A Useful and Easy to Develop Combined Stress Test for Myocardial Perfusion Imaging: Regadenoson and Isometric Exercise, Preliminary Results

J Nucl Cardiol. 2017 Feb;24(1):34-40. doi: 10.1007/s12350-015-0278-1. Epub 2015 Nov 5.

Abstract

Background: Regadenoson, a selective A2a receptor agonist, is a vasodilator increasingly used in myocardial perfusion imaging. Adjunction of isometric exercise is a simple method that could improve side effect profile while providing better image quality.

Methods: Patients undergoing SPECT MPI were prospectively enrolled in handgrip-Regadenoson (HG-Reg test, N = 20) and Regadenoson (Reg) stress test (N = 40). Investigator blinded to stress test analyzed clinical data and images.

Results: Heart rate (HR) increase was statistically higher in the HG-Reg group (27 vs 22 bpm, P = .019). Decrease in SBP was less frequent in the HG-Reg group than in the Reg group (55% vs 85.5%, P = .005), there were less drops >10 mmHg (45% vs 77.7%, P = .012). During stress testing, fewer subjects reported at least one side effect in the HG-Reg compared to Reg group (70% vs 92.5%, P = .021). Images were more often classified as good in the HG-Reg group (75% vs 52.5% in the Reg group, P = .25).

Conclusions: Adjunction of handgrip exercise to Regadenoson administration is a well-tolerated and easy method, without loss of time. Furthermore, image quality seems to be better.

Keywords: Exercise stress; Regadenoson; myocardial perfusion imaging; vasodilator stress.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Aged
  • Coronary Artery Disease / diagnostic imaging*
  • Exercise Test / methods*
  • Female
  • Hand Strength*
  • Humans
  • Image Enhancement / methods*
  • Isometric Contraction
  • Male
  • Myocardial Perfusion Imaging / methods*
  • Purines*
  • Pyrazoles*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tomography, Emission-Computed, Single-Photon / methods*
  • Vasodilator Agents

Substances

  • Purines
  • Pyrazoles
  • Vasodilator Agents
  • regadenoson