Safety and Efficacy of Regadenoson for Pediatric Stress Perfusion Cardiac MRI with Quantification of Myocardial Blood Flow
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. CMR Protocol
2.3. Stress Response Data
2.4. Image Analysis
2.4.1. Qualitative Myocardial Perfusion Analysis
2.4.2. Semi-Quantitative Myocardial Perfusion Analysis
2.4.3. Quantitative Measures of Cardiac Volume, Function, and Fibrosis
2.4.4. Statistical Analysis
3. Results
3.1. Study Population
3.2. CMR Protocol Data
3.2.1. Hemodynamic Response to Regadenoson
3.2.2. Adverse Events of Regadenoson
3.3. Image Analysis
3.3.1. Qualitative Myocardial Perfusion Analysis
3.3.2. Semi-Quantitative Myocardial Perfusion Analysis
3.3.3. Quantitative Measures of Cardiac Volume, Function, and Fibrosis
3.4. Clinical Course
4. Discussion
4.1. Safety and Efficacy of Regadenoson
4.2. Semiquantitative Assessment of Myocardial Perfusion Reserve
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Clinical Diagnosis | Number |
---|---|
Status post orthotopic heart transplant | 16 |
Coronary aneurysms | 10 |
- Isolated coronary aneurysm with mitral regurgitation | - 1 |
Status post coronary artery revision | 8 |
- D-TGA status post arterial switch | - 3 |
- Anomalous RCA from left sinus s/p unroofing | - 3 |
- Anomalous LCA from right sinus s/p unroofing and creation of a neo-ostium | - 1 |
- Congenital aortic stenosis s/p Ross | - 1 |
Abnormal coronary artery anatomy, no intervention | 3 |
- Single coronary artery with intramural LAD | - 1 |
- Single coronary artery with LAD between aorta and PA | - 1 |
- Anomalous LCA from non-coronary sinus | - 1 |
Anginal chest pain with abnormal ECG | 1 |
Patient | Diagnosis | Stress Perfusion Defect | Rest Perfusion Defect | Wall Motion Abnormality | Late Gadolinium Enhancement |
---|---|---|---|---|---|
1 | Kawasaki | Yes | No | No | No |
2 | DTGA s/p ASO | Yes | No | Yes | No |
3 | AAOLCA from right sinus s/p surgery | Yes | No | No | No |
4 | Kawasaki | Yes | No | No | No |
Patients with Perfusion Defect (n = 4) | Patients without Perfusion Defect s/p Orthotopic Heart Transplant (n = 16) | Patients without Perfusion Defect Non-Transplant (n = 18) | ||
---|---|---|---|---|
Global MPRI | 1.13 ± 0.27 | 0.75 ± 0.22 | 0.92 ± 0.23 | p = 0.03 * |
Segmental MPRI | 0.78 ± 0.22 | 0.99 ± 0.36 | p = 0.07 |
Patients with Stress Perfusion Deficits | Tests Performed Post Perfusion | ||||||
---|---|---|---|---|---|---|---|
Diagnosis | Indication | CTA | Cath | NM Stress | EST | Outcome | |
1 | AAOLCA from right sinus s/p surgery | exertional chest pain | No | * LAD bridge | Normal | Normal | Surgical myocardial bridge unroofing |
2 | Kawasaki | Coronary aneurysm with LAD occlusion | No | No | Normal | Normal | No intervention |
3 | D-TGA s/p ASO | Acutely angulated and compressed reimplanted LMCA | No | No | Normal | Started on aspirin | |
4 | Kawasaki | Coronary aneurysm with LAD occlusion | No | No | Normal | Normal | No intervention |
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Patel, S.G.; Husain, N.; Rigsby, C.K.; Robinson, J.D. Safety and Efficacy of Regadenoson for Pediatric Stress Perfusion Cardiac MRI with Quantification of Myocardial Blood Flow. Children 2022, 9, 1332. https://doi.org/10.3390/children9091332
Patel SG, Husain N, Rigsby CK, Robinson JD. Safety and Efficacy of Regadenoson for Pediatric Stress Perfusion Cardiac MRI with Quantification of Myocardial Blood Flow. Children. 2022; 9(9):1332. https://doi.org/10.3390/children9091332
Chicago/Turabian StylePatel, Shivani G., Nazia Husain, Cynthia K. Rigsby, and Joshua D. Robinson. 2022. "Safety and Efficacy of Regadenoson for Pediatric Stress Perfusion Cardiac MRI with Quantification of Myocardial Blood Flow" Children 9, no. 9: 1332. https://doi.org/10.3390/children9091332