High-dose dobutamine-atropine stress cardiovascular magnetic resonance was successfully performed in 99.6% of patients, with limiting side effects occurring in 7.4%.
Observational (n=1,000)
Is high-dose dobutamine-atropine stress cardiovascular magnetic resonance safe and feasible for the diagnosis of myocardial ischaemia?
High-dose dobutamine-atropine stress-CMR is highly feasible and has a safety profile similar to other dobutamine stress modalities, though close monitoring is required.
AIMS: To determine the safety of high-dose dobutamine-atropine stress cardiovascular magnetic resonance (stress-CMR), which recently emerged as a highly accurate modality for diagnosis of inducible myocardial ischaemia. METHOD AND RESULTS: From 1997 to 2002, 1000 consecutive stress-CMR examinations were performed. Images were acquired at rest and during a high-dose dobutamine-atropine protocol in 3 short-axis, a 4- and a 2-chamber view. Stress testing was discontinued when > or =85% of age-predicted heart rate was reached, on patient request, maximum pharmacologic infusion, or when new or worsening wall motion abnormalities, severe angina, dyspnoea, increase or decrease in blood pressure, or severe arrhythmias occurred. Stress-CMR was successfully performed in all but four patients (0.4%; insufficient ECG-triggering). Target heart rate was not reached in 95 cases (9.5%), due to maximum pharmacologic infusion in submaximal negative examinations in 21 cases (2.1%), and limiting side effects in 74 (7.4%). Side effects included one case (0.1%) of sustained and four cases (0.4%) of non-sustained ventricular tachycardia, 16 cases (1.6%) of atrial fibrillation, and two cases (0.2%) of transient second degree AV block. CONCLUSION: The safety profile of stress-CMR is similar to other methodologies using dobutamine infusions. Patients must be closely monitored, and resuscitation equipment and trained personnel must be available.
A WAHL (Wed,) conducted a observational in Myocardial ischaemia (n=1,000). High-dose dobutamine-atropine stress cardiovascular magnetic resonance was evaluated on Safety and feasibility (successful performance and side effects). High-dose dobutamine-atropine stress cardiovascular magnetic resonance was successfully performed in 99.6% of patients, with limiting side effects occurring in 7.4%.