AAOCA dobutamine stress CMR (San Donato)

A retrospective single-centre cohort from IRCCS Policlinico San Donato near Milan of patients with an anomalous aortic origin of a coronary artery (AAOCA), a congenital variant linked to myocardial ischaemia and sudden cardiac death in young athletes. The study tested whether dobutamine stress cardiac MRI finds inducible ischaemia in these patients across all ages, not only in children, and which anatomical and clinical features go with a positive test. A Zenodo record with the study title was published in February 2026 under CC BY 4.0, but its files are restricted and not listed. The paper offers the underlying data on reasonable request to the corresponding author.

Composition

100 consecutive patients referred between April 2015 and January 2024. Median age was 36 years (interquartile range 15 to 51) and 73 were male. The anomalous vessel was the right coronary artery in 70, the left coronary artery in 15, the circumflex in 10 and the left anterior descending artery in 5. 62 had an intramural course and 48 had no symptoms.

Acquisition

All scans ran on a 1.5 T Siemens Aera. Dobutamine was raised stepwise to a peak dose, with cine imaging at rest and at each step. First-pass gadobutrol perfusion was acquired at peak stress and at rest, followed by late gadolinium enhancement. In 36 patients a 3D radial whole-heart research sequence imaged the coronary origins.

Annotations

Each study was read as positive or negative for inducible ischaemia: 14 were positive, all with perfusion defects and one with a wall motion abnormality. Nine patients had ischaemic-pattern scar on late enhancement within the AAOCA territory.

Known limitations

• The image files are not openly available, and neither the record nor the paper says whether shared data include images or only clinical tables.
• Single centre, single scanner, with few positive tests.
• Reader details and analysis software for the images are not reported.