Salgado-Garcia C, Jimenez-Heffernan A, Ramos-Font C, Lopez-Martin J, Sanchez-de-Mora E, Aroui T, Lopez-Aguilar R, Rivera-de-Los-Santos F, Ruiz-Frutos C
Servicio de Medicina Nuclear, Hospital Juan Ramón Jiménez, Complejo Hospitalario Universitario de Huelva, Ronda Norte, s/n, 21005 Huelva, Spain.
Servicio de Medicina Nuclear, Hospital Juan Ramón Jiménez, Complejo Hospitalario Universitario de Huelva, Ronda Norte, s/n, 21005 Huelva, Spain.
Rev Esp Med Nucl Imagen Mol. 2016 Sep-Oct;35(5):283-6. doi: 10.1016/j.remn.2016.03.005. Epub 2016 May 6.
To assess the safety of regadenoson, a selective agonist of A2A adenosine receptors, combined with low-level exercise in subjects with severe chronic obstructive pulmonary disease (COPD), referred for myocardial perfusion imaging (MPI).
We studied prospectively 12 male patients with severe COPD. Stress was 4min of low-level exercise with bolus injection of regadenoson (0.4mg) at 1.5min, followed by (99m)Tc-MPI agent injection. Demographics, medical history, lung medications, adverse events, oxygen saturation (SatO2), MPI findings for coronary artery disease (CAD), and changes in systolic blood pressure (SBP), and heart rate (HR) were registered.
The observed adverse event profile of regadenoson was similar to that of patients with mild-moderate COPD. There was no clinical exacerbation of COPD. Adverse events were self-limiting: dyspnea (33.3%), fatigue (25.0%), chest pain, headache (16.7%, respectively), and gastrointestinal discomfort, dry mouth, flushing, feeling hot and dizziness (8.3%, respectively). 25.0% of patients did not report any symptoms. We observed significant increases in SBP and HR from baseline (142.6mmHg±22.3 vs 152.5mmHg±18.5, and 80 b.p.m.±18 vs 105 b.p.m.±22, respectively; p<0.05).
Regadenoson combined with low-level exercise is safe and well tolerated in stable patients with severe COPD undergoing MPI.
评估选择性A2A腺苷受体激动剂瑞加诺生联合低强度运动应用于因心肌灌注成像（MPI）而转诊的重度慢性阻塞性肺疾病（COPD）患者的安全性。
我们前瞻性研究了12例重度COPD男性患者。应激方式为低强度运动4分钟，在运动1.5分钟时静脉推注瑞加诺生（0.4mg），随后注射（99m）Tc-MPI剂。记录人口统计学资料、病史、肺部用药情况、不良事件、血氧饱和度（SatO2）、冠心病（CAD）的MPI检查结果以及收缩压（SBP）和心率（HR）的变化。
观察到的瑞加诺生不良事件谱与轻中度COPD患者相似。未出现COPD临床加重情况。不良事件均为自限性：呼吸困难（33.3%）、疲劳（25.0%）、胸痛、头痛（均为16.7%）以及胃肠道不适、口干、潮红、发热感和头晕（均为8.3%）。25.0%的患者未报告任何症状。我们观察到SBP和HR较基线显著升高（分别为142.6mmHg±22.3 vs 152.5mmHg±18.5，以及80次/分钟±18 vs 105次/分钟±22；p<0.05）。
对于接受MPI检查的重度COPD稳定期患者，瑞加诺生联合低强度运动是安全的，且耐受性良好。
