ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2017
An assessment of the safety, hemodynamic response, and diagnostic accuracy of commonly used vasodilator stressors in patients with severe aortic stenosis.
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed, 22 citations in OpenAlex.
- Clinical outcomes following fractional flow reserve-guided revascularization using nicorandil versus conventional hyperemic agents: insights from the J-PRIDE Registry.Cardiovascular intervention and therapeutics · 2026Article
- Guideline on Stress Echocardiography - 2026.Arquivos brasileiros de cardiologia · 2026Article
- Coronary artery disease in patients undergoing transcatheter aortic valve replacement: Current evidence and future directions.American heart journal plus : cardiology research and practice · 2026Review
- Unravelling the Fate of Coronary Artery Disease in Patients Undergoing Valve Replacement for Severe Aortic Valve Stenosis.Reviews in cardiovascular medicine · 2023Review
- Perioperative management of aortic stenosis in patients undergoing non-cardiac surgery.Frontiers in cardiovascular medicine · 2023Review
- Regadenoson versus dipyridamole: Evaluation of stress myocardial blood flow response on a CZT-SPECT camera.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- Challenges in Diagnosis and Functional Assessment of Coronary Artery Disease in Patients With Severe Aortic Stenosis.Frontiers in cardiovascular medicine · 2022Review
- Safety and tolerability of regadenoson in comparison with adenosine stress cardiovascular magnetic resonance: Data from a multicentre prospective registry.The international journal of cardiovascular imaging · 2022Article
- Comparison of two dipyridamole infusion protocols for myocardial perfusion imaging in subjects with low likelihood of significant obstructive coronary artery disease.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2020Article
- Coronary Microcirculation in Aortic Stenosis: Pathophysiology, Invasive Assessment, and Future Directions.Journal of interventional cardiology · 2020Review
- Gender-related differences in side-effects and hemodynamic response to regadenoson in patients undergoing SPECT myocardial perfusion imaging.European journal of nuclear medicine and molecular imaging · 2019Article
- The clinical value and safety of ECG-gated dipyridamole myocardial perfusion imaging in patients with aortic stenosis.Scientific reports · 2019Article
- Adenosine MPS in octogenarians: Looking safely into the future.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019Article
- Review of cardiovascular imaging in the Journal of Nuclear Cardiology in 2017. Part 2 of 2: Myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Review
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10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIncreasing numbers of patients are undergoing transcatheter aortic valve replacement, which often involves assessment of coronary artery disease ischemic burden. The safety and diagnostic accuracy of vasodilator stress agents in patients with severe aortic stenosis (AS) undergoing SPECT myocardial perfusion imaging (MPI) has not been established.
methodsPatients with severe AS (valve area <1 cm
resultsA total of 95 cases were identified with 45% undergoing regadenoson, 31% dipyridamole, and 24% adenosine stress. A significant change in systolic blood pressure (BP), cases vs controls, was observed with adenosine [-17.9 ± 20.1 vs -2.6 ± 24.9 P = .03)], with a trend toward significance with regadenoson [-16.8 ± 20.3 vs -9.4 ± 17.9 (P = .08)] and dipyridamole [-17.8 ± 20.6 vs -9.0 ± 12.1 (P = .05)]. The change in heart rate was significantly different only for adenosine [5.3 ± 16.8 vs 14.2 ± 10.8 (P = .04)]. Overall, 45% of cases vs 24% of controls (P = .004) had a >20 mmHg decrease in systolic BP. Age, BMI, and resting systolic BP were related to a >20 mmHg decrease in systolic BP on univariate analysis, although only higher resting systolic BP was a predictor on multivariate analysis. In 33 patients who underwent angiography, the sensitivity, specificity, and diagnostic accuracy of vasodilator stress MPI was 77%, 69%, and 73%, respectively. No serious adverse events occurred in the severe AS patients.
conclusionSevere AS patients are more likely to have a hemodynamically significant decrease in systolic BP with vasodilator stress. There were no serious adverse events in this severe AS cohort with good diagnostic performance of MPI compared to angiography.
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