Effects of antianginal therapy with a calcium antagonist and nitrates on dobutamine--atropine stress echocardiography: Comparison with exercise electrocardiography

Dodi, Claudio; Pingitore, Alessandro; Sicari, Rosa; Bruno, Gabriele; Cordovil, Adriana

doi:10.1093/oxfordjournals.eurheartj.a015226

Cited by 21 publications

(2 citation statements)

References 19 publications

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“…According to Dodi, 18 other drug classes (calcium antagonists and nitrates) have little influence on the test sensitivity (88% vs. 100%, P = ns). Other study by Sicari, 19 analyzing EPIC/EDIC studies populations, showed that positive test in patients treated with antianginal therapy predicted worse prognosis.…”

Section: Discussionmentioning

confidence: 98%

Diagnostic and Prognostic Value of Rapid Pacing Stress Echocardiography for the Detection of Coronary Artery Disease: Influence of Pacing Mode and Concomitant Antiischemic Therapy (Final Results of Multicenter Study Pol‐RAPSE)

et al. 2008

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Section: Discussionmentioning

confidence: 98%

Diagnostic and Prognostic Value of Rapid Pacing Stress Echocardiography for the Detection of Coronary Artery Disease: Influence of Pacing Mode and Concomitant Antiischemic Therapy (Final Results of Multicenter Study Pol‐RAPSE)

et al. 2008

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“…Non-beta-blocker antianginal therapy reduces the severity of dobutamine-induced ischemia by reducing the value of peak wall motion score index and time of ischemia appearance. However, these changes are not correlated to variations in exercise tolerance [26]. …”

Section: Diagnostic Implications Of the Use Of Anti-ischemic Therapy mentioning

confidence: 99%

Anti-ischemic therapy and stress testing: pathophysiologic, diagnostic and prognostic implications

Sicari

2004

Cardiovasc Ultrasound

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Anti-ischemic therapy, in particular beta-blockers, is the most commonly employed drug for the control of myocardial ischemia in patients with stable coronary artery disease. Its widespread use also in patients with suspected coronary artery disease has important practical, clinical diagnostic and prognostic implications because diagnostic tests are heavily influenced by its effects. In the present review, the pathophysiological mechanisms of ischemia protection by antianginal therapy are described. Not all stressors are created equal in front of the different classes of antianginal drugs and on their turn the different classes of drugs exert different levels of protection on inducible ischemia. Several clinical implications can be drawn: From the diagnostic viewpoint antianginal therapy decreases test sensitivity, offsetting the real ischemic burden for a too high percentage of false negative tests. From the prognostic viewpoint test positivity in medical therapy identifies a group of subjects at higher risk of experiencing cardiac death and positivity on medical therapy can be considered a parameter of ischemia severity. Nonetheless in patients with known coronary artery disease the ability of antianginal therapy to modify the ischemic threshold at stress testing represent a powerful means to assess therapy efficacy. From a practical viewpoint, the use of antianginal therapy at time of testing has advantages and disadvantages which are largely dependent on the purpose a test is performed: if the purpose of testing is to diagnose ischemia, it should be performed in the absence of antianginal medications. If the purpose of testing is to assess the protective effects of antianginal therapy, the test should be performed on medications.

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Use of stress echocardiography for planning and evaluation of interventions and medical treatment

Marwick

2003

Stress Echocardiography

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Effects of antianginal therapy with a calcium antagonist and nitrates on dobutamine--atropine stress echocardiography: Comparison with exercise electrocardiography

Cited by 21 publications

References 19 publications

Diagnostic and Prognostic Value of Rapid Pacing Stress Echocardiography for the Detection of Coronary Artery Disease: Influence of Pacing Mode and Concomitant Antiischemic Therapy (Final Results of Multicenter Study Pol‐RAPSE)

Diagnostic and Prognostic Value of Rapid Pacing Stress Echocardiography for the Detection of Coronary Artery Disease: Influence of Pacing Mode and Concomitant Antiischemic Therapy (Final Results of Multicenter Study Pol‐RAPSE)

Anti-ischemic therapy and stress testing: pathophysiologic, diagnostic and prognostic implications

Use of stress echocardiography for planning and evaluation of interventions and medical treatment

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