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Regadenoson versus dipyridamole: Evaluation of stress myocardial blood flow response on a CZT-SPECT camera

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Regadenoson is a selective adenosine receptor agonist. It is currently unclear if the level of hyperemia differs between stress agents. We compared Myocardial Blood Flow (MBF) and Myocardial Flow Reserve (MFR) response on CZT-SPECT Myocardial Perfusion Imaging (MPI) to evaluate if dipyridamole and regadenoson could induce the same level of hyperemia.

Methods

228 patients with dynamic CZT-SPECT MPI were retrospectively analyzed (66 patients stressed with regadenoson and 162 with dipyridamole) in terms of MBF and MFR. To rule out confounding factors, two groups of 41 patients were matched for clinical characteristics in a sub-analysis, excluding high cardiovascular risk patients.

Results

Overall stress MBF was higher in regadenoson patients (1.71 ± 0.73 vs. 1.44 ± 0.55 mL·min−1·g−1 for regadenoson and dipyridamole, respectively, p < .05). However, when confounding factors were ruled out, stress MBF (1.57 ± 0.56 vs. 1.61 ± 0.62 mL·min−1·g−1 for dipyridamole and regadenoson, respectively, p = .88) and MFR (2.62 ± 0.77 vs. 2.46 ± 0.76 for dipyridamole and regadenoson, respectively, p = .40) were not different between regadenoson and dipyridamole.

Conclusions

Our results suggest that dipyridamole and regadenoson induce equivalent hyperemia in dynamic SPECT with similar stress MBF and MFR in comparable patients.

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Abbreviations

CAD:

Coronary artery disease

LAD:

Left anterior descending artery

LA:

Left atrium

LCx:

Left circumflex

LVEF:

Left ventricular ejection fraction

MBF:

Myocardial blood flow

MFR:

Myocardial flow reserve

MPI:

Myocardial perfusion imaging

RCA:

Right coronary artery

ROI:

Region of interest

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Acknowledgments

We express our deepest gratitude to the cardiologists, the technical and radiopharmaceutical staff from CHR of Orleans and CHRU of Tours. This study is part of the French network of University Hospitals HUGO (‘Hôpitaux Universitaires du Grand Ouest’).

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Authors and Affiliations

  1. Nuclear Medicine Department, CHR ORLEANS, 14 Avenue de l’Hôpital, 45100, Orleans, France

    Quentin Brana, Frédérique Thibault MD, Gilles Metrard MD & Matthieu Bailly MD

  2. Nuclear Medicine Department, CHRU TOURS, Tours, France

    Quentin Brana, Maxime Courtehoux MD & Maria Joao Ribeiro MD, PhD

  3. Cardiology Department, CHRU TOURS & EA4245 T2i, Tours University, Tours, France

    Denis Angoulvant MD, PhD

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  1. Quentin Brana
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Correspondence to Matthieu Bailly MD.

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Disclosure

Quentin Brana, Frédérique Thibault, Maxime Courtehoux, and Maria Joao Ribeiro have nothing to disclose. Gilles Metrard received honoraria and travel grants from General Electric Healthcare (from previous and other works). Denis Angoulvant received honoraria and travel grants from Astra Zeneca, MSD, Amgen, Servier, Sanofi, Bayer, BMS, Pfizer, Boehringer, artis, ando Nordisk (from previous and other works). Matthieu Bailly received honoraria and travel grants from General Electric Healthcare (from previous and other works).

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Brana, Q., Thibault, F., Courtehoux, M. et al. Regadenoson versus dipyridamole: Evaluation of stress myocardial blood flow response on a CZT-SPECT camera. J. Nucl. Cardiol. 29, 113–122 (2022). https://doi.org/10.1007/s12350-020-02271-5

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