[Value of metoprolol injection at dobutamine-atropine stress echocardiography for detection of coronary artery disease].
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.
Yao
Jing
J
Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Lu
Feng-xiang
FX
Xu
Di
D
Zhou
Lei
L
Yong
Yong-hong
YH
Xu
Jing
J
Tang
Xiao-xia
XX
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
D008790:Metoprolol