Korean J Med.
2000 Jan;58(1):39-47.
Safety and efficacy of arbutamine stress echocardiography
- Affiliations
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- 1Division of Cardiology, Department of internal medicine, Biochemistry, School of Medicine, Keimyung University, Taegu, Korea.
Abstract
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BACKGROUND: Exercise and pharmacologic stress echocardiography are
widely used for detecting coronary artery disease. Arbutamine is a new synthetic
mild alpha1-receptor and - receptor agonist developed specifically for stress
echocardiography. Arbutamine is superior to dobutamine owing to its enforced
chronotropic action than that of dobutamine. We intended to know safety and efficacy of
arbutamine stress echocardiography in inducing myocardial ischemia and detecting
coronary artery disease.
METHODS
We underwent arbutamine stress echocardiography on 52 patients, dobutamine
stress echocardiography in 35 patients. Alteration of blood pressure, heart rate,
regional wall motion on echocardiography were evaluated. Sensitivity and specificity were
determined by coronary angiography for 61 patients(Arbutamine: 31, Dobutamine : 30)
RESULTS
1) Hemodynamic alterations respect to stress agents
Baseline Maximal Baseline Maximal Interval for
Blood pressure Blood pressure Heartrate Heart rate maximal heartrate
Arbutamine 122/70mmHg 138/72mmHg 69BPM 137BPM 8.2 min*
Dobutamine 126/73mmHg 136/77mmHg 74BPM 102BPM 11.4 min*
(* p < 0.05)
2) Comparison of Arbutamine and Dobutamine in sensitivity
Sensitivity(Specificity) Side effects Atropine
Arbutamine 80.1% (90%) 33(63.5%) 8(15.4%)
Dobutamine 78.2% (71.4%) 21(60%) 7(20%)
3) Side effects of stress agents
Hypotension Palpitation, tremor Arrhythmia Chest pain
Arbutamine 15(28.8%)* 4(7.7%)* 21(40.4%) 8(9.2%)
Dobutamine 3(8.6%)* 9(25.7%)* 12(34.3%) 5(5.7%)
(* p < 0.05)
4) Premature ventricular contraction was most common arrhythmia in both group. There was no fatal or significant complication,
and most complications were subsided after discontinuation of stress agents.
CONCLUSION
Arbutamine is an effective and safe pharmacologic stress agent in
detecting myocardial ischemia and superior to dobutamine in increasing heart rate.
Sensitivity and specificity of arbutamine were higher than that of dobutamine.