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Journal of Nuclear Cardiology
Published in: Journal of Nuclear Cardiology 1/2017

01-02-2017 | Editorial

A helping hand for regadenoson tests

Authors: Preeti Kansal, MD, Thomas A. Holly, MD

Published in: Journal of Nuclear Cardiology | Issue 1/2017

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Excerpt

Noninvasive stress testing is ideally performed by allowing patients to exercise to maximal capacity. However, not all patients are able to perform sufficient exercise or are on medications that blunt the necessary heart rate increase. For these individuals, pharmacologic stress testing is performed, often with adjunctive treadmill exercise. Low-level exercise has been combined with pharmacologic stress for years, and has been shown to reduce side effects and improve image quality.1-6 Pharmacologic stress has also been combined with symptom-limited exercise in suitable patients as a means to obtain valuable functional data while ensuring adequate stress.7-12 …
Literature
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Hashimoto A, Palmar EL, Scott JA, Abraham SA, Fischman AJ, Force TL, et al. Complications of exercise and pharmacologic stress tests: Differences in younger and elderly patients. J Nucl Cardiol 1999;6:612-9.CrossRefPubMed
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Elliott MD, Holly TA, Leonard SM, Hendel RC. The impact of an abbreviated adenosine protocol incorporating adjunctive treadmill exercise on side effects and image quality in patients undergoing stress myocardial perfusion imaging. J Nucl Cardiol 2000;7:584-9.CrossRefPubMed
3.
Thomas GS, Prill NV, Majmundar H, Fabrizi RR, Thomas JJ, Hayashida C, et al. Treadmill exercise during adenosine infusion is safe, results in fewer adverse reactions, and improves myocardial perfusion image quality. J Nucl Cardiol 2000;7:439-46.CrossRefPubMed
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Samady H, Wackers FJ, Joska TM, Zaret BL, Jain D. Pharmacologic stress perfusion imaging with adenosine: Role of simultaneous low-level treadmill exercise. J Nucl Cardiol 2002;9:188-96.CrossRefPubMed
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Thomas GS, Thompson RC, Miyamoto MI, Ip TK, Rice DL, Milikien D, et al. The RegEx trial: A randomized, double-blind, placebo- and active-controlled pilot study combining regadenoson, a selective A(2A) adenosine agonist, with low-level exercise, in patients undergoing myocardial perfusion imaging. J Nucl Cardiol 2009;16:63-72.CrossRefPubMed
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Kwon DH, Cerqueira MD, Young R, Houghtaling P, Lieber E, Menon V, et al. Lessons from regadenoson and low-level treadmill/regadenoson myocardial perfusion imaging: Initial clinical experience in 1263 patients. J Nucl Cardiol 2010;17:853-7.CrossRefPubMed
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Pennell DJ, Mavrogeni SI, Forbat SM, Karwatowski SP, Underwood SR. Adenosine combined with dynamic exercise for myocardial perfusion imaging. J Am Coll Cardiol 1995;25:1300-9.CrossRefPubMed
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Holly TA, Satran A, Bromet DS, Mieres JH, Frey MJ, Elliott MD, et al. Impact of adjunctive adenosine infusion during exercise myocardial perfusion imaging: Results of the Both Exercise and Adenosine Stress Test (BEAST) Trial. J Nucl Cardiol 2003;10:291-6.CrossRefPubMed
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Partington SL, Lanka V, Hainer J, Blankstein R, Skali H, Forman DE, et al. Safety and feasibility of regadenoson use for suboptimal heart rate response during symptom-limited standard Bruce exercise stress test. J Nucl Cardiol 2012;19:970-8.CrossRefPubMedPubMedCentral
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Parker MW, Morales DC, Slim HB, Ahlberg AW, Katten DM, Cyr G, et al. A strategy of symptom-limited exercise with regadenoson-as-needed for stress myocardial perfusion imaging: A randomized controlled trial. J Nucl Cardiol 2013;20:185-96.CrossRefPubMed
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Ross MI, Wu E, Wilkins JT, Gupta D, Shen S, Aulwes D, et al. Safety and feasibility of adjunctive regadenoson injection at peak exercise during exercise myocardial perfusion imaging: The Both Exercise and Regadenoson Stress Test (BERST) trial. J Nucl Cardiol 2013;20:197-204.CrossRefPubMed
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Thompson RC, Patil H, Thompson EC, Thomas GS, Al-Amoodi M, Kennedy KF, et al. Regadenoson pharmacologic stress for myocardial perfusion imaging: A three-way comparison between regadenoson administered at peak exercise, during walk recovery, or no exercise. J Nucl Cardiol 2013;20:214-21.CrossRefPubMed
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Ghimre G, Fadi GH, Jaekyeong H, Iskandrian AE. Regadenoson: A focused update. J Nucl Cardiol 2013;20:284-8.CrossRef
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Hendel RC. Off-Label, but on-target: Use of regadenoson with exercise. J Nucl Cardiol 2013;20:179-81.CrossRefPubMed
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Janvier L, Pinaquy J, Douard H, Karcher G, Bordenave L. A useful and easy to develop combined stress test for myocardial perfusion imaging: Regadenoson and isometric exercise, preliminary results. J Nucl Cardiol 2015. doi:10.​1007/​s12350-015-0278-1.PubMed
Metadata
Title
A helping hand for regadenoson tests
Authors
Preeti Kansal, MD
Thomas A. Holly, MD
Publication date
01-02-2017
Publisher
Springer US
Published in
Journal of Nuclear Cardiology / Issue 1/2017
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-015-0298-x

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