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Failed heart rate control with oral metoprolol prior to coronary CT angiography: effect of additional intravenous metoprolol on heart rate, image quality and radiation dose

Overview of attention for article published in The International Journal of Cardiovascular Imaging, April 2012
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Title
Failed heart rate control with oral metoprolol prior to coronary CT angiography: effect of additional intravenous metoprolol on heart rate, image quality and radiation dose
Published in
The International Journal of Cardiovascular Imaging, April 2012
DOI 10.1007/s10554-012-0049-x
Pubmed ID
Authors

Laura Jiménez-Juan, Elsie T. Nguyen, Bernd J. Wintersperger, Hadas Moshonov, Andrew M. Crean, Djeven P. Deva, Narinder S. Paul, Felipe S. Torres

Abstract

The purpose of this study was to evaluate the effect of intravenous (i.v.) metoprolol after a suboptimal heart rate (HR) response to oral metoprolol (75-150 mg) on HR control, image quality (IQ) and radiation dose during coronary CTA using 320-MDCT. Fifty-three consecutive patients who failed to achieve a target HR of < 60 bpm after an oral dose of metoprolol and required supplementary i.v. metoprolol (5-20 mg) prior to coronary CTA were evaluated. Patients with HR < 60 bpm during image acquisition were defined as responders (R) and those with HR ≥ 60 bpm as non-responders (NR). Two observers assessed IQ using a 3-point scale (1-2, diagnostic and 3, non-diagnostic). Effective dose (ED) was estimated using dose-length product and a 0.014 mSV/mGy.cm conversion factor. Baseline characteristics and HR on arrival were similar in the two groups. 58% of patients didn't achieve the target HR after receiving i.v. metoprolol (NR). R had a significantly higher HR reduction after oral (mean HR 63.9 ± 4.5 bpm vs. 69.6 ± 5.6 bpm) (p < 0.005) and i.v. (mean HR 55.4 ± 3.9 bpm vs. 67.4 ± 5.3 bpm) (p < 0.005) doses of metoprolol. Studies from NR showed a significantly higher ED in comparison to R (8.0 ± 2.9 vs. 6.1 ± 2.2 mSv) (p = 0.016) and a significantly higher proportion of non-diagnostic coronary segments (9.2 vs. 2.5%) (p < 0.001). 58% of patients who do not achieve a HR of <60 bpm prior to coronary CTA with oral fail to respond to additional i.v. metoprolol and have studies with higher radiation dose and worse image quality.

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Mendeley readers

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Geographical breakdown

Country Count As %
Unknown 24 100%

Demographic breakdown

Readers by professional status Count As %
Other 4 17%
Student > Master 3 13%
Student > Doctoral Student 2 8%
Researcher 2 8%
Student > Ph. D. Student 2 8%
Other 4 17%
Unknown 7 29%
Readers by discipline Count As %
Medicine and Dentistry 13 54%
Pharmacology, Toxicology and Pharmaceutical Science 1 4%
Nursing and Health Professions 1 4%
Business, Management and Accounting 1 4%
Sports and Recreations 1 4%
Other 1 4%
Unknown 6 25%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 July 2013.
All research outputs
#22,760,732
of 25,374,917 outputs
Outputs from The International Journal of Cardiovascular Imaging
#1,460
of 2,012 outputs
Outputs of similar age
#159,639
of 175,433 outputs
Outputs of similar age from The International Journal of Cardiovascular Imaging
#11
of 18 outputs
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So far Altmetric has tracked 2,012 research outputs from this source. They receive a mean Attention Score of 2.3. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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We're also able to compare this research output to 18 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.