Key result
Regadenoson is a selective A2A adenosine receptor agonist that provides comparable efficacy to adenosine for myocardial perfusion imaging but with fewer side-effects.
Regadenoson is an effective and well-tolerated pharmacological stress agent for myocardial perfusion imaging, particularly useful in patients with reactive airway disease or renal impairment who cannot undergo exercise stress testing.
May aid stress agent selection in MPI for select patients; leaves open prospective outcome trials.
Single-photon emission computerized tomography for myocardial perfusion imaging (MPI) is a non-invasive technique. MPI is performed by subjecting the patient to exercise or by using a pharmacological stress agent. Regadenoson is a selective A 2A adenosine receptor agonist used when MPI with exercise is contraindicated. It binds to the A 2A receptor and stimulates adenylate cyclase, resulting in increased cAMP, which phosphorylates protein kinase A thereby opening the ATP-dependant potassium channels leading to hyperpolarization in the coronary vascular smooth muscle. After a single bolus dose of regadenoson 400 μg, a peak plasma concentration (C max) of 13.6 ng/mL is attained in 1-4 min, with a terminal half-life of 2 h. It has a quick onset, short duration sufficient enough for hyperemic response, with comparable efficacy to adenosine, but with fewer side-effects. The adverse effects of this drug are dyspnea, headache, flushing, chest pain and atrioventricular block. Regadenoson is used for MPI in patients with co-morbid conditions like mild-to-moderate reactive airway disease, obstructive lung disease and renal impairment.
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Bengalorkar et al. (2012) conducted a review in Myocardial perfusion imaging. Regadenoson vs. Adenosine was evaluated. Regadenoson is a selective A2A adenosine receptor agonist that provides comparable efficacy to adenosine for myocardial perfusion imaging but with fewer side-effects.
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