Document Detail


Arbutamine vs. exercise stress testing in patients with coronary artery disease: evaluation by echocardiography and electrocardiography.
MedLine Citation:
PMID:  8960948     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Arbutamine is a new beta-adrenergic agonist with potent chronotropic and inotropic properties developed to pharmacologically induce stress. A prospective trial was conducted in five centers with a total enrolment of 45 patients with angiographically documented coronary artery disease. The primary purpose of the trial was to compare the efficacy of arbutamine with symptom-limited exercise in provoking clinical (angina), electrocardiographic (> or = 0.1 mV ST depression) and echocardiographic (induced wall motion abnormality) evidence of transient stress-induced ischemia. The secondary purpose was to assess the safety of arbutamine in patients with coronary artery disease. Ischemia was induced at a lower heart rate, systolic blood pressure and pressure-rate product during arbutamine infusion than during exercise. Using angina and/or electrocardiographic evidence of ischemia, arbutamine was more sensitive than exercise in detecting myocardial ischemia (77 vs. 58%, P = 0.021). Using echocardiography, the sensitivity for inducing wall motion abnormalities was 88% with arbutamine and 79% with exercise (P = not significant). Echocardiography in combination with angina and/or electrocardiographic evidence increased the sensitivity to 94% using arbutamine and to 88% with exercise. For the patients with multivessel disease, the sensitivity was 97% and 91%, respectively. No serious adverse events, either cardiac or noncardiac, were associated with arbutamine, and no patient had prolonged ischemia. Although exercise is the preferred method of stress for patients who are able to exercise adequately, arbutamine is at least as sensitive as exercise for the diagnosis of myocardial ischemia, and appears to be a safe and effective alternative to exercise testing in patients unable to exercise adequately.
Authors:
L E Ginzton; P E Pool; C Appleton; S Mohiuddin; W S Robertson; G D Ismail; D S Bach; W F Armstrong
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of cardiology     Volume:  57     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  1996 Nov 
Date Detail:
Created Date:  1997-03-11     Completed Date:  1997-03-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  81-9     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Harbor-UCLA Medical Center, Torrance 90509, USA. lginzton@ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Agonists / diagnostic use*
Adult
Aged
Cardiotonic Agents / diagnostic use*
Catecholamines / diagnostic use*
Constriction, Pathologic
Coronary Disease / diagnosis*,  ultrasonography
Cross-Over Studies
Echocardiography
Exercise Test
Female
Humans
Male
Middle Aged
Prospective Studies
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Cardiotonic Agents; 0/Catecholamines; 130783-37-8/arbutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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