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Safety of regadenoson positon emission tomography stress testing in orthotopic heart transplant patients

  • John J. LazarusEmail author
  • Ashraf Saleh
  • Michael Ghannam
  • Keith Aaronson
  • Monica Colvin
  • Frank Pagani
  • Todd Koelling
  • James R. Corbett
  • Richard L. Weinberg
  • Venkatesh L. Murthy
  • Matthew C. Konerman
Original Article

Abstract

Objectives

We sought to determine the safety of regadenoson (REG) stress testing in patients who have undergone orthotopic heart transplantation (OHT).

Background

Routine screening for cardiac allograft vasculopathy (CAV) is necessary after OHT. Adenosine stress is contraindicated after heart transplantation due to supersensitivity in denervated hearts. Safety of regadenoson stress following OHT has not been well studied.

Methods

We retrospectively reviewed data from OHT patients (N = 123) who were referred to REG stress testing. Medical records were reviewed to determine hemodynamic and ECG response to regadenoson and to identify adverse reactions.

Results

No serious adverse events occurred. No life-threatening arrhythmias or hemodynamic changes occurred. Common side-effects related to regadenoson were observed, dyspnea being the most frequent (66.7%). On average the heart rate rose from 82.8 ± 12 to 95.7 ± 13.4 bpm (P < 0.001), systolic blood pressure decreased from 138.7 ± 20.9 to 115.9 ± 23.9 mmHg (P < 0.001) and mean arterial pressure decreased from 103.5 ± 14.1 to 84.72 ± 15.90 mmHg (P < 0.001) during stress protocol. There was no sustained ventricular tachycardia, ventricular fibrillation, or second-or third-degree atrioventricular block.

Conclusion

Regadenoson stress testing appears to be well tolerated and safe in OHT patients.

Keywords

Positon emission tomography pharmacologic stress cardiac transplantation regadenoson safety heart failure 

Abbreviations

CAV

Cardiac allograft vasculopathy

OHT

Orthotropic heart transplant

IVUS

Coronary intravascular ultrasound

REG

Regadenoson

PET

Positron emission tomography and myocardial perfusion imaging using regadenoson

VT

Ventricular tachycardia

VF

Ventricular fibrillation

Notes

Acknowledgements

Dr. Murthy is supported by 1R01HL136685 from the National, Heart, Lung, and Blood Institute. Dr. Murthy has received consulting/speaking fees from Bracco Diagnostics and Ionetix. Dr. Murthy owns stock in General Electric.

Disclosures

Keith Aaronson has received consultant or speaking fees from Medtronic, NuPulseCV and has stock options with ProCyrion and NuPulseCV. He has received grants or grants pending from Amgen, Medtronic and Thoratec. Venkatesh L. Murthy has received consulting/speaking fees from Bracco Diagnostics and Ionetix. He owns stock in General Electric. John J. Lazarus, Ashraf Saleh, Michael Ghannam, Monica Colvin, Frank Pagani, Todd Koelling, James R. Corbett, Richard L. Weinberg, and Matthew C. Konerman have no reported conflicts of interest.

Supplementary material

12350_2018_1466_MOESM1_ESM.pptx (149 kb)
Supplementary material 1 (PPTX 148 kb)

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Copyright information

© American Society of Nuclear Cardiology 2018

Authors and Affiliations

  • John J. Lazarus
    • 1
    Email author
  • Ashraf Saleh
    • 1
  • Michael Ghannam
    • 1
  • Keith Aaronson
    • 1
  • Monica Colvin
    • 1
  • Frank Pagani
    • 1
  • Todd Koelling
    • 1
  • James R. Corbett
    • 1
  • Richard L. Weinberg
    • 1
  • Venkatesh L. Murthy
    • 1
  • Matthew C. Konerman
    • 1
  1. 1.University of Michigan Frankel Cardiovascular CenterAnn ArborUSA

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