Safety of adenosine pharmacologic stress testing in subjects with low systolic arterial pressure

Showkat Haji, A. Movahed

Research output: Contribution to journalArticle

Abstract

Purpose. Adenosine can be used as a pharmacologic stress agent in conjunction with radionuclide myocardial perfusion imaging in the evaluation of coronary artery disease. Adenosine is known to cause a drop in systolic arterial pressure and atrioventricular block. The data regarding the safety of adenosine stress testing in subjects with low systolic arterial pressure are incomplete. We evaluated the safety of adenosine stress testing in subjects with systolic arterial pressure of <100 mm Hg who had no symptoms of low systolic arterial pressure. Results. Thirty-one subjects had a supine systolic arterial pressure of <100 mm Hg at baseline, with no symptoms. The systolic arterial pressure was 95-99 mm Hg in 14 subjects and ≤ 94 mm Hg in 17 (range, 78-94 mm Hg). There was a mean drop in systolic arterial pressure of 5 and 10 mm Hg in the two groups, respectively. The drop was transient, occurred during or immediately after adeno· sine infusion, and was not associated with any specific symptoms. Only one subject in the group with systolic arterial pressure of ≤ 94 mm Hg had symptomatic hypotension (systolic arterial pressure of 76 mm Hg), which began 5 minutes after the start of adenosine infusion and responded to saline infusion; the pressure returned to baseline at 2 minutes post-infusion. Only one subject (7%) in the group with systolic arterial pressure of 95-99 mm Hg had a transient, second degree atrioventricular block, while three subjects (17%) in the group with systolic arterial pressure of ≤ 94 mm Hg developed transient, second or third degree atrioventricular block. No subject required specific treatment or termination of adenosine infusion due to a drop in systolic arterial pressure or second or third degree atrioventricular block. The baseline systolic arterial pressure had no relationship with either its percentage of decrease with adenosine infusion or the results of radionuclide myocardial perfusion imaging. Conclusion. Adenosine pharmacologic stress testing in conjunction with radionuclide myocardial perfusion imaging can be used safely for diagnosis and assessment of coronary artery disease in subjects with asymptomatic low systolic arterial pressure.

Original languageEnglish (US)
Pages (from-to)61-63
Number of pages3
JournalCardiovascular Reviews and Reports
Volume22
Issue number1
StatePublished - Jan 1 2001

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Adenosine
Arterial Pressure
Blood Pressure
Safety
Atrioventricular Block
Myocardial Perfusion Imaging
Radioisotopes
Coronary Artery Disease
Hypotension

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Safety of adenosine pharmacologic stress testing in subjects with low systolic arterial pressure. / Haji, Showkat; Movahed, A.

In: Cardiovascular Reviews and Reports, Vol. 22, No. 1, 01.01.2001, p. 61-63.

Research output: Contribution to journalArticle

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abstract = "Purpose. Adenosine can be used as a pharmacologic stress agent in conjunction with radionuclide myocardial perfusion imaging in the evaluation of coronary artery disease. Adenosine is known to cause a drop in systolic arterial pressure and atrioventricular block. The data regarding the safety of adenosine stress testing in subjects with low systolic arterial pressure are incomplete. We evaluated the safety of adenosine stress testing in subjects with systolic arterial pressure of <100 mm Hg who had no symptoms of low systolic arterial pressure. Results. Thirty-one subjects had a supine systolic arterial pressure of <100 mm Hg at baseline, with no symptoms. The systolic arterial pressure was 95-99 mm Hg in 14 subjects and ≤ 94 mm Hg in 17 (range, 78-94 mm Hg). There was a mean drop in systolic arterial pressure of 5 and 10 mm Hg in the two groups, respectively. The drop was transient, occurred during or immediately after adeno· sine infusion, and was not associated with any specific symptoms. Only one subject in the group with systolic arterial pressure of ≤ 94 mm Hg had symptomatic hypotension (systolic arterial pressure of 76 mm Hg), which began 5 minutes after the start of adenosine infusion and responded to saline infusion; the pressure returned to baseline at 2 minutes post-infusion. Only one subject (7{\%}) in the group with systolic arterial pressure of 95-99 mm Hg had a transient, second degree atrioventricular block, while three subjects (17{\%}) in the group with systolic arterial pressure of ≤ 94 mm Hg developed transient, second or third degree atrioventricular block. No subject required specific treatment or termination of adenosine infusion due to a drop in systolic arterial pressure or second or third degree atrioventricular block. The baseline systolic arterial pressure had no relationship with either its percentage of decrease with adenosine infusion or the results of radionuclide myocardial perfusion imaging. Conclusion. Adenosine pharmacologic stress testing in conjunction with radionuclide myocardial perfusion imaging can be used safely for diagnosis and assessment of coronary artery disease in subjects with asymptomatic low systolic arterial pressure.",
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