Pooled comparison of regadenoson versus adenosine for measuring fractional flow reserve and coronary flow in the catheterization laboratory

Stolker, Joshua M.; Lim, Michael J.; Shavelle, David M.; Morris, D. Lynn; Angiolillo, Dominick J.; Guzmán, Luis A.; Kennedy, Kevin F.; Weber, E; Zareh, Meena; Neumayr, Robert H.; Zenni, Martin M.

doi:10.1016/j.carrev.2015.05.011

Cited by 16 publications

(8 citation statements)

References 28 publications

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“…The biologic half-life of regadenoson is 2-3 min and thus substantially longer than that of adenosine. However, regadenoson could be a more patient-friendly option given its favorable binding characteristics and ease of administration (12).…”

mentioning

confidence: 99%

Cardiac Displacement During ¹³N-Ammonia Myocardial Perfusion PET/CT: Comparison Between Adenosine- and Regadenoson-Induced Stress

Vleeming

Lazarenko

Zant

et al. 2017

J. Nucl. Med. Technol.

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This study investigated differences in cardiac displacement during adenosine stress versus regadenoson stress in N-ammonia (NH) MP PET/CT scans. In total, 61 myocardial perfusion PET/CT scans were acquired using either adenosine ( = 30) or regadenoson ( = 31) as a stressor. For both groups, cardiac displacement during rest and stress was measured 3-dimensionally, relative to either a fixed reference frame or the previous frame, in each 1-min frame of a list-mode PET acquisition of 25 min. All stress scans were additionally evaluated for the presence of motion artifacts. Also, the tolerability of the agents and the occurrence of side effects were compared between groups. Significantly larger cardiac displacement during stress was detected in the adenosine group than in the regadenoson group, reflected by both maximal cardiac displacement ( = 0.022) and mean cardiac displacement ( = 0.001). The duration of the movement was typically shorter in the regadenoson group. Frames with cardiac displacement of at least 5 mm were observed nearly twice as frequently when adenosine was used instead of regadenoson. The displacement during regadenoson stress is of lower amplitude and shorter duration than that during adenosine stress and may therefore contribute to a lower incidence of motion artifacts on PET/CT scans.

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mentioning

confidence: 99%

Cardiac Displacement During ¹³N-Ammonia Myocardial Perfusion PET/CT: Comparison Between Adenosine- and Regadenoson-Induced Stress

Vleeming

Lazarenko

Zant

et al. 2017

J. Nucl. Med. Technol.

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“…Furthermore, no significant differences were found between the hemodynamic effects of regadenoson bolus vs adenosine infusion and the mechanism of IV access (peripheral vs central) in FFR testing . More recently, a multicenter analysis found potential clinical utility of regadenoson in a more diverse patient population with greater atherosclerotic disease burden, and also supported the use of regadenoson as an alternative to adenosine for FFR coronary measurements …”

Section: Discussionmentioning

confidence: 99%

“…Aminophylline is a nonselective adenosine receptor antagonist that has been used to reverse the adverse effects of regadenoson, adenosine, and dipyridamole . There have been a small number of studies that describe the use of regadenoson for the assessment of FFR, but none has investigated reversal of regadenoson with aminophylline. The goal of the present study was not only to compare the efficacy of regadenoson to adenosine for the measurement of FFR, but also to assess the impact of aminophylline on the hemodynamics and symptoms following regadenoson bolus.…”

Section: Introductionmentioning

confidence: 99%

Intravenous regadenoson with aminophylline reversal is safe and equivalent to intravenous adenosine infusion for fractional flow reserve measurements

Edward

Lee²,

White³

et al. 2018

Clinical Cardiology

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“…In recent years, regadenoson has become widely used in the nuclear cardiology laboratory, given its advantages for patient tolerability, reported overall safety, and mechanism of action. 22 Additional advantages of regadenoson may include: quick response, no need for an infusion or weight-based dosing, a potentially useful alternative for OHT patients to achieve a targeted heart rate without physical exercise; in addition to rapid onset of maximal hyperemia (within 1 minute of regadenoson injection) and the short-lived nature of its hyperemic response (less than 5 minutes) without significant additional monitoring time compared to a standard stress test of about 20 minutes. However, the limited data evaluating the safety and feasibility in MPI PET for OHT patients may be one of the major disadvantages of its common use.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive PET quantitative myocardial blood flow with regadenoson for assessing cardiac allograft vasculopathy in orthotopic heart transplantation patients

Pampaloni

Shrestha

Sciammarella

et al. 2017

Journal of Nuclear Cardiology

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Background Risk stratification and early detection of cardiac allograft vasculopathy (CAV) is essential in orthotopic heart transplantation (OHT) patients. This study assesses the changes in myocardial blood flow (MBF) noninvasively in OHT patients using quantitative cardiac PET with regadenoson. Methods Twelve patients (Group 1) (8 males, 4 females, mean age 55 ± 7 y) with no history of post OHT myocardial ischemia were enrolled after 5.4± 2.0 y after OHT. Fifteen patients (Group 2) (9 males, 6 females, mean age 71 ± 9 y) with intermediate pretest probability but not documented evidence for coronary artery disease (CAD) were also included to serve as control. Global and regional MBFs were assessed using dynamic 13N-NH3 PET at rest and during regadenoson-induced hyperemia. The coronary flow reserve (CFR) was also calculated as the ratio of hyperemic to resting MBF. Results Mean regadenoson-induced rate-pressure products were similar in both groups, while there was an increase in resting rate-pressure product in Group 1 patients. Both mean and median values of resting MBF were higher in Group 1 than Group 2 patients (1.33±0.31 and 1.01±0.21 mL/min/g for Groups 1 and 2, respectively, P<.001), while mean hyperemic MBF values were similar in both Groups (2.68±0.84 and 2.64±0.94 mL/min/g, P=NS) but median hyperemic MBF values were lower in Group 1 than Group 2 patients (2.0 vs. 2.60 mL/min/g, P=.018). Both mean and median CFR values demonstrated a significant reduction toward the Group 1 compared to Group 2 patients (2.07±0.74 vs. 2.63±0.48, P = .025). Conclusions This study suggests that the MBF in OHT patients may be abnormal at resting state with diminished CFR. This hints that the epicardial and microvascular coronary subsystem may be exacerbated after OHT leading to the gradual progression of CAV.

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Pooled comparison of regadenoson versus adenosine for measuring fractional flow reserve and coronary flow in the catheterization laboratory

Cited by 16 publications

References 28 publications

Cardiac Displacement During ¹³N-Ammonia Myocardial Perfusion PET/CT: Comparison Between Adenosine- and Regadenoson-Induced Stress

Cardiac Displacement During ¹³N-Ammonia Myocardial Perfusion PET/CT: Comparison Between Adenosine- and Regadenoson-Induced Stress

Intravenous regadenoson with aminophylline reversal is safe and equivalent to intravenous adenosine infusion for fractional flow reserve measurements

Noninvasive PET quantitative myocardial blood flow with regadenoson for assessing cardiac allograft vasculopathy in orthotopic heart transplantation patients

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Pooled comparison of regadenoson versus adenosine for measuring fractional flow reserve and coronary flow in the catheterization laboratory

Cited by 16 publications

References 28 publications

Cardiac Displacement During 13N-Ammonia Myocardial Perfusion PET/CT: Comparison Between Adenosine- and Regadenoson-Induced Stress

Cardiac Displacement During 13N-Ammonia Myocardial Perfusion PET/CT: Comparison Between Adenosine- and Regadenoson-Induced Stress

Intravenous regadenoson with aminophylline reversal is safe and equivalent to intravenous adenosine infusion for fractional flow reserve measurements

Noninvasive PET quantitative myocardial blood flow with regadenoson for assessing cardiac allograft vasculopathy in orthotopic heart transplantation patients

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Cardiac Displacement During ¹³N-Ammonia Myocardial Perfusion PET/CT: Comparison Between Adenosine- and Regadenoson-Induced Stress

Cardiac Displacement During ¹³N-Ammonia Myocardial Perfusion PET/CT: Comparison Between Adenosine- and Regadenoson-Induced Stress