open access

Vol 78, No 7-8 (2020)
Original article
Published online: 2020-05-12
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Safety of regadenoson with theophylline reversal during dynamic computed tomography perfusion and magnetic resonance imaging in patients with coronary artery disease

Anna Oleksiak, Mariusz Kruk, Mateusz Śpiewak, Barbara Miłosz-Wieczorek, Magdalena Marczak, Marcin Demkow, Cezary Kępka
DOI: 10.33963/KP.15356
·
Pubmed: 32395975
·
Kardiol Pol 2020;78(7-8):709-714.

open access

Vol 78, No 7-8 (2020)
Original article
Published online: 2020-05-12

Abstract

Background: The use of regadenoson in dynamic computed tomography perfusion (CTP) and magnetic resonance myocardial perfusion imaging (MR MPI) is off‑label.

Aims: The study aimed to assess the safety of regadenoson with theophylline reversal during CTP and MR MPI in patients with coronary artery disease (CAD).

Methods: In this prospective study, patients with 1 or more intermediate coronary artery stenoses on computed tomography angiography underwent CTP and MR MPI with 0.4 mg of regadenoson. After examinations, 200 mg of theophylline was given intravenously in 100 ml of saline. Changes in blood pressure (BP) and heart rate (HR) were repeatedly assessed. All side effects and adverse events were recorded.

Results: Out of 106 examinations in 53 patients (25 females, 63.5 [8.5] years), all were diagnostic. There were no deaths, myocardial infarctions, severe arrhythmias, high‑grade atrioventricular blocks, or bronchospasms. The most common symptoms were palpitations (17%), hot flushing (8%), chest discomfort (4%), and mild dyspnea (3%). There were no differences between baseline and peak BP. There was an increase in median (interquartile range) peak HR after regadenoson as compared with baseline (MR MPI, 63 [59–75] bpm vs 93 [86–102] bpm; P < 0.001; and CTP, 65 [60–70] bpm vs 95 [86–107] bpm; P < 0.001). The hemodynamic response to regadenoson and its side effects were completely reversible by theophylline.

Conclusions: Regadenoson may be a safe vasodilator for CTP and MR MPI in patients with CAD. The administration of theophylline after perfusion is safe and reverses side effects of regadenoson.

Abstract

Background: The use of regadenoson in dynamic computed tomography perfusion (CTP) and magnetic resonance myocardial perfusion imaging (MR MPI) is off‑label.

Aims: The study aimed to assess the safety of regadenoson with theophylline reversal during CTP and MR MPI in patients with coronary artery disease (CAD).

Methods: In this prospective study, patients with 1 or more intermediate coronary artery stenoses on computed tomography angiography underwent CTP and MR MPI with 0.4 mg of regadenoson. After examinations, 200 mg of theophylline was given intravenously in 100 ml of saline. Changes in blood pressure (BP) and heart rate (HR) were repeatedly assessed. All side effects and adverse events were recorded.

Results: Out of 106 examinations in 53 patients (25 females, 63.5 [8.5] years), all were diagnostic. There were no deaths, myocardial infarctions, severe arrhythmias, high‑grade atrioventricular blocks, or bronchospasms. The most common symptoms were palpitations (17%), hot flushing (8%), chest discomfort (4%), and mild dyspnea (3%). There were no differences between baseline and peak BP. There was an increase in median (interquartile range) peak HR after regadenoson as compared with baseline (MR MPI, 63 [59–75] bpm vs 93 [86–102] bpm; P < 0.001; and CTP, 65 [60–70] bpm vs 95 [86–107] bpm; P < 0.001). The hemodynamic response to regadenoson and its side effects were completely reversible by theophylline.

Conclusions: Regadenoson may be a safe vasodilator for CTP and MR MPI in patients with CAD. The administration of theophylline after perfusion is safe and reverses side effects of regadenoson.

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About this article
Title

Safety of regadenoson with theophylline reversal during dynamic computed tomography perfusion and magnetic resonance imaging in patients with coronary artery disease

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 78, No 7-8 (2020)

Article type

Original article

Pages

709-714

Published online

2020-05-12

Page views

280

Article views/downloads

277

DOI

10.33963/KP.15356

Pubmed

32395975

Bibliographic record

Kardiol Pol 2020;78(7-8):709-714.

Authors

Anna Oleksiak
Mariusz Kruk
Mateusz Śpiewak
Barbara Miłosz-Wieczorek
Magdalena Marczak
Marcin Demkow
Cezary Kępka

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