Regadenoson is a safe and well-tolerated pharmacological stress agent for myocardial perfusion imaging in post-heart transplant patients

  • João L. Cavalcante
  • Joaquim Barboza
  • Karthik Ananthasubramaniam
Original Article

Abstract

Background

The safety and tolerability of regadenoson (REG), a newer adenosine A2a receptor agonist, has not been tested in orthotopic heart transplant (OHT) patients.

Methods

Retrospective review of a tertiary care center experience of OHT patients who underwent a REG single-photon emission computed tomography (SPECT) study as part of the work-up for cardiac allograft vasculopathy. The control group included those same patients who had prior adenosine-based SPECT.

Results

A total of 40 patients met the above criteria. Mean time from OHT to adenosine-SPECT and REG-SPECT was 8.2 ± 4.8 years vs 9.8 ± 4.5 years, respectively (P < .001). Both vasodilators had similar side effect profiles (P = .10), produced significant heart rate acceleration and asymptomatic hypotension (P < .001). There were no episodes of bradycardia and/or AV block with REG. Despite adjustment for medication status, adenosine was still associated with more conduction abnormalities (8 vs 1 event with REG, P = .02) including five episodes of 2nd degree AV block (Mobitz type II) and three episodes of sinus pause.

Conclusion

This is the first reported use of REG in OHT patients. REG appears to be safe and well tolerated without significant cardiovascular adverse events.

Keywords

Regadenoson heart transplant safety feasibility SPECT 

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Copyright information

© American Society of Nuclear Cardiology 2011

Authors and Affiliations

  • João L. Cavalcante
    • 1
    • 2
  • Joaquim Barboza
    • 1
  • Karthik Ananthasubramaniam
    • 1
  1. 1.Heart and Vascular InstituteHenry Ford HospitalDetroitUSA
  2. 2.Section of Cardiac Imaging, Heart & Vascular InstituteCleveland Clinic FoundationClevelandUSA

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