Document Detail


Comparison of arbutamine and exercise echocardiography in diagnosing myocardial ischemia.
MedLine Citation:
PMID:  9070546     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Arbutamine is a new catecholamine designed for use as a pharmacologic stress agent. This study compared the sensitivity of arbutamine with symptom-limited exercise to induce echocardiographic signs of ischemia. Arbutamine was administered by a computerized closed-loop delivery system that controls the infusion rate of arbutamine toward a predefined rate of heart rate increase and maximum heart rate limit. Beta blockers were stopped > or = 48 hours before both tests. Stress was stopped for intolerable symptoms, or clinical, electrocardiographic or echocardiographic signs of ischemia (new or worsening wall motion abnormality), target heart rate (> or = 85% age predicted maximum heart rate), or plateau of heart rate response. Thirty-seven patients were entered into the study (35 arbutamine and exercise, 1 arbutamine only, 1 exercise only), of which 30 had angiographic evidence of coronary artery disease (> or = 50% lumen diameter narrowing). Rate-pressure product increased significantly in response to both stress modalities (p < 0.001) and was significantly greater with exercise (11,308 +/- 2,443) than with arbutamine (9,486 +/- 2,479, p < 0.001). The time to maximum heart rate was longer during arbutamine stress echocardiography than during exercise testing (17.3 +/- 9.4 versus 9.3 +/- 4.2 minutes, respectively, p < 0.001). There were more patients with interpretable echo data for arbutamine (82%) than for exercise (67%). Sensitivity for recognition of myocardial ischemia was 94% (95% confidence interval 70% to 100%) and 88% (95% confidence interval 62% to 98%), respectively. The most frequent adverse events during arbutamine (n = 36) were dyspnea (5.6%) and tremor (5.6%). Two arbutamine stress tests were discontinued due to arrhythmias: 1 patient had premature atrial and ventricular beats, and the other had premature atrial contractions and atrial fibrillation. Arrhythmias were well tolerated and resolved without sequelae. In conclusion, the sensitivity of arbutamine to induce echocardiographic signs of ischemia was similar to that of exercise despite a lower rate-pressure product. Arbutamine was well tolerated and provides a reliable alternative to exercise echocardiography.
Authors:
A Cohen; H Weber; C Chauvel; J L Monin; J C Dib; B Diebold; P Guéret
Related Documents :
8068466 - Comparative ability of dobutamine and exercise stress in inducing myocardial ischaemia ...
20719336 - Transient peaked t waves during exercise stress testing: an unusual manifestation of re...
11161916 - The incremental prognostic value of pharmacological stress echo over exercise electroca...
16171716 - Assessment of left ventricular function during upright treadmill exercise with tantalum...
10408316 - Influence of menstrual cycle and oral contraceptives on tolerance to uncompensable heat...
22981266 - Reliability of peak exercise testing in patients with heart failure with preserved ejec...
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  79     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-04-09     Completed Date:  1997-04-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  713-6     Citation Subset:  AIM; IM    
Affiliation:
Saint-Antoine University Hospital, Paris, France.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiotonic Agents / adverse effects,  diagnostic use*
Catecholamines / adverse effects,  diagnostic use*
Coronary Angiography
Echocardiography / drug effects,  methods*,  statistics & numerical data
Exercise Test / drug effects,  methods*,  statistics & numerical data
Female
Hemodynamics / drug effects
Humans
Male
Middle Aged
Myocardial Ischemia / diagnosis*,  physiopathology
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Catecholamines; 130783-37-8/arbutamine

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


Previous Document:  Significance of slow upsloping ST-segment depression on exercise stress testing.
Next Document:  Comparison of short- and long-term prognosis in patients with anterior wall versus inferior or later...