Top

Published in:

01-06-2016 | Editorial

Heart rate response to regadenoson: Making the case for its value in clinical practice

Authors: Efstathia Andrikopoulou, MD, Fadi G. Hage, MD, FASH, FACC

Published in: Journal of Nuclear Cardiology | Issue 3/2016

Excerpt

Single-photon emission computed tomography myocardial perfusion imaging (MPI) using regadenoson as a stress agent carries a wealth of prognostic data as documented by a series of recent studies.1-7 It is, therefore, natural to pose the following questions, when reading about a novel prognostic indicator derived from regadenoson MPI 8: Is there really a need for another risk predictor in patients undergoing regadenoson MPI? Will this novel predictor add value to the information that is already available to me? In which patient populations is it useful? How will I use this in my daily clinical practice? …

Hage FG, Ghimire G, Lester D, McKay J, Bleich S, El-Hajj S, et al. The prognostic value of regadenoson myocardial perfusion imaging. J Nucl Cardiol 2015;. doi:10.1007/s12350-014-0050-y.

Iqbal FM, Hage FG, Ahmed A, Dean PJ, Raslan S, Heo J, et al. Comparison of the prognostic value of normal regadenoson with normal adenosine myocardial perfusion imaging with propensity score matching. Jacc 2012;5:1014-21.PubMed

Farzaneh-Far A, Shaw LK, Dunning A, Oldan JD, O’Connor CM, Borges-Neto S. Comparison of the prognostic value of regadenoson and adenosine myocardial perfusion imaging. J Nucl Cardiol 2015;. doi:10.1007/s12350-015-0155-y.PubMed

Bhatti S, Hakeem A, Dhanalakota S, Palani G, Husain Z, Jacobsen G, et al. Prognostic value of regadenoson myocardial single-photon emission computed tomography in patients with different degrees of renal dysfunction. Eur Heart J Cardiovasc Imag 2014;15:933-40.CrossRef

El-Hajj S, AlJaroudi WA, Farag A, Bleich S, Manaoragada P, Iskandrian AE, et al. Effect of changes in perfusion defect size during serial regadenoson myocardial perfusion imaging on cardiovascular outcomes in high-risk patients. J Nucl Cardiol 2015;. doi:10.1007/s12350-015-0174-8.

Hage FG, Dean P, Iqbal F, Heo J, Iskandrian AE. A blunted heart rate response to regadenoson is an independent prognostic indicator in patients undergoing myocardial perfusion imaging. J Nucl Cardiol 2011;18:1086-94.CrossRefPubMed

Lester D, El-Hajj S, Farag A, Bhambhavani P, Tauxe L, Heo J et al. Prognostic value of transient ischemic dilation with regadenoson myocardial perfusion imaging. J Nucl Cardiol 2015. doi:10.1007/s12350-015-0272-7.

Aljaroudi W, Campagnoli T, Fughhi I, Wassouf M, Ali A, Doukky R. Prognostic value of heart rate response during regadenoson stress myocardial perfusion imaging in patients with end stage renal disease. J Nucl Cardiol 2015. doi:10.1007/s12350-015-0234-0.

Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: A meta-analysis. JAMA 2009;301:2024-35.CrossRefPubMed

10.

Lauer MS, Francis GS, Okin PM, Pashkow FJ, Snader CE, Marwick TH. Impaired chronotropic response to exercise stress testing as a predictor of mortality. JAMA 1999;281:524-9.CrossRefPubMed

11.

Azarbal B, Hayes SW, Lewin HC, Hachamovitch R, Cohen I, Berman DS. The incremental prognostic value of percentage of heart rate reserve achieved over myocardial perfusion single-photon emission computed tomography in the prediction of cardiac death and all-cause mortality: Superiority over 85% of maximal age-predicted heart rate. J Am Coll Cardiol 2004;44:423-30.CrossRefPubMed

12.

Abidov A, Hachamovitch R, Hayes SW, Ng CK, Cohen I, Friedman JD, et al. Prognostic impact of hemodynamic response to adenosine in patients older than age 55 years undergoing vasodilator stress myocardial perfusion study. Circulation 2003;107:2894-9.CrossRefPubMed

13.

Bhatheja R, Francis GS, Pothier CE, Lauer MS. Heart rate response during dipyridamole stress as a predictor of mortality in patients with normal myocardial perfusion and normal electrocardiograms. Am J Cardiol 2005;95:1159-64.CrossRefPubMed

14.

Venkataraman R, Hage FG, Dorfman TA, Heo J, Aqel RA, de Mattos AM, et al. Relation between heart rate response to adenosine and mortality in patients with end-stage renal disease. Am J Cardiol 2009;103:1159-64.CrossRefPubMed

15.

Mathur S, Shah AR, Ahlberg AW, Katten DM, Heller GV. Blunted heart rate response as a predictor of cardiac death in patients undergoing vasodilator stress technetium-99m sestamibi gated SPECT myocardial perfusion imaging. J Nucl Cardiol 2010;17:617-24.CrossRefPubMed

16.

Hage FG, Dean P, Bhatia V, Iqbal F, Heo J, Iskandrian AE. The prognostic value of the heart rate response to adenosine in relation to diabetes mellitus and chronic kidney disease. Am Heart J 2011;162:356-62.CrossRefPubMed

17.

Iqbal FM, Al Jaroudi W, Sanam K, Sweeney A, Heo J, Iskandrian AE, et al. Reclassification of cardiovascular risk in patients with normal myocardial perfusion imaging using heart rate response to vasodilator stress. Am J Cardiol 2013;111:190-5.CrossRefPubMed

18.

Hage FG, Wackers FJ, Bansal S, Chyun DA, Young LH, Inzucchi SE, et al. The heart rate response to adenosine: A simple predictor of adverse cardiac outcomes in asymptomatic patients with type 2 diabetes. Int J Cardiol 2013;167:2952-7.CrossRefPubMedPubMedCentral

19.

Shaw LJ, Hage FG, Berman DS, Hachamovitch R, Iskandrian A. Prognosis in the era of comparative effectiveness research: Where is nuclear cardiology now and where should it be? J Nucl Cardiol 2012;19:1026-43.CrossRefPubMed

20.

Bellam N, Veledar E, Dorbala S, Di Carli MF, Shah S, Eapen D, et al. Prognostic significance of impaired chronotropic response to pharmacologic stress Rb-82 PET. J Nucl Cardiol 2014;21:233-44.CrossRefPubMed

21.

Dhalla AK, Wong MY, Wang WQ, Biaggioni I, Belardinelli L. Tachycardia caused by A2A adenosine receptor agonists is mediated by direct sympathoexcitation in awake rats. J Pharmacol Exp Ther 2006;316:695-702.CrossRefPubMed

22.

Hage FG, Heo J, Franks B, Belardinelli L, Blackburn B, Wang W, et al. Differences in heart rate response to adenosine and regadenoson in patients with and without diabetes mellitus. Am Heart J 2009;157:771-6.CrossRefPubMed

23.

Schelbert HR. Anatomy and physiology of coronary blood flow. J Nucl Cardiol 2010;17:545-54.CrossRefPubMedPubMedCentral

24.

Hage FG, Perry G, Heo J, Iskandrian AE. Blunting of the heart rate response to adenosine and regadenoson in relation to hyperglycemia and the metabolic syndrome. Am J Cardiol 2010;105:839-43.CrossRefPubMed

25.

Hage FG, Iskandrian AE. Heart rate response during vasodilator stress myocardial perfusion imaging: Mechanisms and implications. J Nucl Cardiol 2010;17:536-9.CrossRefPubMed

Title: Heart rate response to regadenoson: Making the case for its value in clinical practice
Authors: Efstathia Andrikopoulou, MD
Fadi G. Hage, MD, FASH, FACC
Publication date: 01-06-2016
Publisher: Springer US
Published in: Journal of Nuclear Cardiology / Issue 3/2016
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-015-0269-2

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

At a glance: The STEP trials

Springer Medicine

Heart rate response to regadenoson: Making the case for its value in clinical practice

Excerpt

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The STEP trials

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 3/2016

CME instructions: The prognostic value of non-perfusion variables obtained during vasodilator stress myocardial perfusion imaging

The reproducibility of time-of-flight PET and conventional PET for the quantification of myocardial blood flow and coronary flow reserve with 13N-ammonia

Exercise and Bayes’ Theorem: Some things never go out of style

Cardiovascular disease in the literature: A selection of recent original research papers

Erratum to: Not black or white, but brown: A common finding explained!

Caffeine does not significantly reduce the sensitivity of vasodilator stress MPI: Rebuttal

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page