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Regadenoson pharmacologic rubidium-82 PET: A comparison of quantitative perfusion and function to dipyridamole

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Dipyridamole is used for stress 82rubidium chloride (82RbCl) PET because of its long hyperemic duration. Regadenoson has advantages of a fixed dose and favorable symptom profile, but its mean maximal hyperemia is only 2.3 minutes. To determine its suitability for 82RbCl PET, we imaged subjects using a regadenoson protocol based on its hyperemic response and compared the images in the same subjects having dipyridamole PET.

Methods

In 32 subjects (23 M), we assessed visually by blinded interpretation and quantitatively compared summed stress and difference scores, total perfusion deficit (TPD), LVEF, LV volumes, and change in stress-rest function. Linear correlation and Bland-Altman analysis of the paired measurements were applied for evaluation of differences. Paired t test and Pearson’s correlation were applied for testing of significance.

Results

The images were interpreted the same by visual assessment. Twenty-six (26) subjects had reversible defects; by quantitation the SSS was 12.9 ± 7.0 and 14.1 ± 6.4 (P = .23) and SDS was 7.0 ± 6.8 versus 7.6 ± 6.2 (P = .40) for dipyridamole and regadenoson, respectively. Six (6) subjects had <5% likelihood of CAD and were normal by both. All paired measurements showed a high positive correlation between regadenoson and dipyridamole; stress segmental perfusion Reg = 0.93Dip + 4.4, r = 0.88; TPD Reg = 0.94Dip + 0.41, r = 0.93; LVEF Reg = 0.92Dip + 4.7, r = 0.95; stress minus rest LVEF Reg = 0.87Dip − 0.99, r = 0.82.

Conclusion

Regadenoson stress 82RbCl PET perfusion defect and cardiac function measurements are visually and quantitatively equivalent to dipyridamole studies and can be obtained with the clinical advantages of regadenoson.

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Acknowledgments

The authors would like to acknowledge Bai-Ling Hsu, Ph.D. for his valuable contributions to this study.

Disclosure

This work was supported by an Investigator Initiated research grant from Astellas Pharma U.S.

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Correspondence to S. James Cullom PhD.

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Cullom, S.J., Case, J.A., Courter, S.A. et al. Regadenoson pharmacologic rubidium-82 PET: A comparison of quantitative perfusion and function to dipyridamole. J. Nucl. Cardiol. 20, 76–83 (2013). https://doi.org/10.1007/s12350-012-9636-4

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  • DOI: https://doi.org/10.1007/s12350-012-9636-4

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