Document Detail


Prognostic significance of systolic blood pressure changes during dobutamine-atropine stress technetium-99m sestamibi perfusion scintigraphy in patients with chest pain and known or suspected coronary artery disease.
MedLine Citation:
PMID:  9114759     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To investigate the prognostic value of dobutamine stress-induced changes in systolic blood pressure (BP) 418 patients (mean age 60 years, 238 men) with chest pain and known or suspected coronary artery disease, who underwent a dobutamine-atropine stress technetium-99m sestamibi myocardial perfusion scintigraphic study, were followed up for 25 +/- 15 months. Blood pressure was measured by automatic sphygmomanometry every 3 minutes. A marked decrease and increase in systolic BP from rest to peak were defined as changes of > or = 20 mm Hg, and > or = 30 mm Hg, respectively. Worst outcome events were cardiac death (n = 30), nonfatal myocardial infarction (n = 17), and hospitalization for congestive heart failure (n = 8). A decrease in systolic BP (prevalence 16%) was associated with older age and higher baseline systolic BP. Fixed and reversible sestamibi perfusion defects and follow-up results were similar to patients without a systolic BP decrease. In contrast, an increase in systolic BP (prevalence 24%) was associated with younger age, lower baseline systolic BP, and with absence of a history of prior congestive heart failure or treatment with angiotensin-converting enzyme inhibitors. Furthermore, these patients had fewer fixed perfusion defects and tended to have fewer annual event rates (3.5% vs 7.5%, p < 0.10). In a multivariate model, an increase in systolic BP was not an independent predictor for subsequent events. In conclusion, a dobutamine-induced decrease in systolic BP is not associated with fixed or reversible sestamibi defects or adverse prognosis. An increase in systolic BP, however, is associated with less fixed sestamibi defects and a tendency toward less annual event rates.
Authors:
M L Geleijnse; A Elhendy; R T van Domburg; R Rambaldi; A E Reijs; J R Roelandt; P M Fioretti
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Publication Detail:
Type:  Journal Article; 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 Apr 
Date Detail:
Created Date:  1997-05-08     Completed Date:  1997-05-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1031-5     Citation Subset:  AIM; IM    
Affiliation:
Thoraxcentre, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Agonists / diagnostic use*
Adult
Age Factors
Aged
Aged, 80 and over
Anti-Arrhythmia Agents / therapeutic use
Atropine / therapeutic use
Blood Pressure / drug effects*
Coronary Angiography
Coronary Disease / radiography,  radionuclide imaging*
Dobutamine / diagnostic use*
Female
Humans
Male
Middle Aged
Prognosis
Radiopharmaceuticals / diagnostic use*
Systole
Technetium Tc 99m Sestamibi / diagnostic use*
Chemical
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Anti-Arrhythmia Agents; 0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi; 34368-04-2/Dobutamine; 51-55-8/Atropine

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


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