OBJECTIVES: The goal of this study was to examine the effect of acute beta-blockade on dipyridamoleTc-99m sestamibi myocardial perfusion imaging (DMPI). BACKGROUND: Studies suggest that antianginal drugs may reduce the presence and severity of myocardial perfusion defects with dipyridamole stress. However, there are no data regarding specific drugs. METHODS:Patients with catheterization-proven coronary artery disease (CAD) were enrolled in this prospective, double-blind, placebo-controlled study and randomly assigned to DMPI after placebo, low-dose metoprolol (up to 10 mg), and high-dose metoprolol (up to 20 mg). Patients underwent one Tc-99m sestamibi study at rest on a separate day. The interval between DMPI studies was <or=14 days. Images were interpreted by three observers blinded to clinical data using a 17-segment, five-point model. For each image, a summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) were calculated (SDS = SSS - SRS). Images with an SSS <4 were considered normal. RESULTS: Twenty-one patients completed all four Tc-99m sestamibi studies. The sensitivity of DMPI for detection of CAD was 85.7% with placebo versus 71.4% with low- and high-dose metoprolol. In comparison with placebo, the SSS was significantly lower (p < 0.05) with low- and high-dose metoprolol (12.0 +/- 10.1 vs. 8.7 +/- 9.0 and 9.3 +/- 10.6, respectively). The SDS also was significantly lower (8.4 +/- 8.8 with placebo vs. 5.0 +/- 6.7 [p < 0.001] and 5.4 +/- 7.9 [p < 0.01] with low- and high-dose metoprolol, respectively). CONCLUSIONS: The presence and severity of CAD may be underestimated in patients receiving beta-blocker therapy undergoing dipyridamole stress myocardial perfusion imaging.
RCT Entities:
OBJECTIVES: The goal of this study was to examine the effect of acute beta-blockade on dipyridamole Tc-99m sestamibi myocardial perfusion imaging (DMPI). BACKGROUND: Studies suggest that antianginal drugs may reduce the presence and severity of myocardial perfusion defects with dipyridamole stress. However, there are no data regarding specific drugs. METHODS:Patients with catheterization-proven coronary artery disease (CAD) were enrolled in this prospective, double-blind, placebo-controlled study and randomly assigned to DMPI after placebo, low-dose metoprolol (up to 10 mg), and high-dose metoprolol (up to 20 mg). Patients underwent one Tc-99m sestamibi study at rest on a separate day. The interval between DMPI studies was <or=14 days. Images were interpreted by three observers blinded to clinical data using a 17-segment, five-point model. For each image, a summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) were calculated (SDS = SSS - SRS). Images with an SSS <4 were considered normal. RESULTS: Twenty-one patients completed all four Tc-99m sestamibi studies. The sensitivity of DMPI for detection of CAD was 85.7% with placebo versus 71.4% with low- and high-dose metoprolol. In comparison with placebo, the SSS was significantly lower (p < 0.05) with low- and high-dose metoprolol (12.0 +/- 10.1 vs. 8.7 +/- 9.0 and 9.3 +/- 10.6, respectively). The SDS also was significantly lower (8.4 +/- 8.8 with placebo vs. 5.0 +/- 6.7 [p < 0.001] and 5.4 +/- 7.9 [p < 0.01] with low- and high-dose metoprolol, respectively). CONCLUSIONS: The presence and severity of CAD may be underestimated in patients receiving beta-blocker therapy undergoing dipyridamole stress myocardial perfusion imaging.
Authors: Brian B Ghoshhajra; Ian S Rogers; Pal Maurovich-Horvat; Tust Techasith; Daniel Verdini; Manavjot S Sidhu; Nicola K Drzezga; Hector M Medina; Ron Blankstein; Thomas J Brady; Ricardo C Cury Journal: J Cardiovasc Comput Tomogr Date: 2011-10-31
Authors: E Gordon Depuey; John J Mahmarian; Todd D Miller; Andrew J Einstein; Christopher L Hansen; Thomas A Holly; Edward J Miller; Donna M Polk; L Samuel Wann Journal: J Nucl Cardiol Date: 2012-04 Impact factor: 5.952
Authors: Carolina Valdiviezo; Marietta Ambrose; Vishal Mehra; Albert C Lardo; Joao A C Lima; Richard T George Journal: J Nucl Cardiol Date: 2010-12 Impact factor: 5.952
Authors: Alan W Ahlberg; Sarkis B Baghdasarian; Haris Athar; Jeffrey P Thompsen; Deborah M Katten; Gavin L Noble; Igor Mamkin; Anuj R Shah; Ivette A Leka; Gary V Heller Journal: J Nucl Cardiol Date: 2008 Jan-Feb Impact factor: 5.952
Authors: Mark Doyle; Gerald M Pohost; C Noel Bairey Merz; Leslee J Shaw; George Sopko; William J Rogers; Barry L Sharaf; Carl J Pepine; Diane A Vido-Thompson; Geetha Rayarao; Lindsey Tauxe; Sheryl F Kelsey; Douglas Mc Nair; Robert W Biederman Journal: Cardiovasc Diagn Ther Date: 2013-12
Authors: Vishal C Mehra; Marietta Ambrose; Carolina Valdiviezo-Schlomp; Karl H Schuleri; Albert C Lardo; Joao A C Lima; Richard T George Journal: J Cardiovasc Transl Res Date: 2011-06-14 Impact factor: 4.132