First use in France of regadenoson within the context of radionuclide myocardial perfusion imaging: A comparative study versus dipyridamole

Background. - Dipyridamole is the most frequently used pharmacological stress agent in myocardial perfusion scintigraphy (MPS). However, it is contra-indicated in cases of treated asthma and severe pulmonary hypertension. Regadenoson is a new pharmacological stress agent, first used in France at Le Mans Hospital Center. It is a selective agonist of A(2A) adenosine receptors, which doesn't have the habitual contra-indications of dipyridamole. Objectives. - The main objective of this study was to compare the performances of regadenoson versus reference procedure, based on dipyridamole. Methods. - Thirty-two patients included between July 2013 and February 2014 benefited MPS with a pharmacological stress agent. Two groups of 16 patients were retrospectively compared. The first group underwent a test with regadenoson; the second received dipyridamole. The increase of heart rate (HR), changes in systolic and diastolic blood pressures (SBP and DBP) and ejection fraction of the left ventricle (LVEF) under stimulation (compared to the rest) between these two groups were compared. We also compared the possible occurrence of side effects, the time to complete the test and its current cost. Results. - Regarding the variations of heart rate, blood pressure and left ventricular ejection fraction, there was no clinically significant difference between the 2 treatment groups. Two episodes of headache have been reported in the dipyridamole group, any in the regadenoson one. The stress test with regadenoson was 3 times faster compared with dipyridamole. However, the effective cost is slightly higher for regadenoson than for dipyridamole. Conclusion. - The hospital of Le Mans was the first French center to use regadenoson. It seems to have the same properties as dipyridamole in terms of hemodynamic response but remains simpler to use and can be used in patients with treated asthma or severe pulmonary hypertension. Only its high cost could limit its use exclusively to a population in which dipyridamole would be contra-indicated. (C) 2015 Elsevier Masson SAS. All rights reserved.