St Joseph Mercy Oakland Hospital, Pontiac, MI, USA.
Int J Cardiovasc Imaging. 2012 Oct;28(7):1841-9. doi: 10.1007/s10554-011-0003-3. Epub 2011 Dec 27.
Regadenoson (REG) is a A2a receptor selective pharmacologic SPECT imaging agent. Its safety in unselected chronic obstructive pulmonary disease (COPD) or asthma (AM) undergoing SPECT imaging has not been well evaluated. We retrospectively identified 228 patients (COPD n = 126 and AM n = 102, Grp 1) undergoing REG SPECT from Jan to Nov 2009 and compared to 1,142 patients without COPD and AM (control, Grp 2). A standard 400 μg REG bolus was used and gated Tc-99 m tetrofosmin SPECT done. Patient demographics, REG SPECT data, side effects, arrhythmia occurrences, and any exacerbation of COPD or AM leading to treatment, hospitalization or death were evaluated. The side effect profile of Grp 1 was also compared to a historical cohort who underwent intravenous dipyridamole thallium-201 imaging and adenosine SPECT. Both groups were comparable with regards to baseline characteristics. There was 0% incidence of clinical exacerbation of COPD or AM after REG. COPD patients had more non-significant arrhythmias (58.3% vs. Grp 2, 43%, P = 0.004). There was 0% incidence of any atrio-ventricular block and only 2 instances of brief supraventricular tachycardia. When compared to the historical cohort of COPD who underwent IV dipyridamole thallium imaging, COPD in Grp 1, had more dyspnea and flushing and when compared to COPD/AM patients who underwent adenosine SPECT, Grp 1 pts had more of flushing and headache (24.9% vs. 2.8%, P = <0.001) but less of bronchospasm (1.3% vs. 6.9%, P = 0.022) and AV block (0% vs. 4.2%, P = 0.014). REG SPECT can be safely performed in COPD and AM population.
雷加登松（REG）是一种 A2a 受体选择性药理学单光子发射计算机断层扫描（SPECT）成像剂。尚未充分评估其在未经选择的慢性阻塞性肺疾病（COPD）或哮喘（AM）患者中进行 SPECT 成像的安全性。我们回顾性地确定了 2009 年 1 月至 11 月期间接受 REG SPECT 的 228 名患者（COPD 患者 126 名，AM 患者 102 名，第 1 组），并将其与 1142 名无 COPD 和 AM 的患者（对照组，第 2 组）进行比较。使用标准的 400μg REG 推注，进行门控 Tc-99m 四氟甲氧基磷 SPECT。评估患者的人口统计学数据、REG SPECT 数据、副作用、心律失常的发生以及导致治疗、住院或死亡的 COPD 或 AM 的任何加重情况。还将第 1 组的副作用谱与接受静脉滴注双嘧达莫铊-201 成像和腺苷 SPECT 的历史队列进行了比较。两组在基线特征方面具有可比性。REG 后 COPD 或 AM 的临床加重发生率为 0%。COPD 患者出现更多无意义的心律失常（58.3%比第 2 组，43%，P=0.004）。没有任何房室传导阻滞的发生，仅有 2 例短暂的室上性心动过速。与接受 IV 双嘧达莫铊成像的 COPD 历史队列相比，第 1 组的 COPD 患者出现更多的呼吸困难和潮红，与接受腺苷 SPECT 的 COPD/AM 患者相比，第 1 组的患者出现更多的潮红和头痛（24.9%比 2.8%，P <0.001），但较少的支气管痉挛（1.3%比 6.9%，P=0.022）和房室传导阻滞（0%比 4.2%，P=0.014）。REG SPECT 可安全用于 COPD 和 AM 人群。
