Division of Cardiovascular Medicine, Cleveland Clinic, Cleveland 44195, OH, USA.
J Nucl Cardiol. 2011 Feb;18(1):90-5. doi: 10.1007/s12350-010-9288-1. Epub 2010 Sep 18.
Regadenoson is a selective A(2A) receptor agonist that is used for vasodilator stress myocardial perfusion imaging (MPI). Since the drug is partially metabolized by the liver, its safety in patients with end-stage liver disease (ESLD) needs to be determined.
We studied 168 consecutive patients with ESLD who had regadenoson stress gated single photon emission computed tomography MPI between January 2008 and March 2010 before planned orthotopic liver transplantation and compared the hemodynamic responses and safety profile to 168 control patients. There were 72 women (43%) in ESLD versus 87 (52%) in the control group (P = .1). The patients with ESLD were younger (58 ± 7 vs 62 ± 12 years, P = .0002), but more likely to be Caucasians (P = .002). The MPI images were normal in 161 patients (96%) in each group. The left ventricular ejection fraction was 72 ± 10% in ESLD and 66 ± 11% in the control patients (P = .0001). The heart rate increase in response to regadenoson was lower in patients with ESLD than in the control group (16 ± 11 vs 23 ± 16 bpm, P = .0001), but the changes in systolic and diastolic blood pressures were similar (-9 ± 12 vs -11 ± 14 mmHg and -6 ± 8 vs -7 ± 10 mmHg, respectively, P = NS). There were no deaths or medication-related adverse events that required hospitalization in either group within 30 days of the study.
This is the first study to document the tolerability and safety profile of regadenoson in patients with ESLD.
雷卡弹酸是一种选择性 A（2A）受体激动剂，用于血管扩张剂应激心肌灌注成像（MPI）。由于该药物部分在肝脏中代谢，因此需要确定其在终末期肝病（ESLD）患者中的安全性。
我们研究了 2008 年 1 月至 2010 年 3 月期间计划进行原位肝移植前的 168 例连续 ESLD 患者，他们接受了雷卡弹酸应激门控单光子发射计算机断层扫描 MPI，并将其与 168 例对照患者的血流动力学反应和安全性特征进行了比较。ESLD 组中有 72 名女性（43％），对照组中有 87 名（52％）（P=.1）。ESLD 患者年龄较小（58 ± 7 岁对 62 ± 12 岁，P=.0002），但更可能是白人（P=.002）。两组患者的 MPI 图像均正常（161 例患者中有 161 例，占 96％）。ESLD 患者的左心室射血分数为 72 ± 10％，对照组为 66 ± 11％（P=.0001）。ESLD 患者对雷卡弹酸的心率反应低于对照组（16 ± 11 比 23 ± 16 bpm，P=.0001），但收缩压和舒张压的变化相似（-9 ± 12 比-11 ± 14 mmHg 和-6 ± 8 比-7 ± 10 mmHg，分别，P= NS）。在研究后 30 天内，两组均无死亡或与药物相关的不良事件需要住院治疗。
这是第一项研究，证明了雷卡弹酸在 ESLD 患者中的耐受性和安全性。
