title: The effect of beta blocker withdrawal on adenosine myocardial perfusion imaging.
abstract: BACKGROUND
  The effect of beta blockers on myocardial blood flow (MBF) under vasodilators has been studied in several SPECT and PET myocardial perfusion imaging (MPI) studies with divergent results. The present study evaluated the effect of a beta blocker withdrawal on quantitative adenosine MBF and on MPI results.
  
  
  METHODS
  Twenty patients with beta blockers and CAD history were studied with quantitative adenosine N-13 ammonia PET. The first study was performed under complete medication and the second after beta blocker withdrawal. The PET studies were independently read with respect to MPI result and clinical decision making.
  
  
  RESULTS
  Global MBF showed an increase from 180.2 ± 59.9 to 193.6 ± 60.8 mL·minute(-1)/100 g (P = .02) after beta blocker withdrawal. The segmental perfusion values were closely correlated (R(2) = 0.82) over the entire range of perfusion values. An essentially different interpretation after beta blocker discontinuation was found in two cases (10%).
  
  
  CONCLUSIONS
  A beta blocker withdrawal induces an increase in adenosine MBF. In the majority of cases, MPI interpretation and decision making are independent of beta blocker intake. If a temporary beta blocker withdrawal before MPI is not possible or was not realized by the patient, it is appropriate to perform adenosine stress testing without loss of the essential MPI result.
authors.affiliation: Diabetes Center, Heart and Diabetes Center North Rhine-Westphalia, University Hospital of the Ruhr-University Bochum, Bad Oeynhausen, Germany, choffmeister@hdz-nrw.de.
authors.forename: C
authors.initials: C
authors.lastname: Hoffmeister
authors.forename: R
authors.initials: R
authors.lastname: Preuss
authors.forename: R
authors.initials: R
authors.lastname: Weise
authors.forename: W
authors.initials: W
authors.lastname: Burchert
authors.forename: O
authors.initials: O
authors.lastname: Lindner
mesh_terms: D000241:Adenosine / Q000008:administration & dosage; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage* / Q000627:therapeutic use; D000368:Aged; D016477:Artifacts; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D004347:Drug Interactions; D005080:Exercise Test / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D000319:Adrenergic beta-Antagonists; D014665:Vasodilator Agents; D000241:Adenosine