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- W2313213048 abstract "Background: Image quality in computed tomography coronary angiography (CTCA) is highly dependent on heart rate (HR). Intravenous metoprolol is widely used as an adjunct to oral beta-blockers. The short-acting parenteral beta-blocker esmolol is rapidly inactivated by circulating plasma esterases and may be a preferable agent to use in this setting. Methods: Eighty-three consecutive patients referred for inpatient CTCA from November 2011 to March 2012 were loaded with 50–200 mg of oral metoprolol at least 2 h prior to being scanned, if their resting HR was >60. Patients who still had a HR > 60 on the scanner table were given intravenous esmolol in boluses of 40–60 mg up to a maximum of 150 mg under the supervision of a medical officer. Continuous cardiac monitoring was used from the commencement of oral metoprolol loading, up until 1 h following scanning. Results: Seventy-four patients (89.2%) received metoprolol at a mean dose of 110.5 mg. Twenty-seven patients (32.5%) received intravenous esmolol at a mean dose of 68.5 mg. Mean HR at image acquisition was 58.6 beats per minute. No adverse events or significant bradyarrhythmias were recorded. Discussion: The half-life of metoprolol is 3–7 h, compared to 9 min with esmolol. In this small non-randomised study, the use of oral metoprolol with adjunctive intravenous esmolol was safe, well-tolerated and efficacious. Adjunctive esmolol may be particularly well-suited to the outpatient setting, where patients are discharged soon after being scanned, but further study is needed." @default.
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- W2313213048 date "2012-01-01" @default.
- W2313213048 modified "2023-10-05" @default.
- W2313213048 title "Efficacy and Safety of Intravenous Esmolol to Control Heart Rate Prior to 320-Slice Computed Tomography Coronary Angiography" @default.
- W2313213048 doi "https://doi.org/10.1016/j.hlc.2012.05.500" @default.
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