Regadenoson use in patients with chronic obstructive pulmonary disease: the state of current knowledge.
Stress testing is challenging in patients with chronic obstructive pulmonary disease (COPD). Functional capacity is generally decreased in this patient population, limiting patients' ability to achieve physiologic stress through exercise. Additionally, due to emphysematous changes, COPD patients tend to have poor acoustic windows that impair the quality and therefore diagnostic accuracy of stress echocardiography techniques. Pharmacologic stress myocardial perfusion imaging (MPI) testing is also problematic, particularly due to the concern for adenosine-induced bronchoconstriction with conventional vasodilator stress agents. Regadenoson, a selective A2A adenosine receptor agonist, has gained popularity due to its ease of administration and improved patient experience in the general population. The literature describing the experience with regadenoson in COPD patients, though limited, is rapidly growing and reassuring. This review summarizes the pharmacology and clinical application of this novel stress agent and presents the available data on the safety and tolerability of its use in COPD patients.
Division of Adult Cardiology, John H Stroger Jr, Hospital of Cook County, Chicago, IL, USA ; Division of Cardiology, Rush University Medical Center, Chicago, IL, USA.
Yasmeen
Y
Golzar
Division of Adult Cardiology, John H Stroger Jr, Hospital of Cook County, Chicago, IL, USA ; Division of Cardiology, Rush University Medical Center, Chicago, IL, USA.
Rami
R
Doukky
D058908:Adenosine A2 Receptor Agonists / Q000009:adverse effects / Q000493:pharmacokinetics; D001249:Asthma / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D025401:Echocardiography, Stress / Q000379:methods*; D005080:Exercise Test / Q000379:methods*; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D018579:Patient Selection; D011237:Predictive Value of Tests; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D011687:Purines / Q000009:adverse effects / Q000493:pharmacokinetics; D011720:Pyrazoles / Q000009:adverse effects / Q000493:pharmacokinetics; D012307:Risk Factors; D012720:Severity of Illness Index; D014665:Vasodilator Agents / Q000009:adverse effects / Q000493:pharmacokinetics
D058908:Adenosine A2 Receptor Agonists; D011687:Purines; D011720:Pyrazoles; D014665:Vasodilator Agents; C430916:regadenoson
COPD; asthma; chronic obstructive pulmonary disease; emphysema; myocardial perfusion imaging; regadenoson; safety; tolerability