Author + information
- Jennifer Jue,
- Simone Romano,
- Brent White,
- Raksha Indorkar,
- Devang Parikh and
- Afshin Farzaneh-Far
Background: Regadenoson is a selective adenosine A2A receptor agonist often used for CMR stress perfusion imaging. It increases heart rate by both direct and indirect stimulation of the sympathetic nervous system. Cardiac autonomic dysfunction has been associated with increased cardiovascular risk. We therefore hypothesized that abnormal cardiac autonomic function as reflected by a blunted heart rate response to regadenoson may be a predictor of adverse cardiovascular outcomes.
Methods: Consecutive patients referred for suspected myocardial ischemia (n=303) underwent CMR stress perfusion following administration of 0.4 mg of regadenoson. Heart rate response (HRR) was calculated as 100 × (peak stress heart rate – baseline heart rate)/(baseline heart rate). Patients were followed for occurrence of major adverse cardiac events (all-cause mortality, nonfatal myocardial infarction, late revascularization, and hospitalization for heart failure).
Results: Median HRR was 33.8%. By Kaplan-Meier analysis, patients with HRR≤median experienced significantly more adverse cardiac events than patients with HRR>median (Figure). Cox proportional hazard modeling showed that HRR was significantly associated with adverse cardiac events (Hazard ratio=1.23 per 10% decrease in HRR, p=0.04) even when adjusted to known clinical risk factors.
Conclusions: A blunted heart rate response to regadenoson during stress CMR is a significant predictor of major adverse cardiac events.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Non Invasive Imaging: MR Structure and Valuvular Heart Disease
Abstract Category: 29. Non Invasive Imaging: MR
Presentation Number: 1290-214
- 2017 American College of Cardiology Foundation