Regadenoson Induces Comparable Left Ventricular Perfusion Defects as AdenosineA Quantitative Analysis From the ADVANCE MPI 2 Trial
John J. Mahmarian, MD*,*,
Manuel D. Cerqueira, MD ,
Ami E. Iskandrian, MD ,
Timothy M. Bateman, MD ,
Gregory S. Thomas, MD, MPH||,
Robert C. Hendel, MD¶,
Lemuel A. Moye, MD, PhD#,
Ann W. Olmsted, PhD**
* Methodist DeBakey Heart and Vascular Center, Houston, Texas
Cleveland Clinic, Cleveland, Ohio
University of Alabama at Birmingham, Birmingham, Alabama
Mid America Heart Institute of Saint Luke's Hospital, Kansas City, Missouri
|| University of California, Irvine, Orange, California
¶ Midwest Heart Specialists, Winfield, Illinois
# University of Texas School of Public Health, Houston, Texas
** CV Therapeutics, Inc., Palo Alto, California
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Figure 1 Linear Regression Analysis of Serial Adenosine–Regadenoson SPECT Results
Excellent agreement is seen between the adenosine and regadenoson induced total (A) and ischemic (B) perfusion defect size (PDS) results. SPECT = single-photon emission computed tomography.
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Figure 2 Absolute Differences in Serial Imaging Results
Shown are differences ( ) in total perfusion defect size (PDS) (A) and ischemic PDS (B) from the initial adenosine study (Ad1) to the regadenoson study. The differences reflect a typical Gaussian distribution. – = decrease in PDS with regadenoson; + = increase in PDS with regadenoson; NL = normal.
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Figure 3 Scintigraphic Results in Patients With a Visually Abnormal Baseline Perfusion study
Serial mean total and ischemic left ventricular (LV) perfusion defect size (PDS) results are shown for the entire cohort and the 2 randomized groups. p = not significant, all comparisons study 1 to study 2.
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Figure 4 Representative Patient Example
The reoriented adenosine, regadenoson, and rest images are displayed in the short, vertical long, and horizontal long axes. The polar maps for adenosine and regadenoson both show a total perfusion defect size (PDS) of 40% with 27% ischemia (adenosine) and 25% ischemia (regadenoson) (green).
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