Quantitative myocardial perfusion response to adenosine and regadenoson in patients with suspected coronary artery disease

J Nucl Cardiol. 2022 Feb;29(1):24-36. doi: 10.1007/s12350-021-02731-6. Epub 2021 Aug 12.

Abstract

Background: 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).

Methods: Hyperemic 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.

Results: Global 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.

Conclusion: The 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.

背景: 本文目的是对疑似或确诊的冠状动脉心脏病患者行15O水 PET心脏显像, 比较瑞加德松和腺苷影响心肌血流反应的定量研究。 方法: 21例患者依次行静息-腺苷15O水 PET心脏显像和静息-瑞加德松15O水 PET心脏显像, 对应用腺苷和瑞加德松后的两次充血性心肌血流量(MBF)行相关性和Bland Altman分析。 结果: 腺苷组静息和负荷下的整体MBF分别为0.92±0.27和2.68±0.80 mL/g/min, 瑞加德松组静息和负荷下的整体MBF分别为0.95±0.29和2.76±0.79mL/g/min (p=0.55 和 p=0.49)。腺苷和瑞加德松负荷状态下的整体和局部MBF之间的相关性很强(r=0.80 和 r=0.77)。静息状态下的整体和局部MBF两者偏倚均较小(0.08 and 0.09mL/min/g), 但对于负荷下的整体和局部MBF, 两组一致性限度值较宽。 结论: 使用瑞加德松和腺苷后的充血性MBF之间的相关性很强, 但一致性一般。该研究结果表明在应用瑞加德松行15O水 PET心脏显像时, 应该谨慎使用之前建立的临界值。.

Keywords: Modalities; Myocardial blood flow; Vasodilators.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenosine / pharmacology
  • Arteries
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Circulation
  • Humans
  • Hyperemia*
  • Myocardial Perfusion Imaging* / methods
  • Perfusion
  • Positron-Emission Tomography
  • Purines
  • Pyrazoles
  • Water

Substances

  • Purines
  • Pyrazoles
  • Water
  • regadenoson
  • Adenosine