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Katherine N Gharibian, Venkatesh L Murthy, Bruce A Mueller
BACKGROUND: Regadenoson is a novel pharmacological stress agent whose disposition during hemodialysis is not known. The purpose of this study was to determine the clearance of regadenoson under varying dialytic conditions using an in vitro hemodialysis model. METHODS AND RESULTS: Whole human blood was used to analyze the effect of hemodialysis on the clearance of regadenoson. Regadenoson transmembrane clearance (CLD) was assessed for both a standard permeability and a high permeability polysulfone hemodialyzer with blood/dialysate flow rates of 300/600 and 400/800 mL/min...
September 15, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Francesco Maffessanti, Amit R Patel, Mita B Patel, James J Walter, Anuj Mediratta, Diego Medvedofsky, Nadjia Kachenoura, Roberto M Lang, Victor Mor-Avi
AIMS: Abnormal computed tomography coronary angiography (CTCA) often leads to stress testing to determine haemodynamic significance of stenosis. We hypothesized that instead, this could be achieved by fusion imaging of the coronary anatomy with 3D echocardiography (3DE)-derived resting myocardial deformation. METHODS AND RESULTS: We developed fusion software that creates combined 3D displays of the coronary arteries with colour maps of longitudinal strain and tested it in 28 patients with chest pain, referred for CTCA (256 Philips scanner) who underwent 3DE (Philips iE33) and regadenoson stress CT...
July 26, 2016: European Heart Journal Cardiovascular Imaging
Yafim Brodov, Mathews Fish, Mathieu Rubeaux, Yuka Otaki, Heidi Gransar, Mark Lemley, Jim Gerlach, Daniel Berman, Guido Germano, Piotr Slomka
BACKGROUND: Ejection fraction (EF) reserve has been found to be a useful adjunct for identifying high risk coronary artery disease in cardiac positron emission tomography (PET). We aimed to evaluate EF reserve obtained from technetium-99m sestamibi (Tc-99m) high-efficiency (HE) SPECT. METHODS: Fifty patients (mean age 69 years) undergoing regadenoson same-day rest (8-11 mCi)/stress (32-42 mCi) Tc-99m gated HE SPECT were enrolled. Stress imaging was started 1 minute after sequential intravenous regadenoson ...
July 7, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Ines Valenta, Alexander Antoniou, Wael Marashdeh, Thorsten Leucker, Edward Kasper, Steven R Jones, Robert F Dannals, Lilja Solnes, Martin G Pomper, Thomas H Schindler
AIMS: We aimed to evaluate whether a PET-determined longitudinal decrease in myocardial blood flow (MBF) or gradient, assumed as a more specific flow parameter for epicardial resistance, correlates with invasively measured fractional flow reserve (FFR) in coronary artery disease (CAD) patients. METHODS AND RESULTS: In 29 patients with suspected or known CAD, myocardial perfusion and MBF in mL/g/min was determined with (13)N-ammonia PET/CT during regadenoson stimulation and at rest, and corresponding myocardial flow reserve (MFR = MBF stress/MBF rest) was calculated...
June 19, 2016: European Heart Journal Cardiovascular Imaging
Zenith A Jameria, Mouhamad Abdallah, Alok Dwivedi, Erica Washburn, Naseer Khan, Mahyar Khaleghi, Nischelle Kalakota, Myron C Gerson
BACKGROUND: Transient ischemic dilation (TID) of the left ventricle (LV) has not been validated as a marker of extensive coronary artery disease (CAD) for studies using a cadmium-zinc-telluride (CZT) camera with upright imaging. METHODS: TID ratios were obtained from upright stress and rest images on a CZT camera. Separate cut-off values were determined for exercise and for regadenoson stress. The cutoffs were then applied to 28 patients with extensive CAD and 101 patients without extensive CAD...
June 16, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Bunyen Teng, Stephen L Tilley, Catherine Ledent, S Jamal Mustafa
Bolus injections of adenosine and the A2A adenosine receptor (AR) selective agonist (regadenoson) are used clinically as a substitute for a stress test in people who cannot exercise. Using isolated tissue preparations, our lab has shown that coronary flow and cardiac effects of adenosine are mostly regulated by the AR subtypes A1, A2A, and A2B In this study, we used ultrasound imaging to measure the in vivo effects of adenosine on coronary blood flow (left coronary artery) and cardiac function in anesthetized wild-type, A1 knockout (KO), A2AKO, A2BKO, A3KO, A1, and A3 double KO (A1/3 DKO) and A2A and A2B double KO (A2A/2B DKO) mice in real time...
June 2016: Physiological Reports
Javier Gomez, Ibtihaj Fughhi, Tania Campagnoli, Amjad Ali, Rami Doukky
BACKGROUND: We investigated whether integrating heart rate response (HRR) to regadenoson with myocardial perfusion imaging (MPI) analysis can enhance risk prediction in end-stage renal disease (ESRD) patients. METHODS AND RESULTS: We prospectively followed 303 ESRD patients after regadenoson stress MPI for a mean of 35 months. Normal HRR to regadenoson was defined as ≥28% increase from baseline. Normal MPI was defined as a summed stress score ≤3 and left ventricular ejection fraction ≥50%...
June 1, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Ibtihaj Fughhi, Tania Campagnoli, Amjad Ali, Rami Doukky
BACKGROUND: In patients undergoing regadenoson SPECT myocardial perfusion imaging (MPI), it is unknown how soon and at which dose intravenous aminophylline can be administered to reverse regadenoson-related adverse effects without blunting stress-induced myocardial ischemia. METHODS AND RESULTS: We analyzed the pooled database of the ASSUAGE and ASSUAGE-CKD trials (n = 548). These were double-blinded, placebo-controlled, randomized clinical trials in which 75 mg of aminophylline or placebo was administered intravenously 90 seconds following (99m)Tc-tetrofosmin injection...
May 27, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
C Salgado-Garcia, A Jimenez-Heffernan, C Ramos-Font, J Lopez-Martin, E Sanchez-de-Mora, T Aroui, R Lopez-Aguilar, F Rivera-de-Los-Santos, C Ruiz-Frutos
OBJECTIVE: To assess the safety of regadenoson, a selective agonist of A2A adenosine receptors, combined with low-level exercise in subjects with severe chronic obstructive pulmonary disease (COPD), referred for myocardial perfusion imaging (MPI). METHODS: We studied prospectively 12 male patients with severe COPD. Stress was 4min of low-level exercise with bolus injection of regadenoson (0.4mg) at 1.5min, followed by (99m)Tc-MPI agent injection. Demographics, medical history, lung medications, adverse events, oxygen saturation (SatO2), MPI findings for coronary artery disease (CAD), and changes in systolic blood pressure (SBP), and heart rate (HR) were registered...
September 2016: Revista Española de Medicina Nuclear e Imagen Molecular
Victor Mor-Avi, Nadjia Kachenoura, Francesco Maffessanti, Nicole M Bhave, Steven Port, Joseph A Lodato, Sonal Chandra, Benjamin H Freed, Roberto M Lang, Amit R Patel
BACKGROUND: There is no accepted methodology for CT-based vasodilator stress myocardial perfusion imaging and analysis. We developed a technique for quantitative 3D analysis of CT images, which provides several indices of myocardial perfusion. We sought to determine the ability of these indices during vasodilator stress to identify segments supplied by coronary arteries with obstructive disease and to test the accuracy of the detection of perfusion abnormalities against SPECT. METHODS: We studied 93 patients referred for CT coronary angiography (CTCA) who underwent regadenoson stress...
May 2016: European Journal of Radiology
Efstathia Andrikopoulou, Wael A AlJaroudi, Ayman Farag, Davis Lester, Hiren Patel, Ami E Iskandrian, Fadi G Hage
PURPOSE: The heart rate response (HRR, percentage change from baseline) to regadenoson during myocardial perfusion imaging (MPI) can provide incremental prognostic value in patients with known or suspected coronary artery disease. Our purpose was to evaluate the variability and prognostic value of HRR on serial measurements. METHODS: We studied 648 consecutive patients (61 ± 11 years, 48 % with diabetes) who underwent two regadenoson MPI studies (16 ± 9 months between studies)...
July 2016: European Journal of Nuclear Medicine and Molecular Imaging
Aaron F Jolly, Gregory S Thomas
No abstract text is available yet for this article.
April 12, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Jesse A Doran, Waseem Sajjad, Marabel D Schneider, Rohit Gupta, Maria L Mackin, Ronald G Schwartz
BACKGROUND: Aminophylline shortages led us to compare intravenous (IV) aminophylline with IV and oral (PO) caffeine during routine pharmacologic stress testing with SPECT MPI. METHODS: We measured presence, duration, and reversal of adverse symptoms and cardiac events following regadenoson administration in consecutive patients randomized to IV aminophylline (100 mg administered over 30-60 seconds), IV caffeine citrate (60 mg infused over 3-5 minutes), or PO caffeine as coffee or diet cola...
March 29, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Nasir Hussain, Waseem Chaudhry, Alan W Ahlberg, Richard S Amara, Ahmed Elfar, Matthew W Parker, John A Savino, Ruwanthi Titano, Milena J Henzlova, William L Duvall
BACKGROUND: Increasing numbers of patients are undergoing transcatheter aortic valve replacement, which often involves assessment of coronary artery disease ischemic burden. The safety and diagnostic accuracy of vasodilator stress agents in patients with severe aortic stenosis (AS) undergoing SPECT myocardial perfusion imaging (MPI) has not been established. METHODS: Patients with severe AS (valve area <1 cm(2)) on echocardiography who underwent vasodilator stress SPECT MPI at two centers were identified...
March 15, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Andrew Van Tosh, Nathaniel Reichek, Christopher J Palestro, Kenneth J Nichols
UNLABELLED: Algorithms are able to compute myocardial blood flow (MBF) from dynamic PET data for each of the 17 left ventricular segments, with global MBF obtained by averaging segmental values. This study was undertaken to compare MBFs with and without the basal-septal segments. METHODS: Data were examined retrospectively for 196 patients who underwent rest and regadenoson-stress (82)Rb PET/CT scanning for evaluation of known or suspected coronary artery disease...
June 2016: Journal of Nuclear Medicine Technology
Marianne Pape, Helle D Zacho, Jens Aarøe, Svend Eggert Jensen, Lars J Petersen
OBJECTIVES: Evaluating safety and tolerability of the selective A2A receptor agonist, regadenoson, in patients referred for single photon emission computed tomography myocardial perfusion imaging (MPI). DESIGN: Observational study of patients referred for MPI stress testing using a 400 μg regadenoson (Rapiscan(®)) bolus. Hemodynamic variables and severity of adverse events (AE) were recorded before, during, and after administration. RESULTS: A total of 232 patients were included...
June 2016: Scandinavian Cardiovascular Journal: SCJ
Mridula Rai, Alan W Ahlberg, Julianna Marwell, Waseem Chaudhary, John A Savino, Eric L Alter, Milena J Henzlova, W Lane Duvall
BACKGROUND: While adenosine and dipyridamole as myocardial perfusion imaging (MPI) stress agents have literature supporting their safety in the setting of myocardial infarction (MI), regadenoson does not. Studying a high risk cohort of patients with elevated cardiac biomarkers may shed light on potential safety issues of these agents which might also affect lower risk cohorts. METHODS: All patients who had undergone a clinically indicated stress MPI study at two academic centers from 1/1/2010 through 12/31/2012 with elevated troponin ≤7 days prior to testing were included...
February 22, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Sara Seitun, Margherita Castiglione Morelli, Irilda Budaj, Sara Boccalini, Athena Galletto Pregliasco, Alberto Valbusa, Filippo Cademartiri, Carlo Ferro
Since its introduction about 15 years ago, coronary computed tomography angiography has become today the most accurate clinical instrument for noninvasive assessment of coronary atherosclerosis. Important technical developments have led to a continuous stream of new clinical applications together with a significant reduction in radiation dose exposure. Latest generation computed tomography scanners (≥ 64 slices) allow the possibility of performing static or dynamic perfusion imaging during stress by using coronary vasodilator agents (adenosine, dipyridamole, or regadenoson), combining both functional and anatomical information in the same examination...
February 2016: Revista Española de Cardiología
Gregory S Thomas, Aaron F Jolly, Michael Safani
No abstract text is available yet for this article.
December 29, 2015: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Heidi L Brink, Jennifer A Dickerson, Julie A Stephens, Kerry K Pickworth
STUDY OBJECTIVE: To compare the adverse effect profiles of adenosine and regadenoson in patients undergoing outpatient cardiac stress testing. DESIGN: Single-center retrospective cohort study. SETTING: Two outpatient clinics, both of which are part of a single tertiary academic medical health system; one clinic exclusively used adenosine for cardiac stress testing, and the other clinic exclusively used regadenoson. PATIENTS: A total of 489 patients who underwent an outpatient cardiac stress test between January 1, 2014, and December 31, 2014; of those patients, 254 received adenosine and 235 received regadenoson...
December 2015: Pharmacotherapy
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