Arbutamine (Gensia, Inc., San Diego, CA) is a newly-developed sympathomimetic agent specifically designed for cardiovascular stress testing. It has been successfully used for the detection of coronary artery disease in conjunction with electrocardiography, echocardiographic and radionuclide techniques. Arbutamine increases heart rate and contractility, thus provoking ischaemia in a manner analogous to that of physical exercise. Ischaemia becomes manifest by reproduction of typical angina, diagnostic electrocardiographic changes, the development of a wall motion abnormality on two-dimensional echocardiography or of a perfusion defect on thallium scintigraphy. Thus far in clinical trials it has shown an acceptable side-effect profile and a level of diagnostic accuracy for the detection of patients with coronary disease equivalent to or exceeding that seen with physical exercise.
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