Key result
Weight-based dosing of regadenoson (8 μg/kg) for stress cardiac MRI in children under 40 kg was safe and feasible, with no major adverse events and 19.6% minor adverse events.
Why the study?
To determine the safety and feasibility of stress cardiac MRI using weight-based regadenoson dosing in patients under 40 kg, and whether it affects patient management.
Does stress cardiac MRI using weight-based dosing of regadenoson safely and feasibly guide patient management in infants and young children?
Observational (n=36)
No
Does stress cardiac MRI using weight-based dosing of regadenoson safely and feasibly guide patient management in infants and young children?
Weight-based dosing of regadenoson for stress cardiac MRI is safe and feasible in infants and young children, effectively guiding subsequent clinical management and interventions.
Hypothesis-generating for pediatric stress CMR; should not change practice pending larger prospective studies.
Purpose To determine the safety and feasibility of stress cardiac MRI by using weight-based dosing of regadenoson in patients less than 40 kg and whether stress cardiac MRI affects patient management. Materials and Methods All patients less than 40 kg undergoing stress cardiac MRI by using weight-based dosing (8 μg/kg) of regadenoson were included in this retrospective single-center study. Hemodynamic response, adverse events, and cardiac MRI abnormalities in myocardial perfusion, wall motion, and delayed enhancement were evaluated. Patient management based on the results of the stress cardiac MRI were evaluated. Results Forty-six consecutive stress cardiac MRI examinations were performed in 36 patients (median age, 9.0 years; age range, 2 months to 13.9 years) with congenital and acquired heart disease. Thirty-one of 46 (67.4%) studies were performed with the use of sedation. A myocardial perfusion defect was present in 20 of 46 (43.5%) studies, five with inducible defects only, and the remaining 15 with fixed or irreversible defects. In the 46 total studies, there were no major adverse events and nine (19.6%) minor adverse events including emesis (n = 1) and transient hypotension requiring pharmacologic intervention in eight patients who were all sedated. Sedation was an independent predictor for hypotension (P =.040). Twenty-six negative studies had no coronary interventions performed, and of the 20 positive studies, 15 were referred for catheterization, eight of which underwent coronary interventions. Conclusion Weight-based dosing of regadenoson for stress cardiac MRI was safe and feasible in infants and young children and played an integral role in the outcome and treatment decisions for children with coronary artery disease.
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Wilkinson et al. (2019) conducted an observational in Congenital and acquired heart disease (n=36). Regadenoson was evaluated on Safety and feasibility (hemodynamic response, adverse events, and cardiac MRI abnormalities). Weight-based dosing of regadenoson (8 μg/kg) for stress cardiac MRI in children under 40 kg was safe and feasible, with no major adverse events and 19.6% minor adverse events.
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