Efficacy of bolus injections of landiolol hydrochloride as premedication in coronary artery CT angiography
Abstract Purpose To assess the efficacy of bolus injections of landiolol hydrochloride as premedication in coronary artery CT angiography (CCTA). Methods The study population consisted of 37 patients (17 female; median age, 56 years; IQR, 19 years; range, 19–88 years) who underwent CCTA after intrav...
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SpringerOpen
2025-01-01
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| Series: | Insights into Imaging |
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| Online Access: | https://doi.org/10.1186/s13244-024-01892-5 |
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| author | Mark Barwig Michael Janisch Johannes Gessl Wolfgang Kübler Christopher König Gerold Schwantzer Helmut Schöllnast |
| author_facet | Mark Barwig Michael Janisch Johannes Gessl Wolfgang Kübler Christopher König Gerold Schwantzer Helmut Schöllnast |
| author_sort | Mark Barwig |
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| description | Abstract Purpose To assess the efficacy of bolus injections of landiolol hydrochloride as premedication in coronary artery CT angiography (CCTA). Methods The study population consisted of 37 patients (17 female; median age, 56 years; IQR, 19 years; range, 19–88 years) who underwent CCTA after intravenous injection of landiolol hydrochloride due to a heart rate > 60 bpm. Landiolol hydrochloride was administered in a stepwise manner until a heart rate of ≤ 60 bpm was achieved or a maximum dose of 60 mg was reached after six injections. Heart rates routinely displayed continuously on the CT scanner before the start of the landiolol hydrochloride injection (HRPRE), after each partial dose (HR1–6), during the CT scan (HRCT), and after the examination before moving from the CT table (HRPOST) were recorded. Furthermore, the blood pressure routinely measured before (BPPRE) and after the examination before moving from the CT table (BPPOST) was recorded. Results A HRCT of ≤ 60 bpm was achieved in 13 patients (35%) and a HRCT ≤ 65 bpm was achieved in 25 patients (68%). The mean difference (± SD) between HRPRE and HRCT was −11 ± 9 bpm in total, −14 ± 10 bpm in patients without oral beta-blocker premedication and −6 ± 5 bpm in patients with oral Beta-blocker premedication. Conclusions Landiolol hydrochloride enables a reduction of the heart rate in patients with and without oral beta-blocker premedication, whereby the use of serial partial doses is a simple and effective approach in clinical routine. Critical relevance statement In cardiac CT, weight-independent, stepwise landiolol hydrochloride injection up to 40 mg reduces heart rate by −14 bpm without and −5 bpm with oral beta-blocker premedication, and achieves heart rates of ≤ 65 bpm in a significant proportion of patients. Key Points The ideal heart rate for cardiac CT is ≤ 60–65 bpm, which improves image quality and reduces radiation dose. In cardiac CT, landiolol hydrochloride intravenously reduces heart rate by −14 bpm. Heart rate of ≤ 65 bpm can be achieved in a significant proportion of patients. Graphical Abstract |
| format | Article |
| id | doaj-art-2d86ff98964645288d23fdfe71a6a85c |
| institution | Kabale University |
| issn | 1869-4101 |
| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-2d86ff98964645288d23fdfe71a6a85c2025-01-12T12:26:32ZengSpringerOpenInsights into Imaging1869-41012025-01-011611810.1186/s13244-024-01892-5Efficacy of bolus injections of landiolol hydrochloride as premedication in coronary artery CT angiographyMark Barwig0Michael Janisch1Johannes Gessl2Wolfgang Kübler3Christopher König4Gerold Schwantzer5Helmut Schöllnast6Institute of Radiology, LKH Graz IIDivision of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of GrazDivision of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of GrazInstitute of Radiology, LKH Graz IIInstitute of Radiology, LKH Graz IIInstitute for Medical Informatics, Statistics and Documentation, Medical University of GrazInstitute of Radiology, LKH Graz IIAbstract Purpose To assess the efficacy of bolus injections of landiolol hydrochloride as premedication in coronary artery CT angiography (CCTA). Methods The study population consisted of 37 patients (17 female; median age, 56 years; IQR, 19 years; range, 19–88 years) who underwent CCTA after intravenous injection of landiolol hydrochloride due to a heart rate > 60 bpm. Landiolol hydrochloride was administered in a stepwise manner until a heart rate of ≤ 60 bpm was achieved or a maximum dose of 60 mg was reached after six injections. Heart rates routinely displayed continuously on the CT scanner before the start of the landiolol hydrochloride injection (HRPRE), after each partial dose (HR1–6), during the CT scan (HRCT), and after the examination before moving from the CT table (HRPOST) were recorded. Furthermore, the blood pressure routinely measured before (BPPRE) and after the examination before moving from the CT table (BPPOST) was recorded. Results A HRCT of ≤ 60 bpm was achieved in 13 patients (35%) and a HRCT ≤ 65 bpm was achieved in 25 patients (68%). The mean difference (± SD) between HRPRE and HRCT was −11 ± 9 bpm in total, −14 ± 10 bpm in patients without oral beta-blocker premedication and −6 ± 5 bpm in patients with oral Beta-blocker premedication. Conclusions Landiolol hydrochloride enables a reduction of the heart rate in patients with and without oral beta-blocker premedication, whereby the use of serial partial doses is a simple and effective approach in clinical routine. Critical relevance statement In cardiac CT, weight-independent, stepwise landiolol hydrochloride injection up to 40 mg reduces heart rate by −14 bpm without and −5 bpm with oral beta-blocker premedication, and achieves heart rates of ≤ 65 bpm in a significant proportion of patients. Key Points The ideal heart rate for cardiac CT is ≤ 60–65 bpm, which improves image quality and reduces radiation dose. In cardiac CT, landiolol hydrochloride intravenously reduces heart rate by −14 bpm. Heart rate of ≤ 65 bpm can be achieved in a significant proportion of patients. Graphical Abstracthttps://doi.org/10.1186/s13244-024-01892-5Multidetector computed tomographyCardiac imaging techniquesBeta-adrenergic blockerHeart–drug effectsHeart rate |
| spellingShingle | Mark Barwig Michael Janisch Johannes Gessl Wolfgang Kübler Christopher König Gerold Schwantzer Helmut Schöllnast Efficacy of bolus injections of landiolol hydrochloride as premedication in coronary artery CT angiography Insights into Imaging Multidetector computed tomography Cardiac imaging techniques Beta-adrenergic blocker Heart–drug effects Heart rate |
| title | Efficacy of bolus injections of landiolol hydrochloride as premedication in coronary artery CT angiography |
| title_full | Efficacy of bolus injections of landiolol hydrochloride as premedication in coronary artery CT angiography |
| title_fullStr | Efficacy of bolus injections of landiolol hydrochloride as premedication in coronary artery CT angiography |
| title_full_unstemmed | Efficacy of bolus injections of landiolol hydrochloride as premedication in coronary artery CT angiography |
| title_short | Efficacy of bolus injections of landiolol hydrochloride as premedication in coronary artery CT angiography |
| title_sort | efficacy of bolus injections of landiolol hydrochloride as premedication in coronary artery ct angiography |
| topic | Multidetector computed tomography Cardiac imaging techniques Beta-adrenergic blocker Heart–drug effects Heart rate |
| url | https://doi.org/10.1186/s13244-024-01892-5 |
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