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Published on: February 16, 2016
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Reduced response to regadenoson with increased weight: An artificial intelligence-based quantitative myocardial
Emmanouil Androulakis1, Georgios Georgiopoulos2, Alessia Azzu1
1Royal Brompton and Harefield Hospitals, Guy's & St Thomas' NHS Foundation Trust, London, UK.
Summary
Fixed-dose regadenoson may be inadequate for patients with high body weight, leading to reduced myocardial perfusion. Weight-adjusted stressors like adenosine may be a better alternative for these individuals.
Area of Science:
- Cardiology
- Medical Imaging
- Pharmacology
Background:
- Conflicting evidence exists on regadenoson efficacy in high body weight patients.
- Quantitative cardiovascular magnetic resonance (CMR) perfusion parameters offer novel insights.
Purpose of the Study:
- Evaluate regadenoson effectiveness across varying body weights using quantitative CMR.
- Compare regadenoson with adenosine stress in patients with coronary artery disease risk factors.
Main Methods:
- Utilized a dual-sequence quantitative CMR perfusion protocol with AI-generated parameters.
- Administered a fixed 0.4 mg regadenoson dose to 217 patients.
- Compared results with 218 patients undergoing adenosine stress perfusion.
Main Results:
- Found an inverse association between weight and myocardial perfusion reserve with regadenoson (P=0.045).
- Increased weight correlated with higher odds of inadequate stress response (OR=1.36, P=0.005).
- High weight (>93 kg) or BSA (>2.06 m²) significantly increased odds for inadequate regadenoson response (ORs ~8).
Conclusions:
- A fixed regadenoson dose may not achieve maximal hyperemia in heavier patients.
- Quantitative CMR reveals an inverse relationship between weight and regadenoson response.
- Consider weight-adjusted stressors like adenosine for patients >93 kg or BSA >2.06 m².
