Safety of regadenoson positron emission tomography stress testing in orthotopic heart transplant patients

John J. Lazarus; Ashraf Saleh; Michael Ghannam; Keith Aaronson; Monica Colvin; Frank Pagani; Todd Koelling; James R. Corbett; Richard L. Weinberg; Venkatesh L. Murthy; Matthew C. Konerman

doi:10.1007/s12350-018-01466-1

Safety of regadenoson positron emission tomography stress testing in orthotopic heart transplant patients

John J. Lazarus^*, Ashraf Saleh, Michael Ghannam, Keith Aaronson, Monica Colvin, Frank Pagani, Todd Koelling, James R. Corbett, Richard L. Weinberg, Venkatesh L. Murthy, Matthew C. Konerman

^*Corresponding author for this work

Medicine, Cardiology Division

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Objectives: We sought to determine the safety of regadenoson (REG) stress testing in patients who have undergone orthotopic heart transplantation (OHT). Background: Routine screening for cardiac allograft vasculopathy (CAV) is necessary after OHT. Adenosine stress is contraindicated after heart transplantation due to supersensitivity in denervated hearts. Safety of regadenoson stress following OHT has not been well studied. Methods: We retrospectively reviewed data from OHT patients (N = 123) who were referred to REG stress testing. Medical records were reviewed to determine hemodynamic and ECG response to regadenoson and to identify adverse reactions. Results: No serious adverse events occurred. No life-threatening arrhythmias or hemodynamic changes occurred. Common side-effects related to regadenoson were observed, dyspnea being the most frequent (66.7%). On average the heart rate rose from 82.8 ± 12 to 95.7 ± 13.4 bpm (P < 0.001), systolic blood pressure decreased from 138.7 ± 20.9 to 115.9 ± 23.9 mmHg (P < 0.001) and mean arterial pressure decreased from 103.5 ± 14.1 to 84.72 ± 15.90 mmHg (P < 0.001) during stress protocol. There was no sustained ventricular tachycardia, ventricular fibrillation, or second-or third-degree atrioventricular block. Conclusion: Regadenoson stress testing appears to be well tolerated and safe in OHT patients.

Original language	English (US)
Pages (from-to)	943-948
Number of pages	6
Journal	Journal of Nuclear Cardiology
Volume	27
Issue number	3
DOIs	https://doi.org/10.1007/s12350-018-01466-1
State	Published - Jun 1 2020

Funding

Dr. Murthy is supported by 1R01HL136685 from the National, Heart, Lung, and Blood Institute. Dr. Murthy has received consulting/speaking fees from Bracco Diagnostics and Ionetix. Dr. Murthy owns stock in General Electric. Keith Aaronson has received consultant or speaking fees from Medtronic, NuPulseCV and has stock options with ProCyrion and NuPulseCV. He has received grants or grants pending from Amgen, Medtronic and Thoratec. Venkatesh L. Murthy has received consulting/speaking fees from Bracco Diagnostics and Ionetix. He owns stock in General Electric. John J. Lazarus, Ashraf Saleh, Michael Ghannam, Monica Colvin, Frank Pagani, Todd Koelling, James R. Corbett, Richard L. Weinberg, and Matthew C. Konerman have no reported conflicts of interest.

Keywords

Positron emission tomography
heart failure
pharmacologic stress cardiac transplantation
regadenoson
safety

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Radiology Nuclear Medicine and imaging

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s12350-018-01466-1

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title = "Safety of regadenoson positron emission tomography stress testing in orthotopic heart transplant patients",

abstract = "Objectives: We sought to determine the safety of regadenoson (REG) stress testing in patients who have undergone orthotopic heart transplantation (OHT). Background: Routine screening for cardiac allograft vasculopathy (CAV) is necessary after OHT. Adenosine stress is contraindicated after heart transplantation due to supersensitivity in denervated hearts. Safety of regadenoson stress following OHT has not been well studied. Methods: We retrospectively reviewed data from OHT patients (N = 123) who were referred to REG stress testing. Medical records were reviewed to determine hemodynamic and ECG response to regadenoson and to identify adverse reactions. Results: No serious adverse events occurred. No life-threatening arrhythmias or hemodynamic changes occurred. Common side-effects related to regadenoson were observed, dyspnea being the most frequent (66.7\%). On average the heart rate rose from 82.8 ± 12 to 95.7 ± 13.4 bpm (P < 0.001), systolic blood pressure decreased from 138.7 ± 20.9 to 115.9 ± 23.9 mmHg (P < 0.001) and mean arterial pressure decreased from 103.5 ± 14.1 to 84.72 ± 15.90 mmHg (P < 0.001) during stress protocol. There was no sustained ventricular tachycardia, ventricular fibrillation, or second-or third-degree atrioventricular block. Conclusion: Regadenoson stress testing appears to be well tolerated and safe in OHT patients.",

keywords = "Positron emission tomography, heart failure, pharmacologic stress cardiac transplantation, regadenoson, safety",

author = "Lazarus, \{John J.\} and Ashraf Saleh and Michael Ghannam and Keith Aaronson and Monica Colvin and Frank Pagani and Todd Koelling and Corbett, \{James R.\} and Weinberg, \{Richard L.\} and Murthy, \{Venkatesh L.\} and Konerman, \{Matthew C.\}",

note = "Publisher Copyright: {\textcopyright} 2018, American Society of Nuclear Cardiology.",

year = "2020",

month = jun,

day = "1",

doi = "10.1007/s12350-018-01466-1",

language = "English (US)",

volume = "27",

pages = "943--948",

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T1 - Safety of regadenoson positron emission tomography stress testing in orthotopic heart transplant patients

AU - Lazarus, John J.

AU - Saleh, Ashraf

AU - Ghannam, Michael

AU - Aaronson, Keith

AU - Colvin, Monica

AU - Pagani, Frank

AU - Koelling, Todd

AU - Corbett, James R.

AU - Weinberg, Richard L.

AU - Murthy, Venkatesh L.

AU - Konerman, Matthew C.

PY - 2020/6/1

Y1 - 2020/6/1

N2 - Objectives: We sought to determine the safety of regadenoson (REG) stress testing in patients who have undergone orthotopic heart transplantation (OHT). Background: Routine screening for cardiac allograft vasculopathy (CAV) is necessary after OHT. Adenosine stress is contraindicated after heart transplantation due to supersensitivity in denervated hearts. Safety of regadenoson stress following OHT has not been well studied. Methods: We retrospectively reviewed data from OHT patients (N = 123) who were referred to REG stress testing. Medical records were reviewed to determine hemodynamic and ECG response to regadenoson and to identify adverse reactions. Results: No serious adverse events occurred. No life-threatening arrhythmias or hemodynamic changes occurred. Common side-effects related to regadenoson were observed, dyspnea being the most frequent (66.7%). On average the heart rate rose from 82.8 ± 12 to 95.7 ± 13.4 bpm (P < 0.001), systolic blood pressure decreased from 138.7 ± 20.9 to 115.9 ± 23.9 mmHg (P < 0.001) and mean arterial pressure decreased from 103.5 ± 14.1 to 84.72 ± 15.90 mmHg (P < 0.001) during stress protocol. There was no sustained ventricular tachycardia, ventricular fibrillation, or second-or third-degree atrioventricular block. Conclusion: Regadenoson stress testing appears to be well tolerated and safe in OHT patients.

AB - Objectives: We sought to determine the safety of regadenoson (REG) stress testing in patients who have undergone orthotopic heart transplantation (OHT). Background: Routine screening for cardiac allograft vasculopathy (CAV) is necessary after OHT. Adenosine stress is contraindicated after heart transplantation due to supersensitivity in denervated hearts. Safety of regadenoson stress following OHT has not been well studied. Methods: We retrospectively reviewed data from OHT patients (N = 123) who were referred to REG stress testing. Medical records were reviewed to determine hemodynamic and ECG response to regadenoson and to identify adverse reactions. Results: No serious adverse events occurred. No life-threatening arrhythmias or hemodynamic changes occurred. Common side-effects related to regadenoson were observed, dyspnea being the most frequent (66.7%). On average the heart rate rose from 82.8 ± 12 to 95.7 ± 13.4 bpm (P < 0.001), systolic blood pressure decreased from 138.7 ± 20.9 to 115.9 ± 23.9 mmHg (P < 0.001) and mean arterial pressure decreased from 103.5 ± 14.1 to 84.72 ± 15.90 mmHg (P < 0.001) during stress protocol. There was no sustained ventricular tachycardia, ventricular fibrillation, or second-or third-degree atrioventricular block. Conclusion: Regadenoson stress testing appears to be well tolerated and safe in OHT patients.

KW - Positron emission tomography

KW - heart failure

KW - pharmacologic stress cardiac transplantation

KW - regadenoson

KW - safety

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ER -

Safety of regadenoson positron emission tomography stress testing in orthotopic heart transplant patients

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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