Document Detail


Use of atropine in patients with submaximal heart rate during exercise myocardial perfusion SPECT.
MedLine Citation:
PMID:  12569331     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Failure to reach 85% of maximal predicted heart rate (MPHR) during exercise may render a myocardial perfusion single photon emission computed tomography (MPS) study nondiagnostic for ischemia detection. Although commonly used to increase heart rate (HR) during dobutamine stress, the administration of atropine for patients failing to achieve 85% of MPHR during exercise performed for MPS is still infrequent. METHODS AND RESULTS: Patients undergoing dual-isotope MPS were considered candidates for the study when, during exercise treadmill testing, they had less than 85% of MPHR and were unable to continue because of fatigue, without an ischemic response. Forty-seven patients (aged 65.3 +/- 12.5 years, 78.7% men) received atropine (0.6-1.2 mg). Maximal HR achieved before and after atropine was 118.0 +/- 14.8 beats/min (76.3% +/- 6.2% of MPHR) and 146.4 +/- 12.6 beats/min (94.4% +/- 8.1% of MPHR), respectively (P < .001). Of patients, 44 (93.6%) reached at least 85% of MPHR after atropine and had diagnostic MPS studies. After atropine, arrhythmias occurred in 14 patients (29.8%) and other minor side effects in 1 (2.1%). CONCLUSIONS: Atropine allows patients initially failing to achieve 85% of MPHR during exercise to increase HR and have a diagnostic MPS study, without major complications. It may provide an alternative to pharmacologic stress for patients with a blunted HR response to exercise.
Authors:
Andrea De Lorenzo; James Foerster; Maria G Sciammarella; Cathy Suey; Sean W Hayes; John D Friedman; Daniel S Berman
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology     Volume:  10     ISSN:  1071-3581     ISO Abbreviation:  J Nucl Cardiol     Publication Date:    2003 Jan-Feb
Date Detail:
Created Date:  2003-02-05     Completed Date:  2003-08-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  51-5     Citation Subset:  IM    
Affiliation:
Department of Imaging (Division of Nuclear Medicine), Cedars-Sinai Medical Center, Los Angeles, Calif 90048, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Arrhythmias, Cardiac / etiology
Atropine / adverse effects,  diagnostic use*,  pharmacology
Exercise Test*
Female
Heart Rate / drug effects*
Humans
Male
Middle Aged
Myocardial Ischemia / radionuclide imaging*
Parasympatholytics / adverse effects,  diagnostic use*,  pharmacology
Radiopharmaceuticals / diagnostic use
Technetium Tc 99m Sestamibi / diagnostic use
Thallium Radioisotopes / diagnostic use
Tomography, Emission-Computed, Single-Photon / methods
Chemical
Reg. No./Substance:
0/Parasympatholytics; 0/Radiopharmaceuticals; 0/Thallium Radioisotopes; 109581-73-9/Technetium Tc 99m Sestamibi; 51-55-8/Atropine

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