Use of regadenoson for measurement of fractional flow reserve

Prasad, Arun; Zareh, Meena; Doherty, Reece; Gopal, Ambarish; Vora, Hita; Somma, Keith; Mehra, Anilkumar; Clavijo, Leonardo; Matthews, Ray V.; Shavelle, David M.

doi:10.1002/ccd.25055

Cited by 29 publications

(15 citation statements)

References 22 publications

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“…22 Accordingly, regadenoson stress PET MPI showed a good diagnostic accuracy in the detection of obstructive CAD. 23 Recently, it has been demonstrated the evidence for the use of regadenoson as the primary agent for fractional flow reserve measurement 24,25 also in consideration of its effective hyperemia. However, despite the higher myocardial blood flow induced by regadenoson compared to adenosine, 7 these two stressors produce similar pressure-derived fractional flow reserve.…”

Section: Clinical Use or Regadenoson Mpimentioning

confidence: 99%

Prognostication in the era of a new stressor for myocardial perfusion imaging

Acampa

Salvatore

Cuocolo

2015

Journal of Nuclear Cardiology

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Section: Clinical Use or Regadenoson Mpimentioning

confidence: 99%

Prognostication in the era of a new stressor for myocardial perfusion imaging

Acampa

Salvatore

Cuocolo

2015

Journal of Nuclear Cardiology

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“…To our knowledge, this is the first study that demonstrates the clinical utility of aminophylline reversal following regadenoson administration for FFR testing. Previous single‐center studies have implemented sequential adenosine infusion followed by IV bolus regadenoson in the same patient during clinically indicated FFR testing in order to evaluate the clinical utility of regadenoson . Each study demonstrated consistency of final FFR values using both pharmacological agents and concluded that regadenoson was a better tolerated and more rapid option compared to weight‐based adenosine infusion.…”

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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“…There were no significant adverse reactions to either drug and REG was overall better tolerated than adenosine. [72] In a more recent study by Prasad et al, [74] the authors compared 57 patients (60 lesions) undergoing FFR measurements first with adenosine followed by a 10 min washout phase and then with REG. They showed high correlation in hyperemic response between the two drugs (R 2 = 0.93) ( Figure 7) and substantially shorter time to peak hyperemia with REG than adenosine as well as a trend to a better side effect profile with REG.…”

Section: Fractional Flow Reserve (Ffr)mentioning

confidence: 99%

Regadenoson — Overview of Applications in Cardiology

Palani¹,

Baumann²,

KarthikAnanthasubramaniam³

2015

Coronary Artery Disease - Assessment, Surgery, Prevention

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Coronary artery disease is a leading cause of morbidity and mortality in developed countries. "ccording to a Center for Disease Control report, one out of four deaths is attributed to coronary artery disease. It costs the United States human lives, productivity, and more than billion dollars each year. Due to increased incidence in both men and women and all ethnicities, risk stratification of patients at risk for developing myocardial infarction and death is of paramount importance. Various tests are available for diagnosis and prognosis in coronary heart disease such as exercise treadmill testing, coronary calcium scoring, dobutamine stress echocardiography, exercise, dipyridamole, adenosine or dobutamine stress nuclear myocardial perfusion imaging MPI , and dobutamine or adenosine stress cardiac magnetic resonance imaging. Since a new vasodilator, regadenoson REG , has become available and is now widely used for nuclear perfusion imaging. Pharmacologic stress testing challenges the coronary flow reserve to evaluate the hyperemic capacity of the heart, which can be impaired in significant epicardial stenosis or microvascular dysfunction.In the presence of either of these conditions, ischemia induced by hyperemia manifests as wall motion abnormalities on echocardiography or as perfusion defects in nuclear perfusion imaging.REG is a selective adenosine " " receptor agonist, and due to its targeted coronary vasodilator properties and bolus administration of a standard dose in all patients, it has rapidly gained popularity as the preferred MPI stress agent. In this chapter we will review the basis of pharmacologic vasodilator stress imaging starting with a brief discussion of the various adenosine receptors and their function, the structure and mechanism of action of REG, and its development and approval. It will be compared with other myocardial perfusion pharmacologic stress agents like adenosine and © 2015 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.dipyridamole in terms of safety, efficacy, and side effect profile. We will also address the utility of REG in special situations like renal disease, chronic obstructive pulmonary disease, heart transplant, left bundle branch block, and paced rhythms. The prognostic value of REG MPI in the general population, its effectiveness with and without exercise, and the emerging applications of REG in other modalities of imaging such as positron emission tomography and stress echocardiography will be discussed. Keywords:Regadenoson, single photon emission computed tomography, positron emission tomography, stress echocardiography, fractional flow reserve, coronary artery disease . IntroductionCardiovascular disease remains a leading cause of death in the United States. "ccording to a report by the Center for Disease Control, on...

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Use of regadenoson for measurement of fractional flow reserve

Abstract: Regadenoson is a viable alternative to intravenous adenosine for achieving maximal hyperemia during FFR assessment. Compared to adenosine, regadenoson has a similar hemodynamic response, achieves more rapid hyperemia, is easier to use, and has an excellent side-effect profile.

Cited by 29 publications

References 22 publications

Prognostication in the era of a new stressor for myocardial perfusion imaging

Prognostication in the era of a new stressor for myocardial perfusion imaging

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

Regadenoson — Overview of Applications in Cardiology

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