Document Detail

Safety of dobutamine-atropine stress echocardiography in patients with suspected or proven coronary artery disease.
MedLine Citation:
PMID:  8141086     Owner:  NLM     Status:  MEDLINE    
The purpose of this study was to establish the safety of high-dose dobutamine-atropine stress echocardiography in patients with suspected or proven coronary artery disease. Six hundred fifty consecutive examinations were completed. Mean age of patients was 61 years; 300 had a previous myocardial infarction. Heart rate increased from 73 to 129 beats/min during stress testing, blood pressure did not change significantly (from 140/81 to 150/80 mm Hg). Atropine was added to dobutamine in 239 patients when no ischemia was induced with dobutamine alone and the peak heart rate was < 85% of the theoretical maximal heart rate. Atropine was more frequently administered to patients taking beta blockers (77 vs 27%, p < 0.001). New wall motion abnormalities developed in 243 patients (37%). Significant or symptomatic cardiac tachyarrhythmias, or both, developed during 24 examinations: 1 patient developed ventricular fibrillation, 3 patients developed sustained ventricular tachycardia, 12 patients experienced nonsustained ventricular tachycardia (< 10 beats) and 8 patients had paroxysmal atrial fibrillation. Cardiac arrhythmias were more frequent in patients with a history of ventricular arrhythmias (ventricular tachycardia and fibrillation) (odds ratio 9.9, 2.0 to 45) or left ventricular dysfunction at rest (wall motion score > 1.12) (odds ratio 2.9, 1.1-7.6), but not associated with atropine addition. No death or myocardial infarction occurred. The full dose was not given to 13 patients despite absence of signs or markers of ischemia for limiting side effect, yielding an overall feasibility of the stress test of 98%.(ABSTRACT TRUNCATED AT 250 WORDS)
D Poldermans; P M Fioretti; E Boersma; T Forster; H van Urk; J H Cornel; M Arnese; R T Roelandt
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  73     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1994 Mar 
Date Detail:
Created Date:  1994-04-25     Completed Date:  1994-04-25     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:  456-9     Citation Subset:  AIM; IM    
Thoraxcenter, University Hospital Rotterdam-Dijkzigt, The Netherlands.
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MeSH Terms
Aged, 80 and over
Atropine / adverse effects*,  diagnostic use
Coronary Disease / physiopathology,  ultrasonography*
Dobutamine / adverse effects*,  diagnostic use
Echocardiography / methods
Feasibility Studies
Hemodynamics / drug effects*
Middle Aged
Statistics as Topic
Reg. No./Substance:
34368-04-2/Dobutamine; 51-55-8/Atropine

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