TY - JOUR
T1 - Safety of single-site adenosine thallium-201 scintigraphy
AU - Korkmaz, Mehmet Emin
AU - Mahmarian, John J.
AU - Guidry, Gerald W.
AU - Verani, Mario S.
N1 - Funding Information:
From the Section of Cardiology, Department of Medicine, Baylor College of Medicine, The Methodist Hospital, Houston, Texas. Computational assistance was provided by the CLINPO Project, funded by Grant RI-00350 from the Division of Research Resources of the National Institutes of Health, Bethesda, Maryland. Manuscript received May 10, 1993; revised manuscript received July 22, 1993, and accepted July 23.
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 1994/1/15
Y1 - 1994/1/15
N2 - The diagnostic accuracy, safety and tolerance of adenosine thallium scintigraphy have been reported using a 2-site intravenous infusion with either a titrated or fixed-dose protocol. A single-site infusion would considerably simplify the test procedure, but its safety must be established before it can be recommended. Accordingly, 400 consecutive patients who had adenosine and thallium-201 administered through the same intravenous line were classified into 2 groups. Group I (n = 201) patients received a 7-minute titrated intravenous infusion of adenosine, with an initial dose of 50 μg/kg/min that increased at 1-minute intervals to a maximum of 140 μg/kg/min. Group II (n = 199) patients received a fixed dose of adenosine at 140 μg/kg/min for 6 minutes. Adenosine significantly (p < 0.001) increased heart rate and decreased systolic blood pressure by similar amounts in both groups. Adverse effects occurred more often (88 vs 71%, p < 0.001) and started earlier (2.8 vs 3.6 minutes, p < 0.001) in group II. There was no significant difference in the occurrence of second- and third-degree atrioventricular block between the 2 groups (4.0 vs 5.0%); however, chest pain, flushing and nausea were all more frequent in group II. Severe side effects were seldom seen in either group and occurred in 9 group I and 8 group II patients. Scintigraphic findings were similar in both groups. Transient perfusion defects were seen more often in patients with than without second- or third-degree atrioventricular block (42 vs 21%, p < 0.05). Despite a high frequency of side effects for both the fixed dose and stepwise infusion regimens, adenosine and thallium administration through a single intravenous site is safe and well-tolerated.
AB - The diagnostic accuracy, safety and tolerance of adenosine thallium scintigraphy have been reported using a 2-site intravenous infusion with either a titrated or fixed-dose protocol. A single-site infusion would considerably simplify the test procedure, but its safety must be established before it can be recommended. Accordingly, 400 consecutive patients who had adenosine and thallium-201 administered through the same intravenous line were classified into 2 groups. Group I (n = 201) patients received a 7-minute titrated intravenous infusion of adenosine, with an initial dose of 50 μg/kg/min that increased at 1-minute intervals to a maximum of 140 μg/kg/min. Group II (n = 199) patients received a fixed dose of adenosine at 140 μg/kg/min for 6 minutes. Adenosine significantly (p < 0.001) increased heart rate and decreased systolic blood pressure by similar amounts in both groups. Adverse effects occurred more often (88 vs 71%, p < 0.001) and started earlier (2.8 vs 3.6 minutes, p < 0.001) in group II. There was no significant difference in the occurrence of second- and third-degree atrioventricular block between the 2 groups (4.0 vs 5.0%); however, chest pain, flushing and nausea were all more frequent in group II. Severe side effects were seldom seen in either group and occurred in 9 group I and 8 group II patients. Scintigraphic findings were similar in both groups. Transient perfusion defects were seen more often in patients with than without second- or third-degree atrioventricular block (42 vs 21%, p < 0.05). Despite a high frequency of side effects for both the fixed dose and stepwise infusion regimens, adenosine and thallium administration through a single intravenous site is safe and well-tolerated.
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U2 - 10.1016/0002-9149(94)90215-1
DO - 10.1016/0002-9149(94)90215-1
M3 - Article
C2 - 8296744
AN - SCOPUS:0027976916
VL - 73
SP - 200
EP - 204
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 2
ER -