Cardiovascular disease is the leading cause of death worldwide. Many cardiovascular diseases are better diagnosed during a cardiac stress test. Current approaches include either exercise or pharmacological stress echocardiography and pharmacological stress magnetic resonance imaging (MRI). MRI is the most accurate noninvasive method of assessing cardiac function. Currently there are very few exercise devices that allow collection of cardiovascular MRI data during exercise. We developed a low-cost exercise device that utilizes adjustable weight resistance and is compatible with magnetic resonance (MR) imaging. It is equipped with electronics that measure power output. Our device allows subjects to exercise with a leg-stepping motion while their torso is in the MR imager. The device is easy to mount on the MRI table and can be adjusted for different body sizes. Pilot tests were conducted with 5 healthy subjects (3 male and 2 female, 29.2 ± 3.9 yr old) showing significant exercise-induced changes in heart rate (+42%), cardiac output (+40%) and mean pulmonary artery (PA) flow (+%49) post exercise. These data demonstrate that our MR compatible stepper exercise device successfully generated a hemodynamically stressed state while allowing for high quality imaging. The adjustable weight resistance allows exercise stress testing of subjects with variable exercise capacities. This low-cost device has the potential to be used in a variety of pathologies that require a cardiac stress test for diagnosis and assessment of disease progression.

References

1.
Torpy
,
J. M.
,
Lynm
,
C.
, and
Glass
,
R. M.
,
2008
, “
JAMA Patient Page. Cardiac Stress Testing
,”
JAMA
,
300
(
15
), p.
1836
.10.1001/jama.300.15.1836
2.
Murphy
,
S. L.
,
Xu
,
J.
, and
Kochanek
,
K. D.
,
2012
, “
Deaths: Preliminary Data for 2010
,” National Vital Statistics Reports, Vol. 60, No. 4. National Center for Health Statistics, Hyattsville, MD.
3.
Picano
,
E.
,
Pibarot
,
P.
,
Lancellotti
,
P.
,
Monin
,
J. L.
, and
Bonow
,
R. O.
,
2009
, “
The Emerging Role of Exercise Testing and Stress Echocardiography in Valvular Heart Disease
,”
J. Am. Coll. Cardiol.
,
54
(
24
), pp.
2251
2260
.10.1016/j.jacc.2009.07.046
4.
Stringer
,
W. W.
,
2010
, “
Cardiopulmonary Exercise Testing: Current Applications
,”
Expert Rev. Respir. Med.
,
4
(
2
), pp.
179
188
.10.1586/ers.10.8
5.
Tsutsui
,
J. M.
,
Elhendy
,
A.
,
Xie
,
F.
,
O'Leary
,
E. L.
,
McGrain
,
A. C.
, and
Porter
,
T. R.
,
2005
, “
Safety of Dobutamine Stress Real-Time Myocardial Contrast Echocardiography
,”
J. Am. Coll. Cardiol.
,
45
(
8
), pp.
1235
1242
.10.1016/j.jacc.2005.01.024
6.
Wahl
,
A.
,
Paetsch
,
I.
,
Gollesch
,
A.
,
Roethemeyer
,
S.
,
Foell
,
D.
,
Gebker
,
R.
,
Langreck
,
H.
,
Klein
,
C.
,
Fleck
,
E.
, and
Nagel
,
E.
,
2004
, “
Safety and Feasibility of High-Dose Dobutamine-Atropine Stress Cardiovascular Magnetic Resonance for Diagnosis of Myocardial Ischaemia: Experience in 1000 Consecutive Cases
,”
Eur. Heart J.
,
25
(
14
), pp.
1230
1236
.10.1016/j.ehj.2003.11.018
7.
Wieben
,
O.
,
Francois
,
C.
, and
Reeder
,
S. B.
,
2008
, “
Cardiac MRI of Ischemic Heart Disease at 3 T: Potential and Challenges
,”
Eur. J. Radiol.
,
65
(
1
), pp.
15
28
.10.1016/j.ejrad.2007.10.022
8.
Oshinski
,
J. N.
,
Delfino
,
J. G.
,
Sharma
,
P.
,
Gharib
,
A. M.
, and
Pettigrew
,
R. I.
,
2010
, “
Cardiovascular Magnetic Resonance at 3.0T: Current State of the Art
,”
J. Cardiovasc. Magn. Reson.: Off. J. Soc. Cardiovasc. Magn. Reson.
,
12
(
Oct.
), p.
55
.10.1186/1532-429X-12-55
9.
van Rugge
,
F. P.
,
van der Wall
,
E. E.
,
de Roos
,
A.
, and
Bruschke
,
A. V.
,
1993
, “
Dobutamine Stress Magnetic Resonance Imaging for Detection of Coronary Artery Disease
,”
J. Am. Coll. Cardiol.
,
22
(
2
), pp.
431
439
.10.1016/0735-1097(93)90047-5
10.
Kumar
,
A.
,
Patton
,
D. J.
, and
Friedrich
,
M. G.
,
2010
, “
The Emerging Clinical Role of Cardiovascular Magnetic Resonance Imaging
,”
Can. J. Cardiol.
,
26
(
6
), pp.
313
322
.10.1016/S0828-282X(10)70396-2
11.
Axel
,
L.
,
2002
, “
Biomechanical Dynamics of the Heart With MRI
,”
Ann. Rev. Biomed. Eng.
,
4
, pp.
321
347
.10.1146/annurev.bioeng.4.020702.153434
12.
Hunold
,
P.
,
Schlosser
,
T.
, and
Barkhausen
,
J.
,
2006
, “
Magnetic Resonance Cardiac Perfusion Imaging—A Clinical Perspective
,”
Eur. Radiol.
,
16
(
8
), pp.
1779
1788
.10.1007/s00330-006-0269-3
13.
Hundley
,
W. G.
,
Morgan
,
T. M.
,
Neagle
,
C. M.
,
Hamilton
,
C. A.
,
Rerkpattanapipat
,
P.
, and
Link
,
K. M.
,
2002
, “
Magnetic Resonance Imaging Determination of Cardiac Prognosis
,”
Circulation
,
106
(
18
), pp.
2328
2333
.10.1161/01.CIR.0000036017.46437.02
14.
Ryf
,
S.
,
Schwitter
,
J.
,
Spiegel
,
M. A.
,
Rutz
,
A. K.
,
Luechinger
,
R.
,
Crelier
,
G. R.
, and
Boesiger
,
P.
,
2005
, “
Accelerated Tagging for the Assessment of Left Ventricular Myocardial Contraction Under Physical Stress
,”
J. Cardiovasc. Magn. Reson.: Off. J. Soc. Cardiovasc. Magn. Reson.
,
7
(
4
), pp.
693
703
.10.1081/JCMR-200065637
15.
Bossone
,
E.
, and
Armstrong
,
W. F.
,
1999
, “
Exercise Echocardiography. Principles, Methods, and Clinical Use
,”
Cardiol. Clin.
,
17
(
3
), pp.
447
460
.10.1016/S0733-8651(05)70090-4
16.
Jekic
,
M.
,
Foster
,
E. L.
,
Ballinger
,
M. R.
,
Raman
,
S. V.
, and
Simonetti
,
O. P.
,
2008
, “
Cardiac Function and Myocardial Perfusion Immediately Following Maximal Treadmill Exercise Inside the MRI Room
,”
J. Cardiovasc. Magn. Reson.: Off. J. Soc. Cardiovasc. Magn. Reson.
,
10
(
1
), p.
3
.10.1186/1532-429X-10-3
17.
Raman
,
S. V.
,
Dickerson
,
J. A.
,
Jekic
,
M.
,
Foster
,
E. L.
,
Pennell
,
M. L.
,
McCarthy
,
B.
, and
Simonetti
,
O. P.
,
2010
, “
Real-Time Cine and Myocardial Perfusion With Treadmill Exercise Stress Cardiovascular Magnetic Resonance in Patients Referred for Stress SPECT
,”
J. Cardiovasc. Magn. Reson.: Off. J. Soc. Cardiovasc. Magn. Reson.
,
12
(
1
), p.
41
.10.1186/1532-429X-12-41
18.
Srichai
,
M. B.
,
Lim
,
R. P.
,
Wong
,
S.
, and
Lee
,
V. S.
,
2009
, “
Cardiovascular Applications of Phase-Contrast MRI
,”
Am. J. Roentgenol.
,
192
(
3
), pp.
662
675
.10.2214/AJR.07.3744
19.
Lotz
,
J.
,
Meier
,
C.
,
Leppert
,
A.
, and
Galanski
,
M.
,
2002
, “
Cardiovascular Flow Measurement With Phase-Contrast MR Imaging: Basic Facts and Implementation
,”
Radiograph.: Rev. Publ. Radiol. Soc. North Am.
, Inc,
22
(
3
), pp.
651
671
.10.1148/radiographics.22.3.g02ma11651
20.
Gan
,
C. T.
,
Lankhaar
,
J. W.
,
Westerhof
,
N.
,
Marcus
,
J. T.
,
Becker
,
A.
,
Twisk
,
J. W.
,
Boonstra
,
A.
,
Postmus
,
P. E.
, and
Vonk-Noordegraaf
,
A.
,
2007
, “
Noninvasively Assessed Pulmonary Artery Stiffness Predicts Mortality in Pulmonary Arterial Hypertension
,”
Chest
,
132
(
6
), pp.
1906
1912
.10.1378/chest.07-1246
21.
Codullo
,
V.
,
Caporali
,
R.
,
Cuomo
,
G.
,
Ghio
,
S.
,
D'Alto
,
M.
,
Fusetti
,
C.
,
Borgogno
,
E.
,
Montecucco
,
C.
, and
Valentini
,
G.
,
2013
, “
Stress Doppler Echocardiography in Systemic Sclerosis: Evidence for a Role in the Prediction of Pulmonary Hypertension
,”
Arthritis Rheum.
,
65
(
9
), pp.
2403
2411
10.1002/art.38043.
22.
Valsangiacomo Buechel
,
E. R.
, and
Mertens
,
L. L.
,
2012
, “
Imaging the Right Heart: The Use of Integrated Multimodality Imaging
,”
Eur. Heart J.
,
33
(
8
), pp.
949
960
.10.1093/eurheartj/ehr490
23.
Pandya
,
B.
,
Kowalik
,
G.
,
Knight
,
D.
,
Tann
,
O.
,
Derrick
,
G.
, and
Muthurangu
,
V.
,
2013
, “
Towards a More Comprehensive Assessment of Cardiovascular Fitness—Magnetic Resonance Augmented Cardiopulmonary Exercise Testing (MR-CPEX)
,”
J. Cardiovasc. Magn. Reson.
,
15
(
Suppl 1
), p.
58
10.1186/1532-429X-15-S1-P58.
24.
Gusso
,
S.
,
Salvador
,
C.
,
Hofman
,
P.
,
Cutfield
,
W.
,
Baldi
,
J. C.
,
Taberner
,
A.
, and
Nielsen
,
P.
,
2012
, “
Design and Testing of an MRI-Compatible Cycle Ergometer for Non-Invasive Cardiac Assessments During Exercise
,”
Biomed. Eng. Online
,
11
(
1
), p.
13
.10.1186/1475-925X-11-13
25.
Tops
,
L. F.
,
Roest
,
A. A.
,
Lamb
,
H. J.
,
Vliegen
,
H. W.
,
Helbing
,
W. A.
,
van der Wall
,
E. E.
, and
de Roos
,
A.
,
2005
, “
Intraatrial Repair of Transposition of the Great Arteries: Use of MR Imaging After Exercise to Evaluate Regional Systemic Right Ventricular Function
,”
Radiology
,
237
(
3
), pp.
861
867
.10.1148/radiol.2373041347
26.
Roest
,
A. A.
,
Kunz
,
P.
,
Lamb
,
H. J.
,
Helbing
,
W. A.
,
van der Wall
,
E. E.
, and
de Roos
,
A.
,
2001
, “
Biventricular Response to Supine Physical Exercise in Young Adults Assessed With Ultrafast Magnetic Resonance Imaging
,”
Am. J. Cardiol.
,
87
(
5
), pp.
601
605
.10.1016/S0002-9149(00)01438-7
27.
Ergospect,
2008
, “
Cardiologic Module: Measuring the Cardiovascular System During Exercise
,” Ergospect GmbH, Innsbruck, Austria, http://ergospect.com/products-detail-ergospect-medical-equipment,pid,3,bid,1285225342,lid,en,eid,1364308426.html
28.
Ergospect, 2008, “
Ergospect: Medical Technology
,” Ergospect GmbH, Innsbruck, Austria, http://www.ergospect.com/products-detail-ergospect-medical-equipment,pid,3,bid,1285225342,lid,en,eid,1314176913.html
29.
Thompson
,
R. B.
, and
McVeigh
,
E. R.
,
2004
, “
Flow-Gated Phase-Contrast MRI Using Radial Acquisitions
,”
Magn. Reson. Med.: Off. J. Soc. Magn. Reson. Med./Soc. Magn. Reson. Med.
,
52
(
3
), pp.
598
604
.10.1002/mrm.20187
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