title: Safety and predictors of complications with a new accelerated dobutamine stress echocardiography protocol.
abstract: BACKGROUND
  This study sought to document the safety of a new accelerated dobutamine-atropine stress echocardiography protocol and to analyze its complications.
  
  
  METHODS
  Dobutamine-atropine stress echocardiography studies were performed using an incremental dobutamine infusion protocol from 20 to 40 microg/kg/min in 3-minute stages and followed by atropine.
  
  
  RESULTS
  A total of 962 patients were included. Mean age was 64 +/- 11 years and 584 were male (61%). Mean ejection fraction was 62 +/- 10%. Complications included hypertensive responses in 66 patients (7%), arrhythmias in 26 (2.7%), and symptomatic hypotension in 16 (1.7%). No patient developed heart failure, acute myocardial infarction, ventricular fibrillation, or died. The independent predictors of hypertensive responses were age, baseline systolic blood pressure, and treatment with nitrates. The independent predictors of arrhythmias were history of hypertension, previous coronary artery disease, and baseline heart rate.
  
  
  CONCLUSIONS
  This accelerated dobutamine-atropine stress echocardiography protocol is safe in a low-risk population and has a rate of complications similar to that reported for the standard protocol.
authors.affiliation: Institute of Heart Sciences (ICICOR), Clinic University Hospital of Valladolid, Valladolid, Spain. asanroman@secardiologia.es
authors.forename: José Alberto
authors.initials: JA
authors.lastname: San Román
authors.forename: Ricardo
authors.initials: R
authors.lastname: Sanz-Ruiz
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Ortega
authors.forename: Matías
authors.initials: M
authors.lastname: Pérez-Paredes
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Rollán
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Muñoz
authors.forename: Federico
authors.initials: F
authors.lastname: Segura
authors.forename: Diego
authors.initials: D
authors.lastname: Jimenez
authors.forename: Andres
authors.initials: A
authors.lastname: Carnero
authors.forename: Marta
authors.initials: M
authors.lastname: Pinedo
authors.forename: Roman
authors.initials: R
authors.lastname: Arnold
authors.forename: Itziar
authors.initials: I
authors.lastname: Gómez
authors.forename: Francisco
authors.initials: F
authors.lastname: Fernández-Aviles
mesh_terms: D000318:Adrenergic beta-Agonists / Q000009:adverse effects / Q000494:pharmacology; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000503:physiopathology; D001285:Atropine / Q000009:adverse effects / Q000494:pharmacology; D001794:Blood Pressure; D004280:Dobutamine / Q000009:adverse effects / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D004341:Drug Evaluation; D004452:Echocardiography; D025401:Echocardiography, Stress; D004562:Electrocardiography; D005260:Female; D006261:Headache / Q000139:chemically induced; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D007022:Hypotension / Q000150:complications / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000009:adverse effects / Q000494:pharmacology; D009325:Nausea / Q000139:chemically induced; D011237:Predictive Value of Tests; D018570:Risk Assessment; D017180:Tachycardia, Ventricular / Q000139:chemically induced; D013997:Time Factors; D014202:Tremor / Q000139:chemically induced
chemical_list: D000318:Adrenergic beta-Agonists; D018727:Muscarinic Antagonists; D004280:Dobutamine; D001285:Atropine