Department of Radiology, Tokyo Medical University, Tokyo, Japan.
Department of Cardiology, Tokyo Medical University, Tokyo, Japan.
Curr Med Imaging. 2022;18(14):1517-1525. doi: 10.2174/1573405618666220518104929.
β-blockers are widely used for lowering heart rate (HR) during coronary computed tomography angiography (CCTA); however, they should be used with caution for patients with heart failure as they may have a negative inotropic effect.
To clarify the effects of β-blockers (oral and intravenous injection) on cardiac function using CCTA.
A total of 244 patients (men: women = 166: 78; mean age, 64.4 years old) suspected of having ischemic cardiac disease and had undergone echocardiography within 3 months before and after CCTA were included in the study. Systematic errors in ejection fraction (EF) were corrected by calculating ΔEF from the EF difference between echocardiography and CCTA in patients not using β- blockers. Univariate and multivariate analyses were performed for factors affecting ΔEF. In addition, HR between, before, and during CCTA were compared by Wilcoxon's test.
Temporary oral or intravenous administration of β-blockers at the CCTA had no significant effects on EF (p = 0.70), whereas HR was significantly decreased (p < 0.001). However, regular administration of β-blockers increases the EF on CCTA.
The administration of β-blockers immediately before CCTA affects HR but not EF. Premedication with β-blockers can be safely used for patients who undergo CCTA, and CCTA is useful for EF evaluation, independent of the use of β-blockers.
β受体阻滞剂被广泛用于降低冠状动脉 CT 血管造影（CCTA）时的心率（HR）；然而，对于心力衰竭患者应谨慎使用，因为它们可能具有负性肌力作用。
使用 CCTA 阐明β受体阻滞剂（口服和静脉注射）对心功能的影响。
共纳入 244 例疑似缺血性心脏病且在 CCTA 前后 3 个月内行超声心动图检查的患者（男：女=166：78；平均年龄 64.4 岁）。未使用β受体阻滞剂的患者，通过计算超声心动图和 CCTA 之间 EF 差值的ΔEF 来校正射血分数（EF）的系统误差。对影响ΔEF 的因素进行单因素和多因素分析。此外，通过 Wilcoxon 检验比较 CCTA 前后和期间的 HR。
CCTA 时临时口服或静脉给予β受体阻滞剂对 EF 无显著影响（p=0.70），但 HR 显著降低（p<0.001）。然而，β受体阻滞剂的常规给药可增加 CCTA 上的 EF。
CCTA 前给予β受体阻滞剂会影响 HR，但不影响 EF。CCTA 可用于评估 EF，而与β受体阻滞剂的使用无关，因此，对于接受 CCTA 的患者，可以安全地进行β受体阻滞剂的预给药。
