Regadenoson versus dipyridamole: Evaluation of stress myocardial blood flow response on a CZT-SPECT camera

Background Regadenoson is a selective adenosine receptor agonist. It is currently unclear if the level of hyperemia differs between stress agents. We compared Myocardial Blood Flow (MBF) and Myocardial Flow Reserve (MFR) response on CZT-SPECT Myocardial Perfusion Imaging (MPI) to evaluate if dipyridamole and regadenoson could induce the same level of hyperemia. Methods 228 patients with dynamic CZT-SPECT MPI were retrospectively analyzed (66 patients stressed with regadenoson and 162 with dipyridamole) in terms of MBF and MFR. To rule out confounding factors, two groups of 41 patients were matched for clinical characteristics in a sub-analysis, excluding high cardiovascular risk patients. Results Overall stress MBF was higher in regadenoson patients (1.71 +/- 0.73 vs. 1.44 +/- 0.55 mL center dot min(-1)center dot g(-1)for regadenoson and dipyridamole, respectively,p < .05). However, when confounding factors were ruled out, stress MBF (1.57 +/- 0.56 vs. 1.61 +/- 0.62 mL center dot min(-1)center dot g(-1)for dipyridamole and regadenoson, respectively,p = .88) and MFR (2.62 +/- 0.77 vs. 2.46 +/- 0.76 for dipyridamole and regadenoson, respectively,p = .40) were not different between regadenoson and dipyridamole. Conclusions Our results suggest that dipyridamole and regadenoson induce equivalent hyperemia in dynamic SPECT with similar stress MBF and MFR in comparable patients.