CLINICAL STUDY: CORONARY PHYSIOLOGY
Comparison of myocardial blood flow during dobutamine-atropine infusion with that after dipyridamole administration in normal men
Eiji Tadamura, MD, PhD*,
Hidehiro Iida, PhD ,
Keiichi Matsumoto, RT*,
Marcelo Mamede, MD*,
Shigeto Kubo, MD*,
Hiroshi Toyoda, MD*,
Toshiki Shiozaki, MD*,
Takahiro Mukai, PhD*,
Yasuhiro Magata, PhD* and
Junji Konishi, MD, PhD*
* Department of Nuclear Medicine and Diagnostic Imaging, Kyoto University Graduate School of Medicine, Kyoto, Japan
Department of Radiology, National Cardiovascular Center, Suita, Japan
Manuscript received April 10, 2000;
revised manuscript received July 11, 2000,
accepted September 7, 2000.
Reprint requests and correspondence: Dr. Eiji Tadamura, Department of Nuclear Medicine and Diagnostic Imaging, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara, Sakyo-ku, Kyoto, 606-8507, Japan
et{at}kuhp.kyoto-u.ac.jp
OBJECTIVES
The present study was designed to compare the absolute myocardial blood flow (MBF) after intravenous dipyridamole infusion with that during dobutamine-atropine administration in normal healthy male volunteers.
BACKGROUND
Both safety and usefulness of dobutamine-atropine stress in myocardial perfusion imaging have been reported. However, no information exists on whether the magnitude of hyperemia achieved with dipyridamole and dobutamine-atropine is comparable.
METHODS
Myocardial blood flow was measured with positron emission tomography and 15O-labeled water in 20 healthy young men (23 ± 3 years) 1) at baseline, 2) after dipyridamole infusion (0.56 mg/kg over 4 min), and 3) during dobutamine (40 µg/kg/min) and atropine (0.25 to 1.0 mg) infusion.
RESULTS
The MBF was significantly increased during dipyridamole infusion and during dobutamine–atropine stress compared with at rest (4.33 ± 1.23 and 5.89 ± 1.58 vs. 0.67 ± 0.16 ml/min/g, respectively, p < 0.0001). Moreover, dobutamine-atropine infusion produced greater MBF compared with dipyridamole (p = 0.0011), while coronary vascular resistance did not differ significantly after dipyridamole administration and during dobutamine-atropine infusion (17.6 ± 7.9 vs. 18.6 ± 5.6 mm Hg/[ml/min/g], respectively).
CONCLUSIONS
Near maximal coronary vasodilatation caused by dipyridamole is attainable using dobutamine and atropine in young healthy volunteers. Dobutamine in conjunction with atropine is no less effective than dipyridamole in producing myocardial hyperemia.
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Abbreviations and Acronyms
| | BP | = blood pressure | | CAD | = coronary artery disease | | CVR | = coronary vascular resistance | | ECG | = electrocardiogram | | IV | = intravenous | | MBF | = myocardial blood flow | | PET | = positron emission tomography | | ROI | = region of interest |
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