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MyoStrain®, MyoStress™ Rapid Hyperventilation Breath-Hold Maneuver Enables First-of-its-Kind Needle-Free Stress Protocol for the Accurate Detection of Myocardial Ischemia

  • MyoStrain, in combination with a simple standardized breathing maneuver, demonstrated higher diagnostic accuracy in detecting myocardial ischemia and provided a faster and safer assessment compared to traditional stress tests
  • The article underlines MyoStrain’s potential role towards overcoming the diagnostic limitations of traditional stress testing by improving stress testing speed, efficiency and patient experience while reducing operational costs
April 28, 2021
Company News

MORRISVILLE, N.C., April 28, 2021 – A new peer-reviewed study accepted in the Journal of the American College of Cardiology: Cardiovascular Imaging validated Myocardial Solutions (“MSI”) technologies MyoStrain and MyoStress in a new stress testing protocol utilizing a hyperventilation breath-hold (HVBH) maneuver to accurately detect myocardial ischemia. The article demonstrated MyoStrain’s speed and sensitivity to successfully measure cardiac stress during a safe, simple breathing maneuver. This novel technique may provide clinicians with a faster and safer quantitative stress test to help improve the diagnosis and management of coronary artery disease without any pharmacological or physical stress protocols.[1]

The study compared the MyoStrain/MyoStress HVBH maneuver against traditional stress tests Adenosine-perfusion and Adenosine-strain to evaluate the sensitivity of HVBH for detecting changes in heart function as a result of stress on the heart. All three methods were performed randomly on a standard Philips Achieva MRI, and strain measurements were acquired using MyoStrain’s fast-SENC single heartbeat acquisition technique. In total, 122 adults were examined, each patient presented with a significant cardiovascular risk profile and recent coronary angiography.

The MyoStrain/MyoStress HVBH maneuver was performed in a two-step process. First, patients received a standard MyoStrain scan with their heart at rest. Then, while they are still positioned in the scanner, patients were instructed to perform a rapid inhale and exhale maneuver (~35 breaths per minute) followed by a long breath-hold. The maneuver successfully mimics the hyperemic effect of a classical adenosine stress test, resulting in a safe and “needle-free” MRI stress test protocol.

Results showed the MyoStrain/MyoStress HVBH maneuver yielded greater accuracy over traditional stress testing methods for the detection of myocardial ischemia. HVBH exam times were significantly shorter and were performed without contrast agents or pharmacological stressors.

Dr. Marco Ochs, MD, Cardiologist at Theresien Hospital in Mannheim, Germany and lead author of the study, stated: “This study demonstrates the immense clinical utility MyoStrain’s diagnostic speed and accuracy can bring to ischemic stress testing. Hyperventilation/breath-hold maneuver combined with MyoStrain/MyoStress provides a fast and safe scan procedure for clinicians to assess their patients without needing contrast agents or pharma stressors. The result is a 15-minute, needle-free MyoStress test designed to help advance ischemia detection, improve workflow efficiency and enhance the overall patient experience.” 

Professor Matthias Friedrich, MD, FESC, FACC, MSCMR, Professor of Medicine and Chief of Cardiovascular Imaging at McGill University Health Centre in Montreal, Quebec, added: “There are numerous limitations concerning the safety, feasibility, logistical effort, and speed with today’s stress testing techniques. We adapted the hyperventilation/breath-hold maneuver with MyoStrain to help overcome these limitations, providing a fast, safe and non-invasive approach to improve the cardiovascular assessment of patients suspected of coronary artery disease. This is a huge step.”

John Funkhouser, CEO at MSI, stated: “There are over 10 million annual tests performed in the U.S. every year. The majority of stress testing is nuclear, which involves injecting radioactive agents into the patient. This procedure is not highly accurate and can take up to four hours of the patient’s time to complete. MyoStress testing takes about 15 minutes, is totally non-invasive, and is highly accurate in finding ischemia caused by coronary heart diseases. This test could become a new standard of care in stress testing.”

Access to the publication abstract is available here.

[1] Ochs, Met al. J Am Coll Cardiol Cardiovasc Imaging. Apr 14, 2021. DOI: 10.1016/j.jcmg.2021.02.022

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About Myocardial Solutions, Inc.

Myocardial Solutions, Inc. (MSI) is a medical technology company working to transform the cardiac and cancer care continuum. Leveraging more than 400 publications in clinical research and development, MSI’s proprietary technology, MyoStrain®, is a 10-minute, MRI-based heart function test providing physicians with sensitive diagnostic markers to support the early assessment and individualized treatment of heart dysfunction. MyoStrain has received FDA-510(k) pre-market clearance, CE-mark certification, and is commercially available in the United States and Europe.

To learn more about MyoStrain, visit or connect with us on LinkedIn and Twitter @myocardialsoln.  

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