Comparison of hemodynamic and stress testing variables in patients undergoing regadenoson stress myocardial perfusion imaging to regadenoson with adjunctive low-level exercise myocardial perfusion imaging

Rafael Cabrera, Zehra Husain, Guru Palani, Aarthee S. Karthikeyan, Zain Choudhry, Sunita Dhanalakota, Ed Peterson, Karthik Ananthasubramaniam

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Regadenoson (REG), a selective adenosine A2a receptor agonist, is becoming the preferred pharmacologic agent for stress myocardial perfusion imaging (MPI). Hemodynamic and stress variables, immediate safety and use of aminophylline when using REG combined with low-level exercise (REG WALK MPI) compared with REG MPI, have not been well studied and formed the basis of our study. Methods: Retrospective evaluation of patients who underwent REG MPI (n = 887) was compared to patients undergoing REG WALK MPI (n = 485) from January to November 2009. Patient demographics, hemodynamic parameters, REG MPI data, side effects, immediate major clinical events, and use of aminophylline were evaluated. Results: Patients in REG WALK MPI group tended to be younger, male and obese compared to patients in REG MPI group. REG WALK MPI patients had higher stress heart rate (103 ± 20.5 vs 84 ± 19 bpm, P =.001), higher heart rate reserve (36.3 ± 19 vs 14.7 ± 15.5 bpm, P <.001), and greater systolic blood pressure rise (4.8 ± 21.3 vs -8.9 ± 19.8 mm Hg, P <.001), compared to REG MPI patients. No major adverse events were reported immediately after REG WALK MPI. There were no differences in drug-related side effects in between the two groups; however, the use of aminophylline was lower in REG WALK MPI Group (5.6% vs 11.4%, P =.001). Conclusion: REG WALK MPI gives more favorable hemodynamic response with lesser use of aminophylline and no increase in adverse events when compared with REG MPI.

Original languageEnglish (US)
Pages (from-to)336-343
Number of pages8
JournalJournal of Nuclear Cardiology
Volume20
Issue number3
DOIs
StatePublished - Jun 1 2013

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Myocardial Perfusion Imaging
Hemodynamics
Exercise
Aminophylline
regadenoson
Heart Rate
Purinergic P1 Receptor Agonists
Blood Pressure
Drug-Related Side Effects and Adverse Reactions

Keywords

  • MPI with low-level exercise
  • Regadenoson
  • aminophylline
  • hemodynamic parameters
  • immediate adverse effects
  • myocardial perfusion imaging

Cite this

Comparison of hemodynamic and stress testing variables in patients undergoing regadenoson stress myocardial perfusion imaging to regadenoson with adjunctive low-level exercise myocardial perfusion imaging. / Cabrera, Rafael; Husain, Zehra; Palani, Guru; Karthikeyan, Aarthee S.; Choudhry, Zain; Dhanalakota, Sunita; Peterson, Ed; Ananthasubramaniam, Karthik.

In: Journal of Nuclear Cardiology, Vol. 20, No. 3, 01.06.2013, p. 336-343.

Research output: Contribution to journalArticle

Cabrera, Rafael ; Husain, Zehra ; Palani, Guru ; Karthikeyan, Aarthee S. ; Choudhry, Zain ; Dhanalakota, Sunita ; Peterson, Ed ; Ananthasubramaniam, Karthik. / Comparison of hemodynamic and stress testing variables in patients undergoing regadenoson stress myocardial perfusion imaging to regadenoson with adjunctive low-level exercise myocardial perfusion imaging. In: Journal of Nuclear Cardiology. 2013 ; Vol. 20, No. 3. pp. 336-343.
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abstract = "Background: Regadenoson (REG), a selective adenosine A2a receptor agonist, is becoming the preferred pharmacologic agent for stress myocardial perfusion imaging (MPI). Hemodynamic and stress variables, immediate safety and use of aminophylline when using REG combined with low-level exercise (REG WALK MPI) compared with REG MPI, have not been well studied and formed the basis of our study. Methods: Retrospective evaluation of patients who underwent REG MPI (n = 887) was compared to patients undergoing REG WALK MPI (n = 485) from January to November 2009. Patient demographics, hemodynamic parameters, REG MPI data, side effects, immediate major clinical events, and use of aminophylline were evaluated. Results: Patients in REG WALK MPI group tended to be younger, male and obese compared to patients in REG MPI group. REG WALK MPI patients had higher stress heart rate (103 ± 20.5 vs 84 ± 19 bpm, P =.001), higher heart rate reserve (36.3 ± 19 vs 14.7 ± 15.5 bpm, P <.001), and greater systolic blood pressure rise (4.8 ± 21.3 vs -8.9 ± 19.8 mm Hg, P <.001), compared to REG MPI patients. No major adverse events were reported immediately after REG WALK MPI. There were no differences in drug-related side effects in between the two groups; however, the use of aminophylline was lower in REG WALK MPI Group (5.6{\%} vs 11.4{\%}, P =.001). Conclusion: REG WALK MPI gives more favorable hemodynamic response with lesser use of aminophylline and no increase in adverse events when compared with REG MPI.",
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T1 - Comparison of hemodynamic and stress testing variables in patients undergoing regadenoson stress myocardial perfusion imaging to regadenoson with adjunctive low-level exercise myocardial perfusion imaging

AU - Cabrera, Rafael

AU - Husain, Zehra

AU - Palani, Guru

AU - Karthikeyan, Aarthee S.

AU - Choudhry, Zain

AU - Dhanalakota, Sunita

AU - Peterson, Ed

AU - Ananthasubramaniam, Karthik

PY - 2013/6/1

Y1 - 2013/6/1

N2 - Background: Regadenoson (REG), a selective adenosine A2a receptor agonist, is becoming the preferred pharmacologic agent for stress myocardial perfusion imaging (MPI). Hemodynamic and stress variables, immediate safety and use of aminophylline when using REG combined with low-level exercise (REG WALK MPI) compared with REG MPI, have not been well studied and formed the basis of our study. Methods: Retrospective evaluation of patients who underwent REG MPI (n = 887) was compared to patients undergoing REG WALK MPI (n = 485) from January to November 2009. Patient demographics, hemodynamic parameters, REG MPI data, side effects, immediate major clinical events, and use of aminophylline were evaluated. Results: Patients in REG WALK MPI group tended to be younger, male and obese compared to patients in REG MPI group. REG WALK MPI patients had higher stress heart rate (103 ± 20.5 vs 84 ± 19 bpm, P =.001), higher heart rate reserve (36.3 ± 19 vs 14.7 ± 15.5 bpm, P <.001), and greater systolic blood pressure rise (4.8 ± 21.3 vs -8.9 ± 19.8 mm Hg, P <.001), compared to REG MPI patients. No major adverse events were reported immediately after REG WALK MPI. There were no differences in drug-related side effects in between the two groups; however, the use of aminophylline was lower in REG WALK MPI Group (5.6% vs 11.4%, P =.001). Conclusion: REG WALK MPI gives more favorable hemodynamic response with lesser use of aminophylline and no increase in adverse events when compared with REG MPI.

AB - Background: Regadenoson (REG), a selective adenosine A2a receptor agonist, is becoming the preferred pharmacologic agent for stress myocardial perfusion imaging (MPI). Hemodynamic and stress variables, immediate safety and use of aminophylline when using REG combined with low-level exercise (REG WALK MPI) compared with REG MPI, have not been well studied and formed the basis of our study. Methods: Retrospective evaluation of patients who underwent REG MPI (n = 887) was compared to patients undergoing REG WALK MPI (n = 485) from January to November 2009. Patient demographics, hemodynamic parameters, REG MPI data, side effects, immediate major clinical events, and use of aminophylline were evaluated. Results: Patients in REG WALK MPI group tended to be younger, male and obese compared to patients in REG MPI group. REG WALK MPI patients had higher stress heart rate (103 ± 20.5 vs 84 ± 19 bpm, P =.001), higher heart rate reserve (36.3 ± 19 vs 14.7 ± 15.5 bpm, P <.001), and greater systolic blood pressure rise (4.8 ± 21.3 vs -8.9 ± 19.8 mm Hg, P <.001), compared to REG MPI patients. No major adverse events were reported immediately after REG WALK MPI. There were no differences in drug-related side effects in between the two groups; however, the use of aminophylline was lower in REG WALK MPI Group (5.6% vs 11.4%, P =.001). Conclusion: REG WALK MPI gives more favorable hemodynamic response with lesser use of aminophylline and no increase in adverse events when compared with REG MPI.

KW - MPI with low-level exercise

KW - Regadenoson

KW - aminophylline

KW - hemodynamic parameters

KW - immediate adverse effects

KW - myocardial perfusion imaging

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