负荷心肌灌注成像期间瑞加诺生和双嘧达莫安全性的比较
Comparison of Regadenoson and Dipyridamole Safety Profiles During Stress Myocardial Perfusion Imaging.
作者信息
Roczniak Jan, Bączalska Justyna, Kanclerz Gabriela, Zielińska Weronika, Ożga Joanna, Cymerman Błażej, Stępień Agnieszka, Kostkiewicz Magdalena, Holcman Katarzyna
机构信息
Jagiellonian University Medical College, Students' Scientific Group Medical Imaging in Cardiology, Kraków, Poland.
John Paul II Hospital, Jagiellonian University Medical College, Department of Cardiac and Vascular Diseases, Kraków, Poland.
出版信息
Mol Imaging Radionucl Ther. 2023 Jun 20;32(2):131-137. doi: 10.4274/mirt.galenos.2022.72593.
OBJECTIVES
The pharmacological stress test with vasodilator agents is an alternative cardiological diagnostic tool for patients with contraindications to the classical stress test provided by physical activity during single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). The study compared the frequency of the side effects of regadenoson and dipyridamole during a SPECT MPI.
METHODS
This retrospective study included data of 283 consecutive patients who underwent pharmacological stress tests in years 2015-2020. The study group consisted of 240 patients who had received dipyridamole and 43 patients who had received regadenoson. The collected data included the patients' characteristics, the occurrence of side effects (divided into mild: headache, vertigo, nausea, vomiting, dyspnea, chest discomfort, hot flushes, general weakness and severe: bradycardia, hypotension, loss of consciousness), and blood pressure values/measurements.
RESULTS
Overall, complications occurred relatively often (regadenoson: 23.2%, dipirydamol: 26.7%, p=0.639). Procedure discontinuation was necessary in 0.7% of examinations, whereas pharmacological support was necessary in 4.7%. There was no difference in the prevalence of mild (regadenoson: 16.2%, dipirydamol: 18.3%, p=0.747) and severe complications (regadenoson: 11.6%, dipyridamole: 15.0%, p=0.563). However, regadenoson has been found to cause a significantly smaller mean decrease of systolic blood pressure (SBP) (regadenoson: -2.6±10.0 mmHg, dipyridamole: -8.7±9.6 mmHg, p=0.002), diastolic blood pressure (DBP) (regadenoson: -0.9±5.4 mmHg, dipyridamole: -3.6±6.2 mmHg, p=0.032), as well as mean arterial pressure (MAP) (regadenoson: -1.5±5.6 mmHg, dipyridamole: -5.4±6.5 mmHg, p=0.001).
CONCLUSION
Regadenoson and dipyridamole presented a similar safety profile during SPECT MPI. However, regadenoson has been found to cause significantly smaller decreases in SBP, DBP, and MAP.
目的
对于在单光子发射计算机断层扫描（SPECT）心肌灌注成像（MPI）期间因身体活动进行经典负荷试验存在禁忌证的患者，使用血管扩张剂进行药物负荷试验是一种替代性的心脏病诊断工具。本研究比较了在SPECT MPI期间瑞加诺生和双嘧达莫的副作用发生频率。
方法
这项回顾性研究纳入了2015年至2020年期间连续接受药物负荷试验的283例患者的数据。研究组包括240例接受双嘧达莫的患者和43例接受瑞加诺生的患者。收集的数据包括患者特征、副作用的发生情况（分为轻度：头痛、眩晕、恶心、呕吐、呼吸困难、胸部不适、潮热、全身乏力；重度：心动过缓、低血压、意识丧失）以及血压值/测量结果。
结果
总体而言，并发症发生相对频繁（瑞加诺生：23.2%，双嘧达莫：26.7%，p = 0.639）。0.7%的检查需要中止操作，而4.7%的检查需要药物支持。轻度并发症（瑞加诺生：16.2%，双嘧达莫：18.3%，p = 0.747）和重度并发症（瑞加诺生：11.6%，双嘧达莫：15.0%，p = 0.563）的发生率没有差异。然而，已发现瑞加诺生导致的收缩压（SBP）平均下降幅度显著较小（瑞加诺生：-2.6±10.0 mmHg，双嘧达莫：-8.7±9.6 mmHg，p = 0.002），舒张压（DBP）（瑞加诺生：-0.9±5.4 mmHg，双嘧达莫：-3.6±6.2 mmHg，p = 0.032）以及平均动脉压（MAP）（瑞加诺生：-1.5±5.6 mmHg，双嘧达莫：-5.4±6.5 mmHg，p = 0.001）。
结论
在SPECT MPI期间，瑞加诺生和双嘧达莫的安全性相似。然而，已发现瑞加诺生导致SBP、DBP和MAP的下降幅度显著较小。
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