REGADENOSON MYOCARDIAL PERFUSION SCINTIGRAPHY: A SINGLE CENTRE EXPERIENCE

Authors

  • Muhammad Adil Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi-Pakistan
  • Zaigham Salim Dar Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi-Pakistan
  • Shahbaz Afsar Khan Combined Military Hospital Abbottabad-Pakistan
  • Fida Hussain Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi-Pakistan
  • Asad Malik Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi-Pakistan
  • Husnain Saleem Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi-Pakistan

DOI:

https://doi.org/10.55519/JAMC-03-13734

Keywords:

Coronary artery disease, Myocardial perfusion imaging, Regadenoson

Abstract

Background: Regadenoson is highly selective A2A adenosine receptors agonist used for stress myocardial perfusion scintigraphy. This study presents our initial experience utilizing Regadenoson as a myocardial perfusion stress agent, aimed to assess the safety of Regadenoson for stress myocardial perfusion scintigraphy. Methods: Following Institutional Ethical Review Borad approval, adult patients presenting for myocardial stress perfusion scintigraphy were included using non-probability consecutive sampling. Exclusions included second or third-degree AV block, unstable angina, recent myocardial infarction, severe hypotension, or significant heart failure. Demographic data, co-morbidities, vitals, and adverse events were recorded. Results: Sixty-three patients were included, predominantly male (63.5%), with a mean age of 56.81±12.95 years. Hyperlipidaemia was the most common co-morbidity (47.6%). Systolic and diastolic blood pressure decreased acutely but normalised by 60 minutes. No serious adverse effects occurred, though transient ST segment depression was noted in 8.3% of patients. The most common adverse effects were dyspnoea (23.8%) and headache (21.4%). Conclusion: Regadenoson is associated with transient haemodynamic changes and non-serious transient adverse effects.

References

Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;396(10258):1204–22.

Jafar TH, Qadri Z, Chaturvedi N. Coronary artery disease epidemic in Pakistan: more electrocardiographic evidence of ischemia in women than in men. Heart 2008;94(4):408–13.

Dodani S, MacLean DD, LaPorte RE, Joffres M. Distribution and determinants of coronary artery disease in an urban Pakistani setting. Ethn Dis 2005;15(3):429–35.

Volgman AS, Palaniappan LS, Aggarwal NT, Gupta M, Khandelwal A, Krishnan AV, et al. Atherosclerotic cardiovascular disease in South Asians in the United States: Epidemiology, risk factors, and treatments: A scientific statement from the American heart association. Circulation 2018;138(1):e1–34.

Shahjehan RD, Bhutta BS. Coronary artery disease. Treasure Island (FL): StatPearls Publishing; 2024.

Lan WC, Chen YH, Liu SH. Non-invasive imaging modalities for the diagnosis of coronary artery disease: The present and the future. Tzu Chi Med J 2013;25(4):206–12.

Boschi A, Uccelli L, Marvelli L, Cittanti C, Giganti M, Martini P. Technetium-99m radiopharmaceuticals for ideal myocardial perfusion imaging: Lost and found opportunities. Molecules. 2022;27(4):1188. https://doi.org/10.3390/molecules27041188

Mann A, Williams J. Considerations for stress testing performed in conjunction with myocardial perfusion imaging. J Nucl Med Technol 2020;48(2):114–21.

Saab R, Hage FG. Vasodilator stress agents for myocardial perfusion imaging. J Nucl Cardiol. 2017 Apr;24:434–8. doi: http://doi.org/10.1007/s12350-015-0332-2.

Elkholy KO, Hegazy O, Okunade A, Aktas S, Ajibawo T. Regadenoson stress testing: A comprehensive review with a focused update. Cureus 2021;13(1):e12940.

Regadenoson [package insert]. United States Food and Drug Administration. [Internet]. 2018. [cited 2024 Mar]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/022161s015lbl.pdf

Koutsikos J, Angelidis G, Zafeirakis A, Mamarelis I, Vogiatzis M, Ilia E, et al. Performance and safety profile of regadenoson myocardial perfusion imaging: first experience in Greece. Hell J Nucl Med 2017;20(3):232–6.

Pape M, Zacho HD, Aarøe J, Eggert Jensen S, Petersen LJ. Safety and tolerability of regadenoson for myocardial perfusion imaging - first Danish experience. Scand Cardiovasc J 2016;50(3):180–6.

Sakala R, Summers B, Lundie M. Regadenoson compared to other pharmacological stressors used in myocardial perfusion imaging (MPI) at the department of nuclear medicine at a tertiary academic hospital in Gauteng, South Africa. World J Nucl Med 2023;22(2):38.

Keller M, Silber S. Pharmacological stress test for myocardial ischemia when Adenosine is contraindicated: prospective documentation of side effects in over 700 patients with COPD or bronchial asthma. Eur Heart J 2020;41(Suppl_2):ehaa282–946.

Salgado-Garcia C, Jimenez-Heffernan A, Ramos-Font C, Lopez-Martin J, Sanchez-de-Mora E, Aroui T, et al. Safety of regadenoson in patients with severe chronic obstructive pulmonary disease. Rev Esp Med Nucl Imagen Mol 2016;35(5):283–6.

Ananthasubramaniam K, Weiss R, McNutt B, Klauke B, Feaheny K, Bukofzer S. A randomized, double-blind, placebo-controlled study of the safety and tolerance of regadenoson in subjects with stage 3 or 4 chronic kidney disease. J Nucl Cardiol 2012;19(2):319–29.

AlJaroudi WA, Alraies MC, Cerquiera MD, Jaber WA. Safety and tolerability of regadenoson in 514 SPECT MPI patients with and without coronary artery disease and submaximal exercise heart rate response. Eur J Nucl Med Mol Imaging 2013;40(3):341–8.

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Published

2024-09-08

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