Pharmacological applications in stress testing

G. Currie, H. Kiat

    Research output: Contribution to journalMeeting abstract

    3 Citations (Scopus)

    Abstract

    Introduction: While exercise remains the preferred method of cardiac stress
    testing, pharmacological stress plays an important role in nuclear cardiology.
    The globally aging population will see an expansion of the application of
    pharmacological stress testing and with that, comes the need to understand
    the pharmacologic basis, mechanisms of action, potential interactions and
    adverse effects to inform use in less than ideal circumstances. This paper aims
    to enhance the decision-making process in day-to-day clinical nuclear cardiology practice informed by the hospital or community pharmacist as a
    partnership through a better understanding of nuances relevant to the pharmacological agents employed for cardiac stress testing.

    Methods: Pharmacology, nuclear medicine and cardiology reference texts,
    and peer reviewed medical journal manuscripts indexed on Medline were
    included based on currency, accuracy and appropriateness.

    Results: Stress methods are not interchangeable without careful consider-
    ation. Coronary artery disease (CAD) is best detected using vasodilator stress
    while haemodynamic significance is best assessed using dobutamine or exercise. Caffeine consumption, the use of beta blockers and the role of aminophylline require careful consideration in selecting the approach to stress
    testing.

    Conclusion: CAD is best detected using vasodilator stress. Adenosine pro-
    vides superiority over dipyridamole while regadenoson does not appear to
    extend theoretical benefi ts into tangible clinical benefi ts. Haemodynamic
    signifi cance is best assessed using dobutamine or exercise. Caffeine ingestion
    may not necessitate cancellation or rescheduling of the procedure if an
    understanding of pharmacology can be employed to adopt an intuitive
    approach to case based decision making.
    Original languageEnglish
    Article numberP12
    Pages (from-to)21-21
    Number of pages1
    JournalInternal Medicine Journal
    Volume42
    Issue numberSupplement 3
    Publication statusPublished - Sep 2012

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