Comparison between accelerated and conventional dobutamine stress protocols for myocardial perfusion scintigraphy.

20:33 EDT 30th August 2015 | BioPortfolio

Summary of "Comparison between accelerated and conventional dobutamine stress protocols for myocardial perfusion scintigraphy."

The conventional dobutamine (Dob) stress protocol for myocardial perfusion scintigraphy (MPS) is long, with frequent adverse effects, and generally requires atropine injection to reach target heart rate. Atropine is usually administered at the end of the protocol, when adverse effects are more frequent. Earlier atropine injection may be useful to shorten the stress protocol and reduce adverse effects. We sought to compare a Dob stress protocol with early atropine injection to a conventional Dob stress protocol in the same patients undergoing MPS. 30 patients underwent Dob-MPS with a conventional protocol (steps of 10, 20, 30 and 40 mcg/kg/min at 3 min intervals, adding atropine to the maximal Dob dose if necessary to achieve 85% of the age-corrected maximal predicted heart rate) and with an accelerated protocol with early atropine injection (at the end of the first stage). We compared stress duration, maximal heart rate (HR), percentage of maximal predicted HR, rate-pressure product, ST changes, MPS scores and the incidence of adverse effects between the 2 protocols. The accelerated protocol was shorter than the conventional protocol (7.1 ± 3.4 min vs. 11.8 ± 1.3 min; P < 0.0001), had the same efficacy to achieve hemodynamic parameters, without increasing adverse effects. The summed stress scores obtained by automatic analysis were similar in both protocols (6.3 ± 6.3 vs. 6.8 ± 6.3; P = NS) as well as the summed difference scores (2.5 ± 3.6 vs. 2.7 ± 3.4; P = NS). Early atropine injection during dobutamine stress protocol shortens stress duration. Our results suggest that patient safety and accuracy of MPS are unaltered, when compared to the conventional protocol, but further, larger studies are still necessary.


Cardiology Division, Department of Internal Medicine, Federal University of Rio de Janeiro, Rua Rui Vaz Pinto, 220/301, Rio de Janeiro, RJ, 21931390, Brazil.

Journal Details

This article was published in the following journal.

Name: The international journal of cardiovascular imaging
ISSN: 1875-8312


PubMed Articles [14412 Associated PubMed Articles listed on BioPortfolio]

Differing autonomic responses to dobutamine stress in the presence and absence of myocardial ischaemia.

Cardiac autonomic dysfunction has prognostic significance in patients with coronary artery disease. This investigation aimed to assess changes in autonomic modulation induced by dobutamine stress in t...

Strain Echocardiography Combined With Pharmacological Stress Test for Early Detection of Anthracycline Induced Cardiomyopathy.

Advances in echocardiography, including 2-D speckle tracking to quantitate myocardial strain and strain rate, have improved myocardial functional and mechanical evaluation and may provide a more sensi...

Ischemic Burden and Clinical Outcome: Is One 'Culprit' Ischemic Segment by Dobutamine Stress Magnetic Resonance Predictive?

We sought to evaluate the impact of ischemic burden for the prediction of hard cardiac events (cardiac death or nonfatal myocardial infarction) in patients with known or suspected CAD who undergo dobu...

How to do a stress echocardiography?

Stress echocardiography (SE) is a powerful functional imaging technique to assess cardiac performance under work conditions. The main indication is the detection of myocardial ischemia due to coronary...

Patient satisfaction with coronary CT angiography, myocardial CT perfusion, myocardial perfusion MRI, SPECT myocardial perfusion imaging and conventional coronary angiography.

To evaluate patient acceptance of noninvasive imaging tests for detection of coronary artery disease (CAD), including single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI...

Clinical Trials [4723 Associated Clinical Trials listed on BioPortfolio]

Prospective Analysis and Comparison of Stress Echo to Real-Time Myocardial Contrast Stress Echo

The purpose of this study is to prospectively analyze and compare conventional stress echocardiograms and real-time myocardial contrast stress echocardiograms; and to determine the effect ...

Comparison of Dobutamine and Regadenoson Stress Cardiac Magnetic Resonance (MR)

The goal of this research is to determine the utility of Regadenoson (Lexiscan)for use as an imaging agent with cardiac MR. If found useful, it will help us establish a protocol for regade...

Real Time Myocardial Contrast Echocardiography and Dobutamine Stress Perfusion Magnetic Resonance Imaging

The present study is designed to: 1. investigate the safety and efficacy of Real time myocardial echocardiography (RT-MCE) in adolescents and adults ages 13-40 with congenital and ...

Strain-Encoded Cardiac Magnetic Resonance Imaging for Dobutamine Stress Testing

The purpose of this study is to compare the diagnostic value of SENC to that provided by conventional wall motion analysis for the detection of inducible ischemia during DS-MRI.High-dose d...

Myocardial Regional Function by Dobutamine Stress Echocardiography in the Metabolic Syndrome and Type 2 Diabetes

Summary. Theoretical Rationale: The left ventricular myocardial performance results from a complex interplay between linear deformations (longitudinal, circumferential and radial) ...

Medical and Biotech [MESH] Definitions

A beta-2 agonist catecholamine that has cardiac stimulant action without evoking vasoconstriction or tachycardia. It is proposed as a cardiotonic after myocardial infarction or open heart surgery.

Comparison of various psychological, sociological, or cultural factors in order to assess the similarities or diversities occurring in two or more different cultures or societies.

Clinical protocols used to inhibit the growth or spread of NEOPLASMS.

Vinblastine derivative with antineoplastic activity against CANCER. Major side effects are myelosuppression and neurotoxicity. Vindesine is used extensively in chemotherapy protocols (ANTINEOPLASTIC COMBINED CHEMOTHERAPY PROTOCOLS).

Therapeutic practices which are not currently considered an integral part of conventional allopathic medical practice. They may lack biomedical explanations but as they become better researched some (PHYSICAL THERAPY MODALITIES; DIET; ACUPUNCTURE) become widely accepted whereas others (humors, radium therapy) quietly fade away, yet are important historical footnotes. Therapies are termed as Complementary when used in addition to conventional treatments and as Alternative when used instead of conventional treatment.


Relevant Topics

Latest News Clinical Trials Research Drugs Reports Corporate
Stress is caused by your perception of situations around you and then the reaction of your body to them. The automatic stress response to unexpected events is known as 'fight or flight'. Discovered by Walter Cannon in 1932, it is the release of h...

Latest News Clinical Trials Research Drugs Reports Corporate
Cardiology is a specialty of internal medicine.  Cardiac electrophysiology : Study of the electrical properties and conduction diseases of the heart. Echocardiography : The use of ultrasound to study the mechanical function/physics of the h...

Cardiovascular disease (CVD)
Latest News Clinical Trials Research Drugs Reports Corporate
Acute Coronary Syndromes (ACS) Blood Cardiovascular Dialysis Hypertension Stent Stroke Vascular Cardiovascular disease (CVD) includes all the diseases of the heart and circulation including coronary heart disease (angina...


Searches Linking to this Article