Safety and feasibility of high-dose dobutamine-atropine stress cardiovascular magnetic resonance for diagnosis of myocardial ischaemia: experience in 1000 consecutive cases.
Safety and feasibility of high-dose dobutamine-atropine stress cardiovascular magnetic resonance for diagnosis of myocardial ischaemia: experience in 1000 consecutive cases.
复制标题
大剂量多巴酚丁胺-阿托品应激心血管磁共振诊断心肌缺血的安全性和可行性：1000例连续病例的经验。
DOI：
10.1016/j.ehj.2003.11.018
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发表时间：
2003
影响因子：
39.3
通讯作者：
E. Nagel
中科院分区：
文献类型：
--
作者：
A. Wahl;I. Paetsch;A. Gollesch;S. Roethemeyer;D. Foell;R. Gebker;H. Langreck;C. Klein;E. Fleck;E. Nagel
AimsTo确定高剂量多巴酚丁胺-阿托品负荷心血管磁共振（stress-CMR）的安全性，这是最近出现的一个高度准确的模式，用于诊断诱导性心肌ischaemia.Method和resultsFrom 1997年至2002年，1000个连续的stress-CMR检查进行。在静息状态和高剂量多巴酚丁胺-阿托品方案期间采集3个短轴、4个和2个心腔视图的图像。当达到年龄预测心率的≥ 85%时，应患者要求，最大药物输注，或当发生新发或恶化的室壁运动异常、重度心绞痛、呼吸困难、血压升高或降低或重度心律失常时，停止负荷试验。除4例患者（0.4%; ECG触发不足）外，所有患者均成功进行了Stress-CMR。95例（9.5%）未达到目标心率，21例（2.1%）因次最大阴性检查中的最大药物输注，74例（7.4%）因限制性副作用。副作用包括1例（0.1%）的持续性和4例（0.4%）的非持续性室性心动过速，16例（1.6%）的心房颤动，和2例（0.2%）的短暂的二度AV block.ConclusionThe安全配置文件的应力CMR是类似的其他方法使用多巴酚丁胺输注。必须密切监测患者，并提供复苏设备和训练有素的人员。
AimsTo 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 resultsFrom 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 ⩾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.ConclusionThe 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.