title: A comparison of bolus injection of landiolol versus oral administration of propranolol before cardiac computed tomography.
abstract: Heart rate (HR) reduction is essential to achieve good image quality for cardiac computed tomography (CCT). We evaluated the efficacy of a bolus injection of landiolol, an ultra-short acting β-blocker, without the administration of oral β-blocker to reduce HR prior to CCT. We enrolled 678 consecutive patients who underwent CCT from December 2011 to March 2012 and divided them into three groups, which were a propranolol group (n = 277), a low-dose landiolol group (n = 188), and a high-dose landiolol group (n = 213). Patients in the propranolol group received oral propranolol (10-20 mg) prior to CCT. Patients in the low-dose and high-dose landiolol groups were administered a bolus injection of landiolol (0.125 mg/kg), while the high-dose group received an additional 3.75 mg of landiolol if the baseline HR was ≥75/min. Although the average HR was significantly lower in the propranolol group (61.6 ± 8.0/min) than in the low-dose landiolol group (64.1 ± 7.4/min, P < 0.001), there was no significant difference in the image quality (P = 0.91). Among patients with baseline HR ≥75/min, the average HR tended to be lower in the high-dose landiolol group (67.2 ± 6.9/min) compared with the low-dose landiolol group (69.0 ± 6.9/min, P = 0.10), and there was a corresponding difference in image quality between these two groups (P = 0.02). In conclusion, Although the decrease of HR was significantly larger in the propranolol group than in the landiolol groups, the image quality was similar. Among the patients who received landiolol, a higher dose was associated with a lower HR and better image quality. Further investigation to assess higher-dose bolus injection of landiolol or bolus injection following oral administration of a β-blocker would be needed.
authors.affiliation: Division of Radiological Technology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Division of Cardiology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Japan.
authors.forename: Kyohei
authors.initials: K
authors.lastname: Yamaji
authors.affiliation: Division of Radiological Technology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Japan.
authors.forename: Tatsunori
authors.initials: T
authors.lastname: Saho
authors.affiliation: Division of Radiological Technology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Japan.
authors.forename: Zyousin
authors.initials: Z
authors.lastname: Matsuzaki
authors.affiliation: Division of Radiological Technology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Japan.
authors.forename: Itsuo
authors.initials: I
authors.lastname: Yuda
authors.affiliation: Division of Cardiology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Japan.
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Soga
authors.affiliation: Division of Cardiology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Shirai
authors.affiliation: Division of Cardiology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ando
authors.affiliation: Division of Cardiology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Japan.
authors.forename: Masakiyo
authors.initials: M
authors.lastname: Nobuyoshi
keywords: Cardiac computed tomography; Coronary artery disease; Image quality; Landiolol; Propranolol