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The impact of regimented aminophylline use on extracardiac radioisotope activity in patients undergoing regadenoson stress SPECT myocardial perfusion imaging: A substudy of the ASSUAGE trial

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

In patients undergoing regadenoson stress SPECT myocardial perfusion imaging (MPI), the impact of the regimented administration of aminophylline on the cardiac-to-extracardiac photon activity ratio is unknown.

Methods

This is a substudy of the ASSUAGE trial (NCT01250496); a double-blinded, randomized, placebo-controlled clinical trial which investigated the attenuation of regadenoson-related adverse effects using 75 mg of intravenous aminophylline vs placebo, administered 90 seconds following 99mTc-tetrofosmin injection in patients undergoing regadenoson stress SPECT-MPI. In subjects with normal MPI enrolled in the trial, we sampled from the antero-posterior planar projection of the post-stress scintigraphic data the mean photon activity in the myocardium, liver, bowel, and lungs. The mean cardiac-to-extracardiac activity ratios were compared between patients randomized to aminophylline vs placebo.

Results

We studied 158 eligible subjects, randomized to receive aminophylline (n = 86) or placebo (n = 72). The means of photon activity ratios of the heart-to-liver, heart-to-bowel, heart-to-lungs, inferior wall of the heart-to-liver, and inferior wall of the heart-to-bowel were not statistically different between those who received aminophylline vs placebo (P values > .30). Only the time lapse between stress 99mTc-tetrofosmin injection and stress SPECT acquisition independently correlated with higher heart-to-liver and heart-to-bowel activity ratios (P values ≤ .01). Patients’ body mass index independently correlated with lower heart-to-lung ratio (P = .009).

Conclusion

The regimented intravenous aminophylline use following regadenoson stress does not significantly improve the cardiac-to-extracardiac photon activity ratio in patients undergoing regadenoson stress 99mTc-tetrofosmin SPECT-MPI.

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Disclosure

None.

Conflict of interest

Rami Doukky has served on the Advisory Board of Astellas Pharma, US and received investigator initiated research Grant support from Astellas Pharma, US. No conflicts to be reported by other authors.

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Authors and Affiliations

  1. Division of Adult Cardiology, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA

    Wassim Ballany MD, Khaled Mansour MD, Mohammed Al-Amoodi MD & Rami Doukky MD, MSc, FACC

  2. Department of Pediatrics, University of Illinois, Chicago, IL, USA

    Raysa Morales Demori MD

  3. Division of Cardiology, Rush University Medical Center, 1653 W. Congress Pkwy, Chicago, IL, 60612, USA

    Rami Doukky MD, MSc, FACC

Authors
  1. Wassim Ballany MD
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  2. Khaled Mansour MD
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  3. Raysa Morales Demori MD
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  4. Mohammed Al-Amoodi MD
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  5. Rami Doukky MD, MSc, FACC
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Correspondence to Rami Doukky MD, MSc, FACC.

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Ballany, W., Mansour, K., Morales Demori, R. et al. The impact of regimented aminophylline use on extracardiac radioisotope activity in patients undergoing regadenoson stress SPECT myocardial perfusion imaging: A substudy of the ASSUAGE trial. J. Nucl. Cardiol. 21, 496–502 (2014). https://doi.org/10.1007/s12350-014-9864-x

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  • DOI: https://doi.org/10.1007/s12350-014-9864-x

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