Safety and efficacy of arbutamine stress echocardiography.
- Author:
Yi Chul SYNN
1
;
Kee Sik KIM
;
Jang Ho BAE
;
Seong Wook HAN
;
So Young PARK
;
Chang Wook NAM
;
Ki Young KIM
;
Yoon Nyun KIM
;
Kwon Bae KIM
;
You Hee KIM
Author Information
1. Division of Cardiology, Department of internal medicine, Biochemistry, School of Medicine, Keimyung University, Taegu, Korea.
- Publication Type:Original Article
- Keywords:
Arbutamine;
Stress echocardiography;
Ischemic heart disease
- MeSH:
Arrhythmias, Cardiac;
Atropine;
Blood Pressure;
Chest Pain;
Coronary Angiography;
Coronary Artery Disease;
Dobutamine;
Echocardiography;
Echocardiography, Stress*;
Heart Rate;
Hemodynamics;
Humans;
Hypotension;
Myocardial Ischemia;
Sensitivity and Specificity;
Tremor;
Ventricular Premature Complexes
- From:Korean Journal of Medicine
2000;58(1):39-47
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Exercise and pharmacologic stress echocardiography are widely used for detecting coronary artery disease. Arbutamine is a new synthetic mild alpha1-receptor and - receptor agonist developed specifically for stress echocardiography. Arbutamine is superior to dobutamine owing to its enforced chronotropic action than that of dobutamine. We intended to know safety and efficacy of arbutamine stress echocardiography in inducing myocardial ischemia and detecting coronary artery disease. METHODS: We underwent arbutamine stress echocardiography on 52 patients, dobutamine stress echocardiography in 35 patients. Alteration of blood pressure, heart rate, regional wall motion on echocardiography were evaluated. Sensitivity and specificity were determined by coronary angiography for 61 patients(Arbutamine: 31, Dobutamine : 30) RESULTS: 1) Hemodynamic alterations respect to stress agents Baseline Maximal Baseline Maximal Interval for Blood pressure Blood pressure Heartrate Heart rate maximal heartrate Arbutamine 122/70mmHg 138/72mmHg 69BPM 137BPM 8.2 min* Dobutamine 126/73mmHg 136/77mmHg 74BPM 102BPM 11.4 min* (* p < 0.05) 2) Comparison of Arbutamine and Dobutamine in sensitivity Sensitivity(Specificity) Side effects Atropine Arbutamine 80.1% (90%) 33(63.5%) 8(15.4%) Dobutamine 78.2% (71.4%) 21(60%) 7(20%) 3) Side effects of stress agents Hypotension Palpitation, tremor Arrhythmia Chest pain Arbutamine 15(28.8%)* 4(7.7%)* 21(40.4%) 8(9.2%) Dobutamine 3(8.6%)* 9(25.7%)* 12(34.3%) 5(5.7%) (* p < 0.05) 4) Premature ventricular contraction was most common arrhythmia in both group. There was no fatal or significant complication, and most complications were subsided after discontinuation of stress agents. CONCLUSION: Arbutamine is an effective and safe pharmacologic stress agent in detecting myocardial ischemia and superior to dobutamine in increasing heart rate. Sensitivity and specificity of arbutamine were higher than that of dobutamine.
