Pharmacological stress testing may be used in the diagnosis of coronary artery disease when there are contra-indications to the use of conventional exercise protocols.The responses to such testing using arbutamine and to conventional treadmill exercise were compared in eight patients. Respiratory gas analysis and cardiovascular observations were performed during both tests. For an equivalent increment in heart rate, both protocols increased systolic blood pressure and serum lactate. Minute ventilation and oxygen consumption also rose during both protocols, but much more so with exercise. The end-tidal partial pressure of CO2 [35.1 (S.D. 3.1) to 30.8 (6.6) mmHg] and the dead space/tidal volume ratio (VD/VT) [0.37 (0.09) to 0.33 (0.08)] fell significantly during arbutamine infusion, but the respiratory exchange ratio did not change during either protocol. Oxygen pulse, a marker of stroke volume, did not change significantly after arbutamine, but rose markedly after exercise [arbutamine, 3.9 (1.1) to 3.37 (0.7) ml·min-1·beat-1; exercise, 4.7 (1.4) to 16.1 (4.6) ml·min-1·beat-1 (P < 0.0001 compared with baseline); difference between peak responses: P < 0.0001]. We conclude that arbutamine simulates some of the physiological responses to exercise, although a number of these responses are less marked than during conventional exercise, in particular cardiac output (oxygen pulse). An increase in ventilation is produced, possibly due to direct stimulation of arterial chemoreceptors. These data suggest that the main action of arbutamine is to increase central drive rather than to establish peripheral demand.
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Research Article|
March 22 2000
Comparative physiological study of arbutamine with exercise in humans
Sharon L. LOVELL;
Sharon L. LOVELL
*Department of Medicine, Royal Victoria Hospital, Belfast BT12 6BA, N. Ireland, U.K.
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Suzanne M. MAGUIRE;
Suzanne M. MAGUIRE
*Department of Medicine, Royal Victoria Hospital, Belfast BT12 6BA, N. Ireland, U.K.
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Frances TURTLE;
Frances TURTLE
† Regional Cardiology Unit, Royal Victoria Hospital, Belfast BT12 6BA, N. Ireland, U.K.
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Garry McDOWELL;
Garry McDOWELL
*Department of Medicine, Royal Victoria Hospital, Belfast BT12 6BA, N. Ireland, U.K.
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Norman P. S. CAMPBELL;
Norman P. S. CAMPBELL
† Regional Cardiology Unit, Royal Victoria Hospital, Belfast BT12 6BA, N. Ireland, U.K.
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Marshall S. RILEY;
Marshall S. RILEY
*Department of Medicine, Royal Victoria Hospital, Belfast BT12 6BA, N. Ireland, U.K.
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D. Paul NICHOLLS
*Department of Medicine, Royal Victoria Hospital, Belfast BT12 6BA, N. Ireland, U.K.
Correspondence: Professor D. P. Nicholls (e-mail [email protected]).
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Publisher: Portland Press Ltd
Received:
July 26 1999
Revision Received:
November 05 1999
Accepted:
January 10 2000
Online ISSN: 1470-8736
Print ISSN: 0143-5221
The Biochemical Society and the Medical Research Society © 2000
2000
Clin Sci (Lond) (2000) 98 (4): 489–494.
Article history
Received:
July 26 1999
Revision Received:
November 05 1999
Accepted:
January 10 2000
Citation
Sharon L. LOVELL, Suzanne M. MAGUIRE, Frances TURTLE, Garry McDOWELL, Norman P. S. CAMPBELL, Marshall S. RILEY, D. Paul NICHOLLS; Comparative physiological study of arbutamine with exercise in humans. Clin Sci (Lond) 1 April 2000; 98 (4): 489–494. doi: https://doi.org/10.1042/cs0980489
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