Published in:
01-04-2013 | Original Article
Regadenoson pharmacologic stress for myocardial perfusion imaging: A three-way comparison between regadenoson administered at peak exercise, during walk recovery, or no-exercise
Authors:
Randall C. Thompson, MD, Harshal Patil, MD, Elaine C. Thompson, BA, Gregory S. Thomas, MD, MPH, Mohammed Al-Amoodi, MD, Kevin F. Kennedy, MS, Kevin A. Bybee, MD, A. Iain McGhie, MD, James H. O’Keefe Jr., MD, Lisa Oakes, BSN, Timothy M. Bateman, MD
Published in:
Journal of Nuclear Cardiology
|
Issue 2/2013
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Abstract
Background
Regadenoson (Reg) is being administered with increasing frequency either at peak exercise (ExPeak-Reg) or during a slow-down/walking recovery state (ExRec-Reg) rather than at rest (Rest-Reg). The aim of this study was to compare the clinical response of ExPeak-Reg, ExRec-Reg, and Rest-Reg.
Methods
We compared 531 patients divided equally between Rest-Reg, ExPeak-Reg, and ExRec-Reg matched for age, sex, and BMI.
Results
The average systolic blood pressure (SBP) rise following Reg was modest, but there was considerable heterogeneity and the ExPeak-Reg group had a higher percentage of patients who had a SBP rise of 40 mm Hg or a fall of 20 mm Hg than either the ExRec-Reg or the Rest-Reg groups (≥40 mm Hg rise 6.8%, 1.7%, and 1.7%, respectively) (P < .02) (≥20 mm Hg fall 15.8%, 13.0%, and 7.3%, respectively) (P < .05). Chest discomfort, nausea, dizziness, and interfering abdominal radiotracer activity were less common in both exercise Reg groups compared to Rest-Reg (P < .05).
Conclusion
Regadenoson injected at peak of symptom-limited exercise was generally well tolerated, but some patients had a significant rise or drop in SBP. There is no apparent advantage of administering regadenoson at peak exercise rather than during walk recovery, and the latter approach may have a greater safety margin.