title: [Value of metoprolol injection at dobutamine-atropine stress echocardiography for detection of coronary artery disease].
abstract: OBJECTIVE
  To investigate the value of metoprolol injection at dobutamine-atropine stress echocardiography (DASE) for detection of coronary artery disease (CAD).
  
  
  METHODS
  DASE was performed in 72 patients with suspected CAD. All the patients received rapid metoprolol injection immediately after getting peak heart rate at DASE (DASE-Meto) and were subjected to coronary angiography (CAG) within two weeks. Regional wall motion and haemodynamic parameters at peak heart rate during DASE and after metoprolol injection were analyzed, and DASE and DASE-Meto results were compared with CAG.
  
  
  RESULTS
  There were 35 patients with CAG positive and 37 negative. The sensitivity, specificity, accuracy and positive and negative predictive values of DASE for detecting CAD were 65.7%, 86.5%, 76.4%, 82.1% and 84.6%, respectively. There were 10 patients with positive result at CAG undetected by DASE but observed regional wall motion abnormality (RWMA) after metoprolol injection. So the sensitivity, specificity, accuracy and positive and negative predictive values of DASE-Meto for detecting CAD were 94.3%, 83.8%, 88.9%, 72.7%, 93.9%, respectively. After metoprolol injection, the symptoms caused by the medicine used in detection were alleviated soon and recovery time was shortened.
  
  
  CONCLUSIONS
  The use of metoprolol at DASE can improve the accuracy and security of CAD detection.
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Yao
authors.forename: Feng-xiang
authors.initials: FX
authors.lastname: Lu
authors.forename: Di
authors.initials: D
authors.lastname: Xu
authors.forename: Lei
authors.initials: L
authors.lastname: Zhou
authors.forename: Yong-hong
authors.initials: YH
authors.lastname: Yong
authors.forename: Jing
authors.initials: J
authors.lastname: Xu
authors.forename: Xiao-xia
authors.initials: XX
authors.lastname: Tang
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D025401:Echocardiography, Stress / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008790:Metoprolol; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D008790:Metoprolol