Abstract
BackgroundThe aim of the present study was to compare the quantitative flow responses of regadenoson against adenosine using cardiac 15O-water PET imaging in patients with suspected or known coronary artery disease (CAD). MethodsHyperemic myocardial blood flow (MBF) after adenosine and regadenoson was compared using correlation and Bland–Altman analysis in 21 patients who underwent rest and adenosine 15O-water PET scans followed by rest and regadenoson 15O-water PET scans. ResultsGlobal mean (± SD) MBF values at rest and stress were 0.92 ± 0.27 and 2.68 ± 0.80 mL·g·min for the adenosine study and 0.95 ± 0.29 and 2.76 ± 0.79 mL·g·min for the regadenoson study (P = 0.55 and P = 0.49). The correlations between global and regional adenosine- and regadenoson-based stress MBF were strong (r = 0.80 and r = 0.77). The biases were small for both global and regional MBF comparisons (0.08 and 0.09 mL·min·g), but the limits of agreement were wide for stress MBF. ConclusionThe correlation between regadenoson- and adenosine-induced hyperemic MBF was strong but the agreement was only moderate indicating that established cut-off values for 150-water PET should be used cautiously if using regadenoson as vasodilator.
Highlights
The most common pharmacological stressors for myocardial perfusion imaging (MPI) are dipyridamole and adenosine, which cause coronary vasodilatation by stimulating the A2A receptor
The flow responses to adenosine have been investigated in numerous studies and recently normal ranges and optimal cut-off limits have been defined for 15O-water Positron emission tomography (PET) in diagnostic work in patients with suspected coronary artery disease (CAD).[13]
26 patients with known (N = 7) or suspected CAD were included in the study: 17 patients in Uppsala and 9 patients in Turku
Summary
The most common pharmacological stressors for myocardial perfusion imaging (MPI) are dipyridamole and adenosine, which cause coronary vasodilatation by stimulating the A2A receptor. A few PET studies have measured the absolute myocardial flow responses to regadenoson using 82Rb and the results have been conflicting; while the values have been comparable to dipyridamole at group level,[6,7] a more recent direct comparison, demonstrated that compared to dipyridamole, regadenoson administered to the same patients achieved only 80% of maximal hyperemia.[8] 82Rb is not an ideal perfusion tracer because of its limited extraction especially at high blood flow values. The aim of the present study was to compare the quantitative flow responses of regadenoson against adenosine using cardiac 15O-water. The aim of the present study was to compare the quantitative flow responses of regadenoson against adenosine using cardiac 15O-water PET imaging in patients with suspected or known coronary artery disease (CAD)
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