PMID- 17109201
OWN - NLM
STAT- MEDLINE
DCOM- 20070921
LR  - 20220716
IS  - 1569-5794 (Print)
IS  - 1569-5794 (Linking)
VI  - 23
IP  - 4
DP  - 2007 Aug
TI  - Safety and feasibility of atropine added in patients with sub-maximal heart rate 
      during exercise myocardial perfusion SPECT.
PG  - 511-8
AB  - BACKGROUND: Failure to reach 80% of maximal predicted heart rate (HR) during 
      exercise may render a myocardial perfusion single photon emission computed 
      tomography (SPECT) study non-diagnostic for ischemia detection. We sought to 
      investigate the injection of atropine in patients who fail to achieve 80% of 
      age-predicted HR during exercise performed for myocardial perfusion SPECT (MPS), 
      defining its safety and efficacy to raise HR to adequate levels as well as its 
      effect on MPS interpretation. METHODS AND RESULTS: Between January 2002 and 
      December 2004, we studied 3,150 consecutive patients (2,253 men and 897 women, 
      mean age 55 +/- 6 years) who were referred to a single office-based nuclear 
      cardiology laboratory for MPS using SPECT imaging. One milligram of atropine was 
      administered to patients that were unable to continue because of fatigue before 
      reaching minimal HR, without an ischemic response (group A, n = 397). The 
      scintigraphic results for group A were compared with those of patients who 
      spontaneously achieved target HR (group B, n = 2,753). In group A, mean HR before 
      atropine injection was 119.5 +/- 13.6 beats per minute (bpm), and it increased up 
      to 137.3 +/- 13.5 bpm after drug administration, with an incremental of 17.8 +/- 
      6.9 bpm (P < 0.0001). The mean percentage of age-related HR achieved in this 
      group was 83.5 +/- 8.1%. In 302 of this patients (76.1%) more than 80% of their 
      aged-related HR (86.9 +/- 5.1%) was attained. No major adverse effects occurred. 
      When groups A and B were compared, baseline and peak HR, rate pressure product, 
      and maximal metabolic equivalents achieved were higher in group B. There were no 
      significant differences in the percentage of total positive perfusion studies 
      between both groups: 210/397 patients (52.9%) in group A and 1,342/2,753 patients 
      (48.7%) in group B (P = 0.39). Ischemia or ischemia plus scar was found in 
      112/397 patients (28.2%) in group A and in 923/2,753 patients (33.5%) of group B 
      (P = 0.14). CONCLUSION: Atropine added to exercise stress testing in patients who 
      cannot achieve their 80% age-related HR is a safe, well-tolerated, and feasible 
      method for MPS.
FAU - Sarullo, Filippo Maria
AU  - Sarullo FM
AD  - Division of Cardiology, Buccheri La Ferla Fatebenefratelli Hospital, Via 
      Salvatore Puglisi n.15, 90143 Palermo, Italy. fsarullo@neomedia.it
FAU - Ventimiglia, Corrado
AU  - Ventimiglia C
FAU - Taormina, Andrea
AU  - Taormina A
FAU - Azzarello, Vincenzo
AU  - Azzarello V
FAU - Felice, Filippo
AU  - Felice F
FAU - Martino, Annamaria
AU  - Martino A
FAU - Paterna, Salvatore
AU  - Paterna S
FAU - Di Pasquale, Pietro
AU  - Di Pasquale P
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
DEP - 20061116
PL  - United States
TA  - Int J Cardiovasc Imaging
JT  - The international journal of cardiovascular imaging
JID - 100969716
RN  - 0 (Cholinergic Antagonists)
RN  - 0 (Organophosphorus Compounds)
RN  - 0 (Organotechnetium Compounds)
RN  - 0 (Radiopharmaceuticals)
RN  - 42FOP1YX93 (technetium tc-99m tetrofosmin)
RN  - 7C0697DR9I (Atropine)
SB  - IM
MH  - Arrhythmias, Cardiac/chemically induced
MH  - *Atropine/adverse effects
MH  - Blood Pressure/drug effects
MH  - *Cholinergic Antagonists/adverse effects
MH  - Coronary Circulation/*drug effects
MH  - Exercise Test/*methods
MH  - Feasibility Studies
MH  - Female
MH  - Heart Rate/*drug effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Ischemia/*diagnostic imaging/physiopathology
MH  - Organophosphorus Compounds
MH  - Organotechnetium Compounds
MH  - Radiopharmaceuticals
MH  - Research Design
MH  - Severity of Illness Index
MH  - *Tomography, Emission-Computed, Single-Photon
EDAT- 2006/11/17 09:00
MHDA- 2007/09/22 09:00
CRDT- 2006/11/17 09:00
PHST- 2006/03/03 00:00 [received]
PHST- 2006/09/16 00:00 [accepted]
PHST- 2006/11/17 09:00 [pubmed]
PHST- 2007/09/22 09:00 [medline]
PHST- 2006/11/17 09:00 [entrez]
AID - 10.1007/s10554-006-9169-5 [doi]
PST - ppublish
SO  - Int J Cardiovasc Imaging. 2007 Aug;23(4):511-8. doi: 10.1007/s10554-006-9169-5. 
      Epub 2006 Nov 16.