Display options
Share it on

World J Cardiol. 2010 Dec 26;2(12):437-42. doi: 10.4330/wjc.v2.i12.437.

Ergonovine stress echocardiography: Recent experience and safety in our centre.

World journal of cardiology

Alejandro Cortell, Pedro Marcos-Alberca, Carlos Almería, José L Rodrigo, Leopoldo Pérez-Isla, Carlos Macaya, José Luis Zamorano

Affiliations

  1. Alejandro Cortell, Pedro Marcos-Alberca, Carlos Almería, José L Rodrigo, Leopoldo Pérez-Isla, Carlos Macaya, José Luis Zamorano, University Clinic San Carlos, Cardiovascular Institute, Profesor Martín Lagos Street, Madrid 28040, Madrid comunity, Spain.

PMID: 21191545 PMCID: PMC3011139 DOI: 10.4330/wjc.v2.i12.437

Abstract

AIM: To study recent experience and safety of ergonovine stress echocardiography in our centre.

METHODS: In this study we collected the clinical variables of patients referred since 2002 for ergonovine stress echocardiography, in addition to indications, the results of this test, complications, blood pressure and heart rate values during the test and the number and results of tests requested before this technique.

RESULTS: We performed 40 tests in 38 patients, 2 tests were carried out to verify therapy efficacy. The prevalence of classic cardiovascular risk factors was low and the most frequent indication was chest pain (57.5%). Coronary angiography was performed in 32 patients, and showed normal coronary arteries in 27 patients and non-significant stenosis in 5 cases. In 16 patients, coronary angiography was carried out after a positive or inconclusive ischemia test. Another 6 patients had a normal stress test (5 exercise electrocardiography tests and 1 nuclear imaging test). Of the 40 ergonovine stress echocardiography tests, 6 were positive (4 in the right coronary artery territory and 2 in the circumflex coronary artery territory), all of them by echocardiographic criteria, and by electrocardiographic criteria in only 3 (50%). The presence of non-significant coronary artery stenosis was more frequent in patients with positive ergonovine stress echocardiography (50% vs 6%, P = 0.038), and were related to ischemic territory. During the maximum stress stage, there was a higher systolic (130.26 ± 19.17 mmHg vs 136.58 ± 27.27 mmHg, 95% CI: -12.77 to 0.14 mmHg, P = 0.055) and diastolic blood pressure (77.89 ± 13.49 mmHg vs 83.95 ± 15.73 mmHg, 95% CI: -10.41 to -1.69 mmHg, P = 0.008) than at the baseline stage, and the same was registered with heart rate (73 ± 10.96 beats/min vs 79.79 ± 11.72 beats/min, 95% CI: -9.46 to -4.11 beats/min, P < 0.01). Nevertheless, there were only 2 hypertensive reactions during the last stage, which did not force a premature end to the test, without sustained tachy or bradyarrhythmias, and the technique was well tolerated in 58% of cases. A unique complication (2.5%) of this test was a prolonged vasospasm with a slight increase in necrosis biomarkers, however, this was without repercussion.

CONCLUSION: Ergonovine stress echocardiography can be performed with safety, is well tolerated in the majority of cases, and is useful for determining the ischemia mechanism in selected cases.

Keywords: Coronary angiography; Ergonovine; Myocardial ischaemia; Stress echocardiography; Vasospasm

References

  1. Am J Cardiol. 2009 Aug 15;104(4):498-500 - PubMed
  2. Int J Cardiol. 2009 May 1;134(1):91-6 - PubMed
  3. Heart. 2009 Oct;95(20):1669-75 - PubMed
  4. Am J Cardiol. 2010 Apr 15;105(8):1198-9 - PubMed
  5. Circ J. 2005 Jan;69(1):39-43 - PubMed
  6. Cardiovasc Clin. 1985;15(1):83-96 - PubMed
  7. J Am Coll Cardiol. 1996 Apr;27(5):1162-3 - PubMed
  8. Coron Artery Dis. 2001 Dec;12(8):649-54 - PubMed
  9. Cardiologia. 1999 Oct;44(10):901-6 - PubMed
  10. Am J Cardiol. 1982 Mar;49(4):658-64 - PubMed
  11. Am Heart J. 1993 Dec;126(6):1305-11 - PubMed
  12. J Am Soc Echocardiogr. 1994 Nov-Dec;7(6):607-15 - PubMed
  13. J Am Coll Cardiol. 1996 Apr;27(5):1156-61 - PubMed
  14. Circ Cardiovasc Imaging. 2009 Jan;2(1):16-23 - PubMed
  15. J Am Coll Cardiol. 1999 May;33(6):1442-52 - PubMed
  16. Rev Esp Cardiol. 2002 Jul;55(7):775-7 - PubMed
  17. Am Heart J. 1984 Sep;108(3 Pt 1):440-6 - PubMed
  18. Circulation. 2000 Mar 14;101(10):1102-8 - PubMed
  19. Am Heart J. 1985 Jan;109(1):78-83 - PubMed
  20. J Am Soc Echocardiogr. 2002 Nov;15(11):1346-52 - PubMed
  21. J Am Coll Cardiol. 2000 Jun;35(7):1850-6 - PubMed
  22. Am J Cardiol. 1998 Dec 15;82(12):1475-8 - PubMed
  23. World J Cardiol. 2010 Feb 26;2(2):34-42 - PubMed
  24. Am J Cardiol. 1999 Feb 15;83(4):641 - PubMed
  25. Am J Cardiol. 1999 Aug 15;84(4):497-8 - PubMed
  26. Am J Cardiol. 2007 Jan 15;99(2):182-5 - PubMed
  27. Circulation. 1982 Jun;65(7):1299-306 - PubMed
  28. N Engl J Med. 1978 Dec 7;299(23):1271-7 - PubMed

Publication Types