Brana Quentin, Thibault Frédérique, Courtehoux Maxime, Metrard Gilles, Ribeiro Maria Joao, Angoulvant Denis, Bailly Matthieu
Nuclear Medicine Department, CHR ORLEANS, 14 Avenue de l'Hôpital, 45100, Orleans, France.
Nuclear Medicine Department, CHRU TOURS, Tours, France.
J Nucl Cardiol. 2022 Feb;29(1):113-122. doi: 10.1007/s12350-020-02271-5. Epub 2020 Jul 10.
Regadenoson is a selective adenosine receptor agonist. It is currently unclear if the level of hyperemia differs between stress agents. We compared Myocardial Blood Flow (MBF) and Myocardial Flow Reserve (MFR) response on CZT-SPECT Myocardial Perfusion Imaging (MPI) to evaluate if dipyridamole and regadenoson could induce the same level of hyperemia.
228 patients with dynamic CZT-SPECT MPI were retrospectively analyzed (66 patients stressed with regadenoson and 162 with dipyridamole) in terms of MBF and MFR. To rule out confounding factors, two groups of 41 patients were matched for clinical characteristics in a sub-analysis, excluding high cardiovascular risk patients.
Overall stress MBF was higher in regadenoson patients (1.71 ± 0.73 vs. 1.44 ± 0.55 mL·min·g for regadenoson and dipyridamole, respectively, p < .05). However, when confounding factors were ruled out, stress MBF (1.57 ± 0.56 vs. 1.61 ± 0.62 mL·min·g for dipyridamole and regadenoson, respectively, p = .88) and MFR (2.62 ± 0.77 vs. 2.46 ± 0.76 for dipyridamole and regadenoson, respectively, p = .40) were not different between regadenoson and dipyridamole.
Our results suggest that dipyridamole and regadenoson induce equivalent hyperemia in dynamic SPECT with similar stress MBF and MFR in comparable patients.
瑞加诺生是一种选择性腺苷受体激动剂。目前尚不清楚不同应激剂之间的充血水平是否存在差异。我们比较了CZT单光子发射计算机断层扫描心肌灌注成像（MPI）上的心肌血流量（MBF）和心肌血流储备（MFR）反应，以评估双嘧达莫和瑞加诺生是否能诱导相同程度的充血。
对228例行动态CZT-SPECT MPI的患者（66例接受瑞加诺生应激，162例接受双嘧达莫应激）的MBF和MFR进行回顾性分析。为排除混杂因素，在一项亚分析中对两组各41例患者的临床特征进行匹配，排除心血管高危患者。
总体而言，瑞加诺生组患者应激时的MBF较高（瑞加诺生组和双嘧达莫组分别为1.71±0.73和1.44±0.55 mL·min·g，p<0.05）。然而，排除混杂因素后，双嘧达莫组和瑞加诺生组的应激MBF（分别为1.57±0.56和1.61±0.62 mL·min·g，p = 0.88）和MFR（分别为2.62±0.77和2.46±0.76，p = 0.40）并无差异。
我们的结果表明，在动态SPECT中，双嘧达莫和瑞加诺生在可比患者中诱导相似的应激MBF和MFR，从而产生相当的充血。
