Regadenoson pharmacologic rubidium-82 PET: a comparison of quantitative perfusion and function to dipyridamole.

Abstract

BACKGROUND:

Dipyridamole is used for stress (82)rubidium chloride ((82)RbCl) PET because of its long hyperemic duration. Regadenoson has advantages of a fixed dose and favorable symptom profile, but its mean maximal hyperemia is only 2.3 minutes. To determine its suitability for (82)RbCl PET, we imaged subjects using a regadenoson protocol based on its hyperemic response and compared the images in the same subjects having dipyridamole PET.

METHODS:

In 32 subjects (23 M), we assessed visually by blinded interpretation and quantitatively compared summed stress and difference scores, total perfusion deficit (TPD), LVEF, LV volumes, and change in stress-rest function. Linear correlation and Bland-Altman analysis of the paired measurements were applied for evaluation of differences. Paired t test and Pearson's correlation were applied for testing of significance.

RESULTS:

The images were interpreted the same by visual assessment. Twenty-six (26) subjects had reversible defects; by quantitation the SSS was 12.9 ± 7.0 and 14.1 ± 6.4 (P = .23) and SDS was 7.0 ± 6.8 versus 7.6 ± 6.2 (P = .40) for dipyridamole and regadenoson, respectively. Six (6) subjects had <5% likelihood of CAD and were normal by both. All paired measurements showed a high positive correlation between regadenoson and dipyridamole; stress segmental perfusion Reg = 0.93Dip + 4.4, r = 0.88; TPD Reg = 0.94Dip + 0.41, r = 0.93; LVEF Reg = 0.92Dip + 4.7, r = 0.95; stress minus rest LVEF Reg = 0.87Dip - 0.99, r = 0.82.

CONCLUSION:

Regadenoson stress (82)RbCl PET perfusion defect and cardiac function measurements are visually and quantitatively equivalent to dipyridamole studies and can be obtained with the clinical advantages of regadenoson.

• Authors: S James Cullom, James A Case, Staci A Courter, A Iain McGhie, Timothy M Bateman
• Journal: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology (J Nucl Cardiol) Vol. 20 Issue 1 Pg. 76-83 (Feb 2013) ISSN: 1532-6551 [Electronic] United States
• PMID: 23188625 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Chlorides
• Purines
• Pyrazoles
• Radiopharmaceuticals
• Rubidium Radioisotopes
• regadenoson
• Dipyridamole
• Rubidium
• rubidium chloride

Topics

• Aged
• Blood Pressure
• Body Mass Index
• Chlorides (pharmacology)
• Dipyridamole
• Exercise Test
• Female
• Hemodynamics
• Humans
• Image Processing, Computer-Assisted
• Male
• Middle Aged
• Myocardial Perfusion Imaging (methods)
• Perfusion
• Positron-Emission Tomography (methods)
• Purines
• Pyrazoles
• Radiopharmaceuticals
• Rubidium (pharmacology)
• Rubidium Radioisotopes
• Ventricular Function, Left