical research.

Condition	Treatment or Intervention
Heart Disease	Procedure: Magnetic Resonance Imaging (MRI)

Further Study Details: 

Expected Total Enrollment:  2300

This is a teaching protocol. It is in a format for training physicians in the laboratory in cardiovascular MRI techniques necessary for our research protocols. It helps provide experience necessary to develop and maintain our clinical expertise with cardiovascular MRI methods. It also provides physicians in the region access to this technology.

Genders Eligible for Study:  Both

Criteria

INCLUSION CRITERIA
All Arms:
Patients with known or suspected cardiovascular disease will be eligible for participation in this protocol. The patient is eligible under the following conditions:
1. Patient's age is greater than 21 years of age.
Dobutamine Stress MRI:
1. Known or suspected coronary artery disease or valvular heart disease.
EXCLUSION CRITERIA
All Arms:
Patients with a contraindication to MRI scanning will be excluded. These contraindications include patients with the following devices:
1. Central nervous system aneurysm clips
2. Implanted neural stimulator
3. Implanted cardiac pacemaker or defibrillator
4. Cochlear implant
5. Ocular foreign body (e.g. metal shavings)
6. Insulin pump
7. Metal shrapnel or bullet.
In addition the following patient groups will be excluded:
1. Pregnant women( patients who are uncertain as to whether they are pregnant will be required to have a screening urine or blood pregnancy test).
2. Patients with surgery of uncertain type where the presence of metal clips or wires cannot be excluded.
3. Patients with symptoms of myocardial ischemia occurring despite maximally tolerated doses of oral antianginal therapy and intravenous nitroglycerin.
Furthermore, the following patient groups will be excluded from studies involving the administration of MRI contrast agents:
1. Lactating women
2. Patients with hemoglobinopathies
3. Renal disease (CrCl less than 20 ml/min)
Dobutamine Stress MRI:
1. Myocardial infarction within 48 hours (CKMB greater than 3 times normal limits).
2. Uncontrolled congestive heart failure
3. Severe hypertension (SBP greater than 200, DBP greater than 100).
4. Atrial fibrillation.
5. Ventricular tachycardia.
6. Frequent PVC's (more than 1 every 10 heart beats or sustained ventricular tachycardia (greater than 4)).
7. Patients with narrow angle glaucoma will not receive atropine.

Maryland
      National Heart, Lung and Blood Institute (NHLBI), 9000 Rockville Pike,  Bethesda,  Maryland,  20892,  United States; Recruiting

Study ID Numbers:  970204; 97-H-0204
Record last reviewed:  August 7, 2004
Last Updated:  November 23, 2004
Record first received:  November 3, 1999
ClinicalTrials.gov Identifier:  NCT00001638
Health Authority: United States: Federal Government
ClinicalTrials.gov processed this record on 2005-04-08