title: Safety and efficacy of intravenous esmolol before prospective electrocardiogram-triggered high-pitch spiral acquisition for computed tomography coronary angiography.
abstract: BACKGROUND
  In order to acquire a high quality image with a low radiation dose, prospective electrocardiogram (ECG)-triggered computed tomography coronary angiography (CTCA) requires a stable heart rate (HR) < 65 beats/min. Esmolol has the advantage of reducing HR. The objective of this article is to assess the value of intravenous esmolol treatment before prospective ECG-triggered high-pitch spiral acquisition for CTCA.
  
  
  METHODS
  From March 2013 to June 2013, 313 patients underwent prospective ECG-triggered CTCA. Two hundred and thirty two of them received esmolol before angiography. We retrospectively analyzed clinical characteristics, esmolol dose, radiation exposure dose, and the change in HR and blood pressure in these 232 patients.
  
  
  RESULTS
  A total of 232 patients with a HR > 65 beats/min before CTCA examination received intravenous esmolol treatment (mean dose of 57.26 ± 15.39 mg). The mean initial HR (HR1), slowest HR (HR2), and the HR 30 min after HR2 (HR3) were 75.06 ± 5.59, 60.75 ± 4.00, and 75.54 ± 5.96 beats/min, respectively (HR1 vs. HR2, P < 0.0001; HR1 vs. HR3, P = 0.377). The mean time from esmolol administration to HR2 was 24.25 ± 4.97 s and the mean effective radiation dose was 2.28 ± 0.02 mSv.
  
  
  CONCLUSIONS
  HR could be rapidly controlled at an optimum level with intravenous esmolol before prospective ECG-triggered high-pitch spiral acquisition for CTCA. Consequently, the patients received a very low radiation dose.
authors.affiliation: Department of Cardiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: Jin-Da
authors.initials: JD
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: Hua-Wei
authors.initials: HW
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Xin
authors.affiliation: Department of Cardiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: Zhi-Jun
authors.initials: ZJ
authors.lastname: Sun
authors.affiliation: Department of Cardiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: Hong-Bin
authors.initials: HB
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: Lian
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: Luo-Shan
authors.initials: LS
authors.lastname: Du
authors.affiliation: Department of Cardiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: Yun-Dai
authors.initials: YD
authors.lastname: Chen
keywords: Coronary angiography; Electrocardiogram; Esmolol; Heart rate
references.citation: Br J Radiol. 2012 Aug;85(1016):e424-8
references.pmid: 22815422
references.citation: Circulation. 2001 May 29;103(21):2535-8
references.pmid: 11382719
references.citation: PLoS One. 2013 May 31;8(5):e65025
references.pmid: 23741444
references.citation: Eur Heart J. 2002 Nov;23(21):1714-25
references.pmid: 12398830
references.citation: Radiology. 2008 Mar;246(3):742-53
references.pmid: 18195386
references.citation: JACC Cardiovasc Imaging. 2012 May;5(5):484-93
references.pmid: 22595156
references.citation: Ann Pharmacother. 1994 Jun;28(6):701-3
references.pmid: 7919552
references.citation: J Clin Pharmacol. 1986 Mar;26(S1):A3-A14
references.pmid: 2870084
references.citation: Eur J Radiol. 2012 Feb;81(2):e94-100
references.pmid: 21316887
references.citation: JAMA. 2009 Feb 4;301(5):500-7
references.pmid: 19190314
references.citation: BMC Cardiovasc Disord. 2011 Jun 16;11:32
references.pmid: 21679468
references.citation: Radiology. 2008 Aug;248(2):431-7
references.pmid: 18552312
references.citation: Eur J Radiol. 2008 Apr;66(1):37-41
references.pmid: 17587526
references.citation: J Clin Pharmacol. 1986 Mar;26(3):169-74
references.pmid: 2870080
references.citation: Radiology. 2002 Apr;223(1):212-20
references.pmid: 11930069
references.citation: Circulation. 2010 Jun 8;121(22):2509-43
references.pmid: 20479158
references.citation: Med Phys. 2006 Nov;33(11):4236-48
references.pmid: 17153402
references.citation: Radiology. 2008 Oct;249(1):71-80
references.pmid: 18796669