肺动脉高压患者使用雷加腺苷进行应激试验的安全性。
Safety of regadenoson stress testing in patients with pulmonary hypertension.
机构信息
Division of Cardiovascular Medicine, Department of Internal Medicine and Frankel Cardiovascular Center, University of Michigan, 2nd Floor CVC / SPC 5853, 1500 E. Medical Center Dr.,, Ann Arbor, MI, 48109-5853, USA.
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
出版信息
J Nucl Cardiol. 2018 Jun;25(3):820-827. doi: 10.1007/s12350-016-0734-6. Epub 2016 Nov 28.
OBJECTIVES
We sought to determine the safety of regadenoson stress testing in patients with PH.
BACKGROUND
PH is increasingly recognized at more advanced ages. As many as one-third of patients with PH have coronary artery disease. Because of their physical limitations, patients with PH are unable to adequately exercise. Regadenoson can potentially have an adverse impact due to their tenuous hemodynamics. Current guidelines suggest performing a coronary angiography in patients with PH who have angina or multiple coronary risk factors.
METHODS
We identified 67 consecutive patients with confirmed PH by catheterization (mean PA > 25 mmHg not due to left heart disease) who underwent MPI with regadenoson stress. Medical records were reviewed to determine hemodynamic and ECG response to regadenoson.
RESULTS
No serious events occurred. Common side effects related to regadenoson were observed, dyspnea being the most common (70.6%). No syncope occurred. Heart rate increased from 74.6 ± 14 to 96.3 ± 18.3 bpm, systolic blood pressure increased from 129.8 ± 20.9 to 131.8 ± 31 mmHg, and diastolic blood pressure decreased from 77.1 ± 11.4 to 72.9 ± 15.3 mmHg. There was no ventricular tachycardia, ventricular fibrillation, or second- or third-degree atrioventricular block.
CONCLUSION
Regadenoson stress MPI appears to be well tolerated and safe in patients with PH.
目的
我们旨在确定 PH 患者接受瑞加德松负荷试验的安全性。
背景
PH 在年龄较大时越来越被认识到。多达三分之一的 PH 患者患有冠状动脉疾病。由于身体限制，PH 患者无法充分运动。由于血流动力学不稳定，瑞加德松可能会产生不良影响。目前的指南建议对有胸痛或多种冠状动脉危险因素的 PH 患者进行冠状动脉造影。
方法
我们通过导管插入术确定了 67 例经证实的 PH 连续患者（平均肺动脉压>25mmHg ，但不由于左心疾病引起），他们接受了瑞加德松负荷 MPI。回顾病历以确定瑞加德松对血流动力学和心电图的反应。
结果
没有发生严重事件。观察到与瑞加德松相关的常见副作用，呼吸困难最为常见（70.6%）。没有发生晕厥。心率从 74.6±14 次/分增加到 96.3±18.3 次/分，收缩压从 129.8±20.9 毫米汞柱增加到 131.8±31 毫米汞柱，舒张压从 77.1±11.4 毫米汞柱降低到 72.9±15.3 毫米汞柱。没有室性心动过速、心室颤动或二度或三度房室传导阻滞。
结论
瑞加德松负荷 MPI 似乎在 PH 患者中耐受良好且安全。
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