Safety of regadenoson in patients with severe chronic obstructive pulmonary disease / Seguridad de regadenosón en pacientes con enfermedad pulmonar obstructiva crónica severa

Objective. To assess the safety of regadenoson, a selective agonist of A2A adenosine receptors, combined with low-level exercise in subjects with severe chronic obstructive pulmonary disease (COPD), referred for myocardial perfusion imaging (MPI). Methods. We studied prospectively 12 male patients with severe COPD. Stress was 4min of low-level exercise with bolus injection of regadenoson (0.4mg) at 1.5min, followed by 99mTc-MPI agent injection. Demographics, medical history, lung medications, adverse events, oxygen saturation (SatO2), MPI findings for coronary artery disease (CAD), and changes in systolic blood pressure (SBP), and heart rate (HR) were registered. Results. The observed adverse event profile of regadenoson was similar to that of patients with mild-moderate COPD. There was no clinical exacerbation of COPD. Adverse events were self-limiting: dyspnea (33.3%), fatigue (25.0%), chest pain, headache (16.7%, respectively), and gastrointestinal discomfort, dry mouth, flushing, feeling hot and dizziness (8.3%, respectively). 25.0% of patients did not report any symptoms. We observed significant increases in SBP and HR from baseline (142.6mmHg±22.3 vs 152.5mmHg±18.5, and 80 b.p.m.±18 vs 105 b.p.m.±22, respectively; p<0.05). Conclusions. Regadenoson combined with low-level exercise is safe and well tolerated in stable patients with severe COPD undergoing MPI (AU)

Objetivo. Evaluar la seguridad de regadenosón, un agonista selectivo de los receptores adenosínicos A2A, combinado con ejercicio de baja intensidad, en sujetos con enfermedad pulmonar obstructiva crónica (EPOC) severa, en estudios de perfusión miocárdica. Métodos. Se estudiaron de forma prospectiva 12 pacientes con EPOC severa (todos ellos varones). El estrés consistió en la realización de un ejercicio de baja intensidad durante 4min junto con la administración de un bolo de regadenosón (0,4mg) a los 1,5min, seguido de la inyección del radiofármaco tecneciado de perfusión miocárdica. Se registraron los datos demográficos, el historial médico, la medicación para patología respiratoria, los efectos adversos, la saturación de oxígeno (SatO2), los hallazgos de enfermedad coronaria en el estudio de perfusión miocárdica y los cambios en la presión arterial sistólica (PAS) y la frecuencia cardiaca (FC). Resultados. El perfil de efectos adversos de regadenosón fue similar al de pacientes con EPOC leve-moderada. No se produjeron exacerbaciones clínicas de la EPOC. Los efectos adversos experimentados, todos autolimitados, fueron disnea (33,3%), cansancio (25%), dolor torácico, cefalea (16,7%, respectivamente), molestias gastrointestinales, boca seca, rubefacción, calor y mareos (8,3%, respectivamente). El 25% de los pacientes no informaron síntomas. Se observaron aumentos significativos desde los valores basales de la PAS y la FC (142,6mmHg±22,3 vs 152,5mmHg±18,5 y 80l.p.m.±18 vs 105l.p.m.±22, respectivamente; p<0,05). Conclusiones. Regadenosón combinado con ejercicio de baja intensidad es seguro y bien tolerado en pacientes con EPOC severa estable sometidos a estudios de perfusión miocárdica (AU)

Safety of regadenoson in patients with severe chronic obstructive pulmonary disease.

OBJECTIVE: To assess the safety of regadenoson, a selective agonist of A2A adenosine receptors, combined with low-level exercise in subjects with severe chronic obstructive pulmonary disease (COPD), referred for myocardial perfusion imaging (MPI). METHODS: We studied prospectively 12 male patients with severe COPD. Stress was 4min of low-level exercise with bolus injection of regadenoson (0.4mg) at 1.5min, followed by (99m)Tc-MPI agent injection. Demographics, medical history, lung medications, adverse events, oxygen saturation (SatO2), MPI findings for coronary artery disease (CAD), and changes in systolic blood pressure (SBP), and heart rate (HR) were registered. RESULTS: The observed adverse event profile of regadenoson was similar to that of patients with mild-moderate COPD. There was no clinical exacerbation of COPD. Adverse events were self-limiting: dyspnea (33.3%), fatigue (25.0%), chest pain, headache (16.7%, respectively), and gastrointestinal discomfort, dry mouth, flushing, feeling hot and dizziness (8.3%, respectively). 25.0% of patients did not report any symptoms. We observed significant increases in SBP and HR from baseline (142.6mmHg±22.3 vs 152.5mmHg±18.5, and 80 b.p.m.±18 vs 105 b.p.m.±22, respectively; p<0.05). CONCLUSIONS: Regadenoson combined with low-level exercise is safe and well tolerated in stable patients with severe COPD undergoing MPI.