Junpaparp Parichart, Rammohan Harish Raj Seetha, Buppajarntham Saranya, Figueredo Vincent M
Department of Medicine, Albert Einstein Medical Center, Philadelphia, PA, USA.
Department of Cardiology, Albert Einstein Medical Center, Philadelphia, PA, USA.
J Cardiol Cases. 2014 Apr 16;10(2):43-45. doi: 10.1016/j.jccase.2014.03.007. eCollection 2014 Aug.
In 2008, regadenoson, a selective adenosine2A (A) receptor agonist, was approved by the US Federal and Drug Administration for use as a pharmacologic stress agent in myocardial perfusion studies. By stimulating A receptors in coronary smooth muscle, it can increase coronary blood flow by 2.5-fold or greater. Previous data showed non-inferiority of regadenoson in detecting reversible myocardial ischemia, compared to adenosine. Given less serious adverse effects, being better tolerated and easily administered, regadenoson has been widely used for myocardial perfusion imaging. As adenosine receptors have many sub-types and are located in multi-organ systems, regadenoson can cause various adverse effects, including bronchospasm, atrioventricular block, or hypotension. However, adverse effects on the central nervous system are rarely reported. As adenosine receptors (A and A receptors) play a major role in neuron-glial cells interaction, regadenoson can provoke seizure through A receptor activation. We hereby report a case of regadenoson associated-seizure and review seizure mechanism. This may raise more concern for a rare serious adverse effect of regadenoson which should be taken into consideration when selecting cardiac stress modalities. < Regadenoson can provoke seizure through central A receptor activation. This should be taken into consideration when selecting cardiac stress test modalities, particularly in patients with known seizure disorder or history of organic brain disease.>.
2008年，选择性腺苷2A（A2A）受体激动剂瑞加诺生被美国食品药品监督管理局批准用作心肌灌注研究中的药物负荷剂。通过刺激冠状动脉平滑肌中的A2A受体，它可使冠状动脉血流量增加2.5倍或更多。既往数据显示，与腺苷相比，瑞加诺生在检测可逆性心肌缺血方面并不逊色。由于不良反应较轻、耐受性较好且易于给药，瑞加诺生已被广泛用于心肌灌注成像。由于腺苷受体有多种亚型且位于多器官系统中，瑞加诺生可引起多种不良反应，包括支气管痉挛、房室传导阻滞或低血压。然而，对中枢神经系统的不良反应鲜有报道。由于腺苷受体（A1和A2A受体）在神经元-神经胶质细胞相互作用中起主要作用，瑞加诺生可通过激活A2A受体诱发癫痫发作。我们在此报告一例瑞加诺生相关性癫痫发作病例并回顾癫痫发作机制。这可能会引发对瑞加诺生一种罕见严重不良反应的更多关注，在选择心脏负荷方式时应予以考虑。<瑞加诺生可通过激活中枢A2A受体诱发癫痫发作。在选择心脏负荷试验方式时应予以考虑，尤其是对于已知有癫痫发作疾病或有器质性脑病史的患者。>
