Safety of ergotamine-ergic pharmacologic stress echocardiography for vasospasm testing in the echo lab: 14 year experience on 478 tests in 464 patients.

A. Djordjevic-Dikic, A. Varga, O. Rodriguez, M. Morelos, R. Sicari, B. Del Negro, M. A. Morales, C. Carpeggiani, E. Picano

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: The safety of ergonovine/ergometrine stress testing for coronary vasospasm when performed outside the cath lab has vigorously been questioned. The aim of this study was to assess the value of ergonovine/ergometrine stress testing performed in the echo lab. METHODS: We retrospectively reviewed the data prospectively collected in the echo lab of the Institute of Clinical Physiology of Pisa (Italy) from January 1, 1985, to October 1, 1998, on 478 tests performed on 464 patients with either ergonovine or ergometrine stress echo testing. By selection, all patients had history of chest pain, consistent with vasospastic angina, negative or ambiguous exercise stress testing, and normal or near normal resting left ventricular function. Ergonovine or ergometrine maleate was injected up to a total cumulative dosage of 0.35 mg, under continuous 12 lead ECG and two-dimensional echo monitoring. RESULTS: There were no death, myocardial infarction, ventricular fibrillation or III degree atrioventricular block. One patient had non-sustained ventricular tachycardia associated with transient ST segment elevation 30 min after the test. Two patients had II degree atrioventricular block, associated with positive echocardiography test and promptly reversed by nitrate administration. Transient regional myocardial dysfunction occurred in 74 patients (15%). Limiting ischemia-independent side effects were present in 13 patients (3%): hypotension in 1, arterial hypertension in 5, nonsustained ventricular tachycardia in 2, and nausea/vomiting in 5. The overall feasibility was 97%. CONCLUSIONS: Pharmacological stress echocardiography with either ergonovine or ergometrine is highly feasible and can be safely performed in the echo lab in properly selected patients in whom coronary vasospasm is suspected. It is often the only way to document coronary vasospasm otherwise missed by conventional noninvasive stress test and even by coronary angiography.

Original languageEnglish
Pages (from-to)901-906
Number of pages6
JournalCardiologia
Volume44
Issue number10
Publication statusPublished - Oct 1999

Fingerprint

Ergonovine
Ergotamine
Stress Echocardiography
Safety
Coronary Vasospasm
Atrioventricular Block
Ventricular Tachycardia
Ventricular Fibrillation
Coronary Angiography
Chest Pain
Exercise Test
Left Ventricular Function
Nitrates
Hypotension
Nausea
Italy
Vomiting
Echocardiography
Electrocardiography
Ischemia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Djordjevic-Dikic, A., Varga, A., Rodriguez, O., Morelos, M., Sicari, R., Del Negro, B., ... Picano, E. (1999). Safety of ergotamine-ergic pharmacologic stress echocardiography for vasospasm testing in the echo lab: 14 year experience on 478 tests in 464 patients. Cardiologia, 44(10), 901-906.

Safety of ergotamine-ergic pharmacologic stress echocardiography for vasospasm testing in the echo lab : 14 year experience on 478 tests in 464 patients. / Djordjevic-Dikic, A.; Varga, A.; Rodriguez, O.; Morelos, M.; Sicari, R.; Del Negro, B.; Morales, M. A.; Carpeggiani, C.; Picano, E.

In: Cardiologia, Vol. 44, No. 10, 10.1999, p. 901-906.

Research output: Contribution to journalArticle

Djordjevic-Dikic, A, Varga, A, Rodriguez, O, Morelos, M, Sicari, R, Del Negro, B, Morales, MA, Carpeggiani, C & Picano, E 1999, 'Safety of ergotamine-ergic pharmacologic stress echocardiography for vasospasm testing in the echo lab: 14 year experience on 478 tests in 464 patients.', Cardiologia, vol. 44, no. 10, pp. 901-906.
Djordjevic-Dikic, A. ; Varga, A. ; Rodriguez, O. ; Morelos, M. ; Sicari, R. ; Del Negro, B. ; Morales, M. A. ; Carpeggiani, C. ; Picano, E. / Safety of ergotamine-ergic pharmacologic stress echocardiography for vasospasm testing in the echo lab : 14 year experience on 478 tests in 464 patients. In: Cardiologia. 1999 ; Vol. 44, No. 10. pp. 901-906.
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abstract = "BACKGROUND: The safety of ergonovine/ergometrine stress testing for coronary vasospasm when performed outside the cath lab has vigorously been questioned. The aim of this study was to assess the value of ergonovine/ergometrine stress testing performed in the echo lab. METHODS: We retrospectively reviewed the data prospectively collected in the echo lab of the Institute of Clinical Physiology of Pisa (Italy) from January 1, 1985, to October 1, 1998, on 478 tests performed on 464 patients with either ergonovine or ergometrine stress echo testing. By selection, all patients had history of chest pain, consistent with vasospastic angina, negative or ambiguous exercise stress testing, and normal or near normal resting left ventricular function. Ergonovine or ergometrine maleate was injected up to a total cumulative dosage of 0.35 mg, under continuous 12 lead ECG and two-dimensional echo monitoring. RESULTS: There were no death, myocardial infarction, ventricular fibrillation or III degree atrioventricular block. One patient had non-sustained ventricular tachycardia associated with transient ST segment elevation 30 min after the test. Two patients had II degree atrioventricular block, associated with positive echocardiography test and promptly reversed by nitrate administration. Transient regional myocardial dysfunction occurred in 74 patients (15{\%}). Limiting ischemia-independent side effects were present in 13 patients (3{\%}): hypotension in 1, arterial hypertension in 5, nonsustained ventricular tachycardia in 2, and nausea/vomiting in 5. The overall feasibility was 97{\%}. CONCLUSIONS: Pharmacological stress echocardiography with either ergonovine or ergometrine is highly feasible and can be safely performed in the echo lab in properly selected patients in whom coronary vasospasm is suspected. It is often the only way to document coronary vasospasm otherwise missed by conventional noninvasive stress test and even by coronary angiography.",
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AU - Rodriguez, O.

AU - Morelos, M.

AU - Sicari, R.

AU - Del Negro, B.

AU - Morales, M. A.

AU - Carpeggiani, C.

AU - Picano, E.

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N2 - BACKGROUND: The safety of ergonovine/ergometrine stress testing for coronary vasospasm when performed outside the cath lab has vigorously been questioned. The aim of this study was to assess the value of ergonovine/ergometrine stress testing performed in the echo lab. METHODS: We retrospectively reviewed the data prospectively collected in the echo lab of the Institute of Clinical Physiology of Pisa (Italy) from January 1, 1985, to October 1, 1998, on 478 tests performed on 464 patients with either ergonovine or ergometrine stress echo testing. By selection, all patients had history of chest pain, consistent with vasospastic angina, negative or ambiguous exercise stress testing, and normal or near normal resting left ventricular function. Ergonovine or ergometrine maleate was injected up to a total cumulative dosage of 0.35 mg, under continuous 12 lead ECG and two-dimensional echo monitoring. RESULTS: There were no death, myocardial infarction, ventricular fibrillation or III degree atrioventricular block. One patient had non-sustained ventricular tachycardia associated with transient ST segment elevation 30 min after the test. Two patients had II degree atrioventricular block, associated with positive echocardiography test and promptly reversed by nitrate administration. Transient regional myocardial dysfunction occurred in 74 patients (15%). Limiting ischemia-independent side effects were present in 13 patients (3%): hypotension in 1, arterial hypertension in 5, nonsustained ventricular tachycardia in 2, and nausea/vomiting in 5. The overall feasibility was 97%. CONCLUSIONS: Pharmacological stress echocardiography with either ergonovine or ergometrine is highly feasible and can be safely performed in the echo lab in properly selected patients in whom coronary vasospasm is suspected. It is often the only way to document coronary vasospasm otherwise missed by conventional noninvasive stress test and even by coronary angiography.

AB - BACKGROUND: The safety of ergonovine/ergometrine stress testing for coronary vasospasm when performed outside the cath lab has vigorously been questioned. The aim of this study was to assess the value of ergonovine/ergometrine stress testing performed in the echo lab. METHODS: We retrospectively reviewed the data prospectively collected in the echo lab of the Institute of Clinical Physiology of Pisa (Italy) from January 1, 1985, to October 1, 1998, on 478 tests performed on 464 patients with either ergonovine or ergometrine stress echo testing. By selection, all patients had history of chest pain, consistent with vasospastic angina, negative or ambiguous exercise stress testing, and normal or near normal resting left ventricular function. Ergonovine or ergometrine maleate was injected up to a total cumulative dosage of 0.35 mg, under continuous 12 lead ECG and two-dimensional echo monitoring. RESULTS: There were no death, myocardial infarction, ventricular fibrillation or III degree atrioventricular block. One patient had non-sustained ventricular tachycardia associated with transient ST segment elevation 30 min after the test. Two patients had II degree atrioventricular block, associated with positive echocardiography test and promptly reversed by nitrate administration. Transient regional myocardial dysfunction occurred in 74 patients (15%). Limiting ischemia-independent side effects were present in 13 patients (3%): hypotension in 1, arterial hypertension in 5, nonsustained ventricular tachycardia in 2, and nausea/vomiting in 5. The overall feasibility was 97%. CONCLUSIONS: Pharmacological stress echocardiography with either ergonovine or ergometrine is highly feasible and can be safely performed in the echo lab in properly selected patients in whom coronary vasospasm is suspected. It is often the only way to document coronary vasospasm otherwise missed by conventional noninvasive stress test and even by coronary angiography.

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