title: Atropine augmentation of treadmill exercise stress echocardiography.
abstract: OBJECTIVE
  Performance of exercise stress testing depends on adequate workload and is limited by patients' inability to reach target heart rate due to noncardiac illness or medications such as beta-blockers. This study aimed to assess the utility of atropine administration to augment the chronotropic response of patients undergoing treadmill exercise stress echocardiography.
  
  
  METHODS
  In a retrospective study, we assessed the utility of atropine administration to augment the chronotropic response in 1,396 patients undergoing treadmill exercise stress echocardiography between January 2004 and January 2009, compared with a historical control group with no atropine augmentation.
  
  
  RESULTS
  Atropine was well tolerated. The proportion of abnormal studies differed significantly between patients who underwent exercise with and without atropine augmentation (15% vs. 10%; P < 0.0001). Compared with the historical control group, the proportion of patients who achieved ≥85% of their target heart rates increased from 67% to 78% (P < 0.0001).
  
  
  CONCLUSIONS
  While atropine augmentation is safe and feasible, further studies are required to determine whether it is an equivalent surrogate to achieving target heart rate through exercise alone.
authors.affiliation: Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Cynthia K
authors.initials: CK
authors.lastname: Brenden
authors.forename: Peter M
authors.initials: PM
authors.lastname: Eckman
authors.forename: Lorrie
authors.initials: L
authors.lastname: Bruce-Fane
authors.forename: Darryl
authors.initials: D
authors.lastname: Erlien
authors.forename: Charles A
authors.initials: CA
authors.lastname: Herzog
mesh_terms: D000889:Anti-Arrhythmia Agents; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D001285:Atropine; D004452:Echocardiography / Q000187:drug effects* / Q000706:statistics & numerical data*; D005080:Exercise Test / Q000187:drug effects* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D000889:Anti-Arrhythmia Agents; D001285:Atropine