Reduced response to regadenoson with increased weight: An artificial intelligence–based quantitative myocardial perfusion study

• DOI: 10.1016/j.jocmr.2024.101066
• Publication Date: 2024-07-26T14:47:20Z
• Authors: Emmanouil Androul...; Georgios Georgiop...; Alessia Azzu; Elena Surkova; Adam Bakula; Panagiotis Papagk...; Alexandros Briaso...; Ranil De Silva; Peter Kellman; Dudley Pennell; Francisco Alpendu...
• Keywords: Regadenoson; Angiology

There is conflicting evidence regarding the response to a fixed dose of regadenoson in patients with high body weight. The aim this study was evaluate effectiveness varying weights using novel quantitative CMR perfusion parameters addition standard clinical markers. Consecutive typical angina and/or risk factors for coronary artery disease (N=217) underwent stress imaging dual-sequence protocol generated from an artificial intelligence (AI) based algorithm. performed on 1.5 T scanners 0.4 mg injection regadenoson. A cohort consecutive undergoing adenosine (N=218) used as control group. An inverse association myocardial reserve and weight (mean decrease -0.05 per 10Kg increase, 95% CI -0.009/-0.0001, P=0.045) noted group but not stressed (P=0.77). Adjusted logistic regression analysis revealed increase resulted 36% increased odds inadequate (OR= 1.36, 1.10-1.69, P=0.005). Moreover, significant interaction (OR=1.09, 1.02-1.16, P=0.012) between stressor type (regadenoson vs adenosine) noted. This also confirmed propensity matched subgroup (P=0.024) attenuated after adjustment (P=0.041). BSA (P=0.006) BMI (P=0.055) differentially associated conditional used, remained confounders (P=0.025). Patients highest quartile (>93Kg) or (>2.06m2) had substantially (OR=8.19, 2.04-32.97, P=0.003 OR=7.75, 1.93- 31.13, P=0.004 BSA). Both excellent discriminative ability (ROC area under curve 0.84 0.83 respectively). Using pharmacological regadenoson, we found relationship patient both parameters. fixed-dose bolus approach may be adequate induce maximal hyperemia Weight-adjusted stressors like considered instead > 93Kg 2.06m2.