Safety of an IV β-Adrenergic Blockade Protocol for Heart Rate Optimization Before Coronary CT Angiography

Kassamali, Rahil H; Kim, Daniel H.; Patel, Hiten; Raichura, N; Hoey, Edward T.D.; Hodson, James; Hussain, Shahid

doi:10.2214/ajr.13.11492

Cited by 10 publications

(6 citation statements)

References 14 publications

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“…Many centers are reluctant to administer IV medication for HR control during coronary CTA owing to the fear from potential side effects. A recent study by Kassamali et al 19 reported minor complications (transient hypotension) related to IV metoprolol administration only in 1.47% and major complications (not resolving with observation of analgesia) in 0.44% of patients who underwent coronary CTA. These results demonstrate that IV metoprolol is a safe drug to use for this purpose in patients with normal left ventricular function although the study was underpowered to assess for rare major complications.…”

Section: Discussionmentioning

confidence: 97%

Esmolol is noninferior to metoprolol in achieving a target heart rate of 65 beats/min in patients referred to coronary CT angiography: A randomized controlled clinical trial

Maurovich-Horvat

Károlyi

Horváth

et al. 2015

Journal of Cardiovascular Computed Tomography

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Section: Discussionmentioning

confidence: 97%

Esmolol is noninferior to metoprolol in achieving a target heart rate of 65 beats/min in patients referred to coronary CT angiography: A randomized controlled clinical trial

Maurovich-Horvat

Károlyi

Horváth

et al. 2015

Journal of Cardiovascular Computed Tomography

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“…Recent investigations show that the use of intravenous β-adrenergic blockade before coronary CT angiography is a safe prophylactic tool to optimize the heart rate [7,8]. Aggarval et al have presented similar results concluding that betablocker premedication does not increase the frequency of allergic reactions from coronary CT angiography [9].…”

Section: Beneficial Effects Of Beta Blockersmentioning

confidence: 94%

“…On the other hand more recent papers dealing with this topic did not confirm negative influences from the intake of beta blockers [6][7][8][9]. For example, it could be shown that both isoprenaline and salbutamol act as β 2 -adrenoceptors to suppress IgE-mediated mediator release from cultured human mast cells [6].…”

Section: Beneficial Effects Of Beta Blockersmentioning

confidence: 99%

Beta blockers and intravenous roentgen contrast materials: Which risks do exist?

Boehm

Morelli

Nairz

et al. 2016

European Journal of Internal Medicine

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pindolol) are broadly used to treat diseases like hypertension, tachycardia, cardiac arrhythmia, congestive heart failure, essential tremor, migraine prophylaxis, and myocardial infarction for example. Both beta blockers and iodinated radio-contrast media (ICM) are frequently used, so that a relevant proportion of patients undergoing ICM-enhanced computed tomography (CT) or other X-ray related imaging procedures can be estimated to be under treatment with beta blockers. Usually, ICM are well tolerated and safe. However, adverse events (AEs) and hypersensitivity reactions (HSRs) do still occur in a small percentage of patients. Especially, patients at risk will acquire AEs/HSRs. Therefore, the identification of risks is mandatory to efficiently avoid ICM-side effects. While a history of a previous ICM-reaction/-allergy is a well-known risk and a clear indication for a prophylactic task, other risks such as intake of beta-blockers are less clear and therefore, still a matter of debate. Since GPs should be involved in the decision process to safely manage the application of ICM, we summarized the current knowledge concerning beta-blocker medication while undergoing ICM-enhanced radiological imaging procedure.

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“…Although β-blocker may reduce the extent and severity of perfusion abnormalities [ 187 ], one study indicates that diagnostic accuracy of PET perfusion imaging was maintained in patients who received i.v. β-blocker to slow down the heart rate before CCTA [ 188 ]. Proper indications and possible contraindications, such as contrast allergy, should be reviewed separately for PET and CT studies [ 176 ].…”

Section: Perspectives For Pet Mpimentioning

confidence: 99%

EANM procedural guidelines for PET/CT quantitative myocardial perfusion imaging

Sciagrà

Lubberink

Hyafil

et al. 2020

Eur J Nucl Med Mol Imaging

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The use of cardiac PET, and in particular of quantitative myocardial perfusion PET, has been growing during the last years, because scanners are becoming widely available and because several studies have convincingly demonstrated the advantages of this imaging approach. Therefore, there is a need of determining the procedural modalities for performing high-quality studies and obtaining from this demanding technique the most in terms of both measurement reliability and clinical data. Although the field is rapidly evolving, with progresses in hardware and software, and the near perspective of new tracers, the EANM Cardiovascular Committee found it reasonable and useful to expose in an updated text the state of the art of quantitative myocardial perfusion PET, in order to establish an effective use of this modality and to help implementing it on a wider basis. Together with the many steps necessary for the correct execution of quantitative measurements, the importance of a multiparametric approach and of a comprehensive and clinically useful report have been stressed.

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Safety of an IV β-Adrenergic Blockade Protocol for Heart Rate Optimization Before Coronary CT Angiography

Abstract: This study showed that high doses of i.v. metoprolol can be used effectively and with a low rate of major complications to control heart rate before coronary CT angiography in correctly screened patients.

Cited by 10 publications

References 14 publications

Esmolol is noninferior to metoprolol in achieving a target heart rate of 65 beats/min in patients referred to coronary CT angiography: A randomized controlled clinical trial

Esmolol is noninferior to metoprolol in achieving a target heart rate of 65 beats/min in patients referred to coronary CT angiography: A randomized controlled clinical trial

Beta blockers and intravenous roentgen contrast materials: Which risks do exist?

EANM procedural guidelines for PET/CT quantitative myocardial perfusion imaging

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