The effects of beta-blockers on dobutamine-atropine stress echocardiography: early protocol versus standard protocol

Cardiovascular Ultrasound - 2006
Ana C Camarozano1, Plínio Resende2, Aristarco G Siqueira-Filho3, Luis H Weitzel4, Rosangela Noe5
1Cardiology Department, Barra D'or Hospital, National Heart Institute, Rio de Janeiro, Brazil
2Cardiology Department, Barra D'or Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
3Internal Medicine Department, University Hospital, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
4Cardiology Department, National Heart Institute, Rio de Janeiro, Brazil
5Statistical Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

Tóm tắt

To study the effects of Beta-blockers during Dobutamine Stress Echocardiography (DSE) comparing the hemodynamic benefits of an early administration of atropine in patients taking or not Beta-blockers. One hundred and twenty-one patients were submitted to dobutamine stress echocardiography for the investigation of myocardial ischemia. The administration of atropine was randomized into two groups: A or B (early protocol when atropine was administered at 10 and 20 mcg/kg/min of dobutamine, respectively) and C (standard protocol with atropine at 40 mcg/kg/min of dobutamine). Analysis of the effects of Beta-blockers was done regarding the behavior pattern of heart rate and blood pressure, test time, number of conclusive and inconclusive (negative sub-maximum test) results, total doses of atropine and dobutamine, and general complications. Beta-blocked patients who received early atropine (Group A&B) had a significantly lower double product (p = 0.008), a higher mean test time (p = 0.010) and required a higher dose of atropine (p = 0.0005) when compared to the patients in this group who were not Beta-blocked. The same findings occurred in the standard protocol (Group C), however the early administration of atropine reduced test time both in the presence and absence of this therapy (p = 0.0001). The patients with Beta-blockers in Group A&B had a lower rate of inconclusive tests (26%) compared to those in Group C (40%). Complications were similar in both groups. The chronotropic response during dobutamine stress echocardiography was significantly reduced with the use of Beta-blockers. The early administration of atropine optimized the hemodynamic response, reduced test time in patients with or without Beta-blockers and reduced the number of inconclusive tests in the early protocol.

Từ khóa


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