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- Title
Safety and feasibility of atropine added in patients with sub-maximal heart rate during exercise myocardial perfusion SPECT.
- Authors
Filippo Sarullo; Corrado Ventimiglia; Andrea Taormina; Vincenzo Azzarello; Filippo Felice; Annamaria Martino; Salvatore Paterna; Pietro Pasquale
- Abstract
Abstract Background  Failure to reach 80% of maximal predicted heart rate (HR) during exercise may render a myocardial perfusion single photon emission computed tomography (SPECT) study non-diagnostic for ischemia detection. We sought to investigate the injection of atropine in patients who fail to achieve 80% of age-predicted HR during exercise performed for myocardial perfusion SPECT (MPS), defining its safety and efficacy to raise HR to adequate levels as well as its effect on MPS interpretation. Methods and results  Between January 2002 and December 2004, we studied 3,150 consecutive patients (2,253 men and 897 women, mean age 55 � 6 years) who were referred to a single office-based nuclear cardiology laboratory for MPS using SPECT imaging. One milligram of atropine was administered to patients that were unable to continue because of fatigue before reaching minimal HR, without an ischemic response (group A, n = 397). The scintigraphic results for group A were compared with those of patients who spontaneously achieved target HR (group B, n = 2,753). In group A, mean HR before atropine injection was 119.5 � 13.6 beats per minute (bpm), and it increased up to 137.3 � 13.5 bpm after drug administration, with an incremental of 17.8 � 6.9 bpm (P P = 0.39). Ischemia or ischemia plus scar was found in 112/397 patients (28.2%) in group A and in 923/2,753 patients (33.5%) of group B (P = 0.14). Conclusion  Atropine added to exercise stress testing in patients who cannot achieve their 80% age-related HR is a safe, well-tolerated, and feasible method for MPS.
- Subjects
ATROPINE; PERFUSION; HEART beat; PATIENTS
- Publication
International Journal of Cardiovascular Imaging, 2007, Vol 23, Issue 4, p511
- ISSN
1569-5794
- Publication type
Article
- DOI
10.1007/s10554-006-9169-5