Regadenoson for myocardial perfusion scintigraphy.

Area of Science:

• Cardiovascular Imaging and Diagnostics
• Pharmacology of Cardiovascular Drugs
• Nuclear Cardiology

Background:

• Stress myocardial perfusion scintigraphy (MPS) is crucial for detecting obstructive coronary artery disease (CAD).
• Current MPS stress techniques face limitations due to poor tolerability, contraindications, and side effects.
• Selective adenosine A2A receptor agonists offer potential for improved stress tolerability and expanded MPS indications.

Purpose of the Study:

• To review the principles of coronary arteriolar adenosine A2A receptor activation.
• To compare the benefits and limitations of current vasodilator stress agents.
• To highlight the effectiveness, side effect profile, and tolerability of regadenoson.

Main Methods:

• Review of basic principles of adenosine A2A receptor activation.
• Analysis of current vasodilator stress agents.
• Evaluation of regadenoson's clinical data, pharmacokinetics, and mechanism of action.

Main Results:

• Regadenoson's pharmacokinetics and mechanism of action in MPS for CAD assessment are detailed.
• Evidence on the clinical utility and future applications of regadenoson MPS is presented.
• Regadenoson demonstrates effectiveness similar to adenosine but with improved tolerability.

Conclusions:

• Regadenoson provides effective stress for detecting perfusion abnormalities in patients with known or suspected CAD.
• Improved tolerability with regadenoson simplifies stress testing and expands functional imaging applicability.
• Regadenoson can be used in patients unsuitable for conventional vasodilator stress agents like adenosine or dipyridamole.