Key result
Metoprolol cuts ischemia extent by ~43% and blunts peak heart rate during dobutamine stress.
Why the study?
The effect of intravenous metoprolol and the impact of intravenous glucagon on metoprolol's attenuation of dobutamine-induced myocardial ischemia were not well defined.
Does intravenous metoprolol or metoprolol plus glucagon reduce dobutamine-induced myocardial ischemia during stress testing in patients with known reversible perfusion defects?
RCT (n=22)
Double-blind
Randomized
No
Does intravenous metoprolol or metoprolol plus glucagon reduce dobutamine-induced myocardial ischemia during stress testing in patients with known reversible perfusion defects?
Intravenous metoprolol attenuates evidence of myocardial ischemia during dobutamine stress testing, an effect that is not adequately reversed by 1 mg of glucagon.
Answers are grounded in this paper and cite their sources.
IV metoprolol attenuates dobutamine-induced ischemia on stress testing; confirms beta-blocker interference and questions glucagon reversal efficacy.
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Murthy et al. (2000) conducted an RCT in Myocardial ischemia with known reversible perfusion defects (n=22). Metoprolol or metoprolol plus glucagon vs. Control (no therapy) was evaluated on Maximum heart rate, summed stress scores, and summed difference scores (31% reduction in max HR, 29% in summed stress scores, 43% in summed difference scores). During dobutamine stress testing, metoprolol reduced maximum heart rate by 31%, summed stress scores by 29%, and summed difference scores by 43% versus control.
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