Efficacy and Safety of Atropine Administered Prior to Dobutamine Stress Echocardiography
| Autor: | Shigemichi Tanaka, Hironori Murakami, Nagisa Hanawa, Harutatsu Muto, Yasukazu Yamaguchi, Yoshikazu Asano, Mitsugu Hirokami, Kenjiro Miyamoto, Yasuhiro Omoto |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
Myocardial ischemia business.industry Dobutamine stress echocardiography Significant difference Chest pain Atropine Anesthesia Internal medicine Cardiology medicine Radiology Nuclear Medicine and imaging Dobutamine medicine.symptom Differential diagnosis business Adverse effect medicine.drug |
| Zdroj: | Journal of Echocardiography. 5:65-71 |
| ISSN: | 1880-344X 1349-0222 |
| DOI: | 10.2303/jecho.5.65 |
| Popis: | Dobutamine stress echocardiography (DSE) is widely used to evaluate myocardial ischemia or to clarify the differential diagnosis of chest pain. DSE is often complicated by insufficient heart rate response, hypotension or other adverse events. We report the results of the assessment of a modified protocol for DSE, in which 0.5mg of intravenous atropine administration was followed by dobutamine (DOB) infusion at 10 μg/kg/min. Three hundred twenty-two consecutive patients, 172 patients studied with the modified protocol and 150 controls undergoing conventional DSE, were compared. The percentage of patients attaining target heart rate (THR) via the modified protocol was significantly increased (65% vs. 35%, P25mmHg) was significantly decreased (250mmHg, de novo intra-ventricular gradient development (>100mmHg) and intolerable symptoms did not differ between the groups. Coronary angiography was performed in 80 patients including in 45 patients with the conventional protocol and 35 patients with the modified protocol. No significant difference in sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the two protocols was observed. These results indicate that the modified protocol improves attainment of THR and prevents hypotension during DSE. Serious adverse events were not increased. |
| Databáze: | OpenAIRE |
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