Safety and predictors of complications with a new accelerated dobutamine stress echocardiography protocol.
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.
San Román
José Alberto
JA
Institute of Heart Sciences (ICICOR), Clinic University Hospital of Valladolid, Valladolid, Spain. asanroman@secardiologia.es
Sanz-Ruiz
Ricardo
R
Ortega
José Ramón
JR
Pérez-Paredes
Matías
M
Rollán
María Jesús
MJ
Muñoz
Ana Cristina
AC
Segura
Federico
F
Jimenez
Diego
D
Carnero
Andres
A
Pinedo
Marta
M
Arnold
Roman
R
Gómez
Itziar
I
Fernández-Aviles
Francisco
F
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
D000318:Adrenergic beta-Agonists; D018727:Muscarinic Antagonists; D004280:Dobutamine; D001285:Atropine