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Radiation-Dose-Lowering Effects of Landiolol Hydrochloride in Coronary Angiography Using Computed Tomography
Teruhito Kido1, Teruhito Mochizuki, Masaharu Hirano
1Department of Radiology, Ehime University Graduate School of Medicine.
Insights
Landiolol hydrochloride effectively controlled heart rate (HR) during coronary computed tomography angiography (CCTA), significantly reducing radiation exposure by approximately 50%. This beta-blocker proved safe and clinically useful for CCTA procedures.
Area of Science:
- Cardiology
- Radiology
- Pharmacology
Background:
- Heart rate (HR) control is crucial for optimizing image quality and minimizing radiation exposure during coronary computed tomography angiography (CCTA).
- Achieving target HRs can be challenging, necessitating effective pharmacological interventions.
Purpose of the Study:
- To evaluate the efficacy and safety of landiolol hydrochloride for HR control during CCTA.
- To assess the impact of landiolol hydrochloride on radiation dose reduction in CCTA.
Main Methods:
- A prospective multicenter study involving 219 patients with suspected ischemic heart disease and pretest HRs of 50-80 beats/min.
- HR was measured before and after landiolol hydrochloride administration.
- Radiation exposure was estimated based on pre-administration HR and compared with actual dose.
Main Results:
- Landiolol hydrochloride significantly reduced mean HR from 69.3±7.3 to 59.9±6.4 beats/min (P<0.001).
- Eighty percent of patients achieved a controlled HR of ≤65 beats/min.
- Mean radiation dose was reduced by approximately 50% (4.5±3.2 mSv vs. 9.0±3.7 mSv; P<0.001).
- HR and blood pressure returned to baseline post-scan with no adverse events.
Conclusions:
- Landiolol hydrochloride is a safe and effective agent for HR control in CCTA.
- Its use leads to a significant reduction in radiation exposure, highlighting its clinical utility.
Background:
Controlling and decreasing the heart rate (HR) of patients during coronary computed tomography angiography (CCTA) is necessary to reduce radiation exposure and improve image quality. This prospective multicenter study aimed to investigate whether HR control with landiolol hydrochloride is useful for reducing radiation exposure during CCTA.
Methods And Results:
We investigated 219 patients with suspected ischemic heart disease whose pretest HRs were 50-80 beats/min. We measured the HR before and after administration of landiolol hydrochloride and compared the estimated exposure inferred from the HR before administration of landiolol hydrochloride with the actual dose. After administration of landiolol hydrochloride, the mean HR (59.9±6.4 beats/min) at the time of CCTA was significantly lower than before administration (69.3±7.3 beats/min; P<0.001); 80% of the patients had controlled HRs at ≤65 beats/min. HR and blood pressure of all the patients recovered after the scan. The mean radiation dose in all patients was approximately 50% derived from the inferred dose before use of landiolol hydrochloride (4.5±3.2 vs. 9.0±3.7 mSv; P<0.001). There were no adverse events during this study.
Conclusions:
The use of landiolol hydrochloride during CCTA was safe and resulted in approximately 50% decrease in radiation exposure dose, suggesting the clinical usefulness of this drug. (Circ J 2016; 80: 1225-1231).
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