Atropine as an adjunct to supine bicycle stress echocardiography: an alternative strategy to achieve target heart rate or rate pressure product

Nalawadi, Smruti; Tolstrup, Kirsten; Cuk, Olivera; Shiota, Takahiro; Gurudevan, Swaminatha V.; Siegel, Robert J.

doi:10.1093/ejechocard/jer268

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…47,68 Additionally, elevated proinflammatory cytokine levels have been correlated with greater pain sensitivity, 31,48,65,74 perceived stress, 37 and depressed mood, 38 which are phenotypes characteristic of TMD and related pain conditions. Abnormalities in levels of proinflammatory cytokines are often accompanied by alterations in levels of anti-inflammatory cytokines (eg, IL-1 receptor antagonist [IL-1ra]), 2,32,46,68,75 associated with reductions in pain and inflammation. 32,49,84 …”

Section: Methodsmentioning

confidence: 99%

Multisystem Dysregulation in Painful Temporomandibular Disorders

Chen

Nackley

Miller

et al. 2013

The Journal of Pain

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Multiple physiological and psychological regulatory domains may contribute to the pathophysiology of pain in temporomandibular disorder (TMD) and other bodily pain conditions. The purpose of this study was to evaluate the relationship between multisystem dysregulation and the presence of TMD pain, as well as the presence of different numbers of comorbid pain conditions in TMD. Secondary data analysis was conducted in 131 non-TMD (without comorbid pain) controls, 14 TMD subjects without comorbid pain, 78 TMD subjects with 1 comorbid pain, and 67 TMD subjects with multiple comorbid pain conditions who participated in a TMD genetic study. Twenty markers from sensory, autonomic, inflammatory, and psychological domains were evaluated. The results revealed that 1) overall dysregulation in multiple system domains (OR [odds ratio] = 1.6, 95% confidence interval [CI] = 1.4–1.8), particularly in the sensory (OR = 1.9, 95% CI = 1.3–2.9) and the psychological (OR = 2.1, 95% CI = 2.1–2.7) domains, were associated with increased likelihood of being a painful TMD case; and 2) dysregulations in individual system domains were selectively associated with the increased odds of being a TMD case with different levels of comorbid persistent pain conditions. These outcomes indicate that heterogeneous multisystem dysregulations may exist in painful TMD subgroups, and multidimensional physiological and psychological assessments can provide important information regarding pathophysiology, diagnosis, and management of pain in TMD patients. Perspective The concurrent assessment of multiple physiological and psychological systems is critical to our understanding of the pathophysiological processes that contribute to painful TMD and associated comorbid conditions, which will ultimately guide and inform appropriate treatment strategies that address the multisystem dysregulation associated with complex and common persistent pain conditions.

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Section: Methodsmentioning

confidence: 99%

Multisystem Dysregulation in Painful Temporomandibular Disorders

Chen

Nackley

Miller

et al. 2013

The Journal of Pain

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“…The major consideration is to ensure that the patient achieves their maximum workload, since this is an important discriminator of outcome irrespective of protocol (31). Protocols should therefore be tailored to the physical capability of the patient and supplemented with hand-grip exercise or atropine to optimise heart rate response (32).…”

Section: Techniquementioning

confidence: 99%

Stress echocardiography in coronary artery disease: a practical guideline from the British Society of Echocardiography

et al. 2019

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Stress echocardiography is an established technique for assessing coronary artery disease. It has primarily been used for the diagnosis and assessment of patients presenting with chest pain in whom there is an intermediate probability of coronary artery disease. In addition, it is used for risk stratification and to guide revascularisation in patients with known ischaemic heart disease. Although cardiac computed tomography has recently been recommended in the United Kingdom as the first-line investigation in patients presenting for the first time with atypical or typical angina, stress echocardiography continues to have an important role in the assessment of patients with lesions of uncertain functional significance and patients with known ischaemic heart disease who represent with chest pain. In this guideline from the British Society of Echocardiography, the indications and recommended protocols are outlined for the assessment of ischaemic heart disease by stress echocardiography.

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