Regadenoson pharmacologic stress for myocardial perfusion imaging: A three-way comparison between regadenoson administered at peak exercise, during walk recovery, or no-exercise
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. We compar...
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| Veröffentlicht in: | Journal of nuclear cardiology 2013-04, Vol.20 (2), p.214-221 |
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| creator | Thompson, Randall C. Patil, Harshal Thompson, Elaine C. Thomas, Gregory S. Al-Amoodi, Mohammed Kennedy, Kevin F. Bybee, Kevin A. Iain McGhie, A. O’Keefe, James H. Oakes, Lisa Bateman, Timothy M. |
| description | 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.
We compared 531 patients divided equally between Rest-Reg, ExPeak-Reg, and ExRec-Reg matched for age, sex, and BMI.
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 |
| doi_str_mv | 10.1007/s12350-012-9660-4 |
| format | Article |
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We compared 531 patients divided equally between Rest-Reg, ExPeak-Reg, and ExRec-Reg matched for age, sex, and BMI.
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).
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.</description><identifier>ISSN: 1071-3581</identifier><identifier>EISSN: 1532-6551</identifier><identifier>DOI: 10.1007/s12350-012-9660-4</identifier><identifier>PMID: 23233371</identifier><language>eng</language><publisher>Boston: Elsevier Inc</publisher><subject>A2A adenosine receptor agonists ; Adenosine A2 Receptor Agonists ; Cardiology ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - epidemiology ; Coronary Artery Disease - physiopathology ; Exercise ; Exercise Test - methods ; Female ; Humans ; Imaging ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Myocardial Perfusion Imaging - methods ; Nuclear Medicine ; Original Article ; pharmacologic stress ; Physical Endurance ; Prevalence ; Purines ; Pyrazoles ; Radiology ; Reproducibility of Results ; Rest ; Sensitivity and Specificity ; stress testing ; Tomography, Emission-Computed, Single-Photon - statistics & numerical data ; Vasodilator Agents ; Walking</subject><ispartof>Journal of nuclear cardiology, 2013-04, Vol.20 (2), p.214-221</ispartof><rights>2013 American Society of Nuclear Cardiology. Published by ELSEVIER INC. All rights reserved.</rights><rights>American Society of Nuclear Cardiology 2012</rights><rights>American Society of Nuclear Cardiology 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c500t-83853a334ada182ec535343bed9e14d42b0e8cdb14dad59b1b9f14a28f49dec53</citedby><cites>FETCH-LOGICAL-c500t-83853a334ada182ec535343bed9e14d42b0e8cdb14dad59b1b9f14a28f49dec53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12350-012-9660-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12350-012-9660-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23233371$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thompson, Randall C.</creatorcontrib><creatorcontrib>Patil, Harshal</creatorcontrib><creatorcontrib>Thompson, Elaine C.</creatorcontrib><creatorcontrib>Thomas, Gregory S.</creatorcontrib><creatorcontrib>Al-Amoodi, Mohammed</creatorcontrib><creatorcontrib>Kennedy, Kevin F.</creatorcontrib><creatorcontrib>Bybee, Kevin A.</creatorcontrib><creatorcontrib>Iain McGhie, A.</creatorcontrib><creatorcontrib>O’Keefe, James H.</creatorcontrib><creatorcontrib>Oakes, Lisa</creatorcontrib><creatorcontrib>Bateman, Timothy M.</creatorcontrib><title>Regadenoson pharmacologic stress for myocardial perfusion imaging: A three-way comparison between regadenoson administered at peak exercise, during walk recovery, or no-exercise</title><title>Journal of nuclear cardiology</title><addtitle>J. Nucl. Cardiol</addtitle><addtitle>J Nucl Cardiol</addtitle><description>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.
We compared 531 patients divided equally between Rest-Reg, ExPeak-Reg, and ExRec-Reg matched for age, sex, and BMI.
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).
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.</description><subject>A2A adenosine receptor agonists</subject><subject>Adenosine A2 Receptor Agonists</subject><subject>Cardiology</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Coronary Artery Disease - epidemiology</subject><subject>Coronary Artery Disease - physiopathology</subject><subject>Exercise</subject><subject>Exercise Test - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Myocardial Perfusion Imaging - methods</subject><subject>Nuclear Medicine</subject><subject>Original Article</subject><subject>pharmacologic stress</subject><subject>Physical Endurance</subject><subject>Prevalence</subject><subject>Purines</subject><subject>Pyrazoles</subject><subject>Radiology</subject><subject>Reproducibility of Results</subject><subject>Rest</subject><subject>Sensitivity and Specificity</subject><subject>stress testing</subject><subject>Tomography, Emission-Computed, Single-Photon - statistics & numerical data</subject><subject>Vasodilator Agents</subject><subject>Walking</subject><issn>1071-3581</issn><issn>1532-6551</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkctu1TAURSMEog_4ACbIEhMGNfgR38R0VFW8pEpICMbWiX1y6zaJg530cj-LP6yjtKhiUCb2Gay9j713Ubzi7B1nrHqfuJCKUcYF1ZsNo-WT4pArKehGKf40z6ziVKqaHxRHKV0xxrTU-nlxIKSQUlb8sPjzHbfgcAgpDGS8hNiDDV3YekvSFDEl0oZI-n2wEJ2HjowY2zn5TPsetn7YfiBnZLqMiHQHe2JDP0L0i1uD0w5xIPHBBnC9H3yaMKIjMGU3uCb4G6P1CU-Im2N2JDvorrPMhhuM-xOSHzAEek-9KJ610CV8eXcfFz8_ffxx_oVefPv89fzsglrF2ERrWSsJUpbggNcCrZJKlrJBp5GXrhQNw9q6Js_glG54o1tegqjbUruFPi7err5jDL9mTJPpfbLYdTBgmJPhFdO8Evn4Pyr5RlZVjjyjb_5Br8Ich_yRhVK60htWZYqvlI0hpYitGWOOO-4NZ2ap3qzVm1y9Wao3Zda8vnOemx7dX8V91xkQK5DGJWWMD1Y_4nq6ijBHfeOzKFmPg0Xnc0GTccE_or4Fp0HQIw</recordid><startdate>20130401</startdate><enddate>20130401</enddate><creator>Thompson, Randall C.</creator><creator>Patil, Harshal</creator><creator>Thompson, Elaine C.</creator><creator>Thomas, Gregory S.</creator><creator>Al-Amoodi, Mohammed</creator><creator>Kennedy, Kevin F.</creator><creator>Bybee, Kevin A.</creator><creator>Iain McGhie, A.</creator><creator>O’Keefe, James H.</creator><creator>Oakes, Lisa</creator><creator>Bateman, Timothy M.</creator><general>Elsevier Inc</general><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7TS</scope></search><sort><creationdate>20130401</creationdate><title>Regadenoson pharmacologic stress for myocardial perfusion imaging: A three-way comparison between regadenoson administered at peak exercise, during walk recovery, or no-exercise</title><author>Thompson, Randall C. ; Patil, Harshal ; Thompson, Elaine C. ; Thomas, Gregory S. ; Al-Amoodi, Mohammed ; Kennedy, Kevin F. ; Bybee, Kevin A. ; Iain McGhie, A. ; O’Keefe, James H. ; Oakes, Lisa ; Bateman, Timothy M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c500t-83853a334ada182ec535343bed9e14d42b0e8cdb14dad59b1b9f14a28f49dec53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>A2A adenosine receptor agonists</topic><topic>Adenosine A2 Receptor Agonists</topic><topic>Cardiology</topic><topic>Coronary Artery Disease - diagnostic imaging</topic><topic>Coronary Artery Disease - epidemiology</topic><topic>Coronary Artery Disease - physiopathology</topic><topic>Exercise</topic><topic>Exercise Test - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Myocardial Perfusion Imaging - methods</topic><topic>Nuclear Medicine</topic><topic>Original Article</topic><topic>pharmacologic stress</topic><topic>Physical Endurance</topic><topic>Prevalence</topic><topic>Purines</topic><topic>Pyrazoles</topic><topic>Radiology</topic><topic>Reproducibility of Results</topic><topic>Rest</topic><topic>Sensitivity and Specificity</topic><topic>stress testing</topic><topic>Tomography, Emission-Computed, Single-Photon - statistics & numerical data</topic><topic>Vasodilator Agents</topic><topic>Walking</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thompson, Randall C.</creatorcontrib><creatorcontrib>Patil, Harshal</creatorcontrib><creatorcontrib>Thompson, Elaine C.</creatorcontrib><creatorcontrib>Thomas, Gregory S.</creatorcontrib><creatorcontrib>Al-Amoodi, Mohammed</creatorcontrib><creatorcontrib>Kennedy, Kevin F.</creatorcontrib><creatorcontrib>Bybee, Kevin A.</creatorcontrib><creatorcontrib>Iain McGhie, A.</creatorcontrib><creatorcontrib>O’Keefe, James H.</creatorcontrib><creatorcontrib>Oakes, Lisa</creatorcontrib><creatorcontrib>Bateman, Timothy M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Physical Education Index</collection><jtitle>Journal of nuclear cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thompson, Randall C.</au><au>Patil, Harshal</au><au>Thompson, Elaine C.</au><au>Thomas, Gregory S.</au><au>Al-Amoodi, Mohammed</au><au>Kennedy, Kevin F.</au><au>Bybee, Kevin A.</au><au>Iain McGhie, A.</au><au>O’Keefe, James H.</au><au>Oakes, Lisa</au><au>Bateman, Timothy M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Regadenoson pharmacologic stress for myocardial perfusion imaging: A three-way comparison between regadenoson administered at peak exercise, during walk recovery, or no-exercise</atitle><jtitle>Journal of nuclear cardiology</jtitle><stitle>J. Nucl. Cardiol</stitle><addtitle>J Nucl Cardiol</addtitle><date>2013-04-01</date><risdate>2013</risdate><volume>20</volume><issue>2</issue><spage>214</spage><epage>221</epage><pages>214-221</pages><issn>1071-3581</issn><eissn>1532-6551</eissn><abstract>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.
We compared 531 patients divided equally between Rest-Reg, ExPeak-Reg, and ExRec-Reg matched for age, sex, and BMI.
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).
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.</abstract><cop>Boston</cop><pub>Elsevier Inc</pub><pmid>23233371</pmid><doi>10.1007/s12350-012-9660-4</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | A2A adenosine receptor agonists Adenosine A2 Receptor Agonists Cardiology Coronary Artery Disease - diagnostic imaging Coronary Artery Disease - epidemiology Coronary Artery Disease - physiopathology Exercise Exercise Test - methods Female Humans Imaging Male Medicine Medicine & Public Health Middle Aged Myocardial Perfusion Imaging - methods Nuclear Medicine Original Article pharmacologic stress Physical Endurance Prevalence Purines Pyrazoles Radiology Reproducibility of Results Rest Sensitivity and Specificity stress testing Tomography, Emission-Computed, Single-Photon - statistics & numerical data Vasodilator Agents Walking |
| title | Regadenoson pharmacologic stress for myocardial perfusion imaging: A three-way comparison between regadenoson administered at peak exercise, during walk recovery, or no-exercise |
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