Lexiscan (regadenoson) / GE Healthcare, Astellas, Gilead - LARVOL DELTA

Myocardial Perfusion SPECT 2024 in Germany: Results of the 10th Survey. (PubMed, Nuklearmedizin) - "Regadenoson was mostly used...The proportion of departments not scoring decreased to 4% [13%].The MPS 2024 survey indicates that the long-term positive development of MPS imaging is continuing. The procedural and technical details of MPS imaging demonstrate a high level of conformity with guidelines, with a slight improvement observed from 2021 to 2024."

Journal

Exercise versus Regadenoson for Myocardial Perfusion Assessment in Hypertrophic Cardiomyopathy (AHA 2025) - "Preliminary findings suggest that regadenoson, as compared to exercise, overestimates myocardial perfusion defects in HCM, results in frequently impaired CFR (<2.0), and causes frequent symptomatology not reflective of patients' daily symptoms. These results support reevaluating the routine use of supraphysiologic vasodilators in HCM stress testing. Furthermore, CMI use led to higher CFR values, supporting our hypothesis that alleviation of myocyte hypercontractility may improve perfusion in HCM patients."

Cardiomyopathy • Cardiovascular • Hypertrophic Cardiomyopathy

Machine learning prediction of myocardial ischemia using quantitative assessment of coronary calcifications in non-contrast CT calcium scoring scans (AHA 2025) - "This study aimed to develop a novel machine learning model that predicts ischemia based solely on the quantitative analysis of coronary calcifications in CTCS scans.Methods We retrospectively analyzed 987 patients who underwent both non-contrast CTCS and regadenoson stress cardiac positron emission tomography (PET) myocardial perfusion imaging with an NH3 tracer within one year at the University Hospitals of Cleveland...Compared to models using only clinical features (precision 13.2±3.7% and F1 score 21.3±5.3%) or clinical features plus the Agatston score (precision 74.7±9.5% and F1 score 76.4±6.7%), the inclusion of calcium-omics features significantly improved predictive performance (p<0.05), particularly by reducing false positives.ConclusionWe developed a novel machine learning approach for predicting myocardial ischemia using non-contrast CTCS imaging. Our findings suggest that calcium-omics features provide additional predictive value beyond..."

Machine learning • Atherosclerosis • Cardiovascular • Myocardial Ischemia

Epicardial Adipose Tissue Biomarkers Are Associated with Myocardial Perfusion in Women with Angina and No Obstructive Coronary Artery Disease: A CMR study (AHA 2025) - "Subjects underwent CMR scan at 1.5T (Aera), including rest and regadenoson stress perfusion with automated inline global rest and stress myocardial blood flow (MBF), myocardial perfusion reserve (MPR)... CMR-derived EAT T1 relaxation time and SFA fraction are associated with CMD in women with ANOCA. Elevated SFA and reduced T1, reflective of a pro-inflammatory adipose phenotype, are independently associated with impaired myocardial perfusion. These findings support a potential mechanistic link between EAT metabolic dysfunction and CMD and underscore the value of multiparametric CMR in the phenotyping at-risk women with ANOCA."

Biomarker • Clinical • Cardiovascular • Coronary Artery Disease • Inflammation • Metabolic Disorders

Heart Rate Response to Regadenoson Stress with PET MPI: Old Marker, New Insights. (PubMed, J Nucl Cardiol) - No abstract available

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure

Noninvasive Measurement of Coronary Collateral Flow Capacity in Patients with Chronic Total Occlusion: External Counterpulsattion Reduces the Need for High Risk Percutaneous Coronary Intervention (AHA 2025) - "Noninvasive external counterpulsation (ECP) improves invasively measured collateral flow index, angina and walking time in patients with obstructive CAD.We hypothesized that coronary collateral flow capacity can be measured noninvasively in CTO patients by comparing absolute stress perfusion during vasodilator stress (DIP) which reduces supply side pressure in the collateralized ischemic bed, revealing coronary steal, compared with demand ischemic stress (DBT) which maintains supply side pressure. Twenty sequential patients found to have CTO at angiography prompted by abnormal quantitative PET myocardial perfusion imaging with vasodilator stress using dipyridamole or regadenoson (QPET-DIP) underwent 35 one-hour sessions of ECP, rather than PCI, followed by demand ischemic stress PET using dobutamine (QPET-DBT). Coronary collateral flow capacity can be measured noninvasively with quantitative PET myocardial perfusion imaging. Initial treatment of CTO patients with ECP is..."

Clinical • Non-invasive • Cardiovascular

Stress myocardial perfusion imaging with photon-counting CT: Initial validation against reference modalities. (PubMed, Diagn Interv Imaging) - "Stress static PCCT-MPI is feasible and demonstrates excellent diagnostic accuracy for detecting myocardial ischemia. Defect-to-remote iodine ratio from spectral imaging further enhances performance, establishing PCCT as a comprehensive imaging modality that unifies anatomic and functional coronary assessment at a reasonable radiation dose, within a single examination."

Journal • Cardiovascular • Coronary Artery Disease • Ischemic stroke • Myocardial Ischemia

EPIPERICARDIAL FAT NECROSIS: A RARE AND UNDERRECOGNIZED CAUSE OF CHEST PAIN (CHEST 2025) - "He later underwent a regadenoson nuclear stress test which was negative for ischemia... EFN is a rare but benign cause of chest pain that can present similarly to more life-threatening conditions such as ACS, pulmonary embolism, or aortic dissection. With increasing use of CT imaging in the evaluation of acute chest pain, recognition of EFN may improve with time."

Acute Coronary Syndrome • Dyslipidemia • Genito-urinary Cancer • Mood Disorders • Obesity • Pain • Prostate Cancer • Pulmonary Disease • Pulmonary Embolism • Respiratory Diseases • Solid Tumor

ACUTE CORONARY SYNDROME IN ACUTE MYELOID LEUKEMIA: A CASE OF MYOCARDIAL INJURY DUE TO HYPERLEUKOCYTOSIS AND COAGULOPATHY (CHEST 2025) - "He had undergone an echocardiogram and Lexiscan nuclear stress test prior to admission, both of which showed no ischemia and normal left ventricular (LV) function...The patient was treated with aspirin, intravenous heparin, furosemide, and allopurinol... This case highlights the unique pathophysiological mechanisms contributing to myocardial injury in patients with AML and hyperleukocytosis, emphasizing the diagnostic and therapeutic challenges in managing ACS outside the traditional framework of atherosclerotic coronary disease. The patient's clinical deterioration despite conventional ACS treatment emphasizes the complex interplay between leukemia-related hyperviscosity, coagulopathy, and myocardial injury. Meanwhile, leukapheresis remains a debated intervention due to its uncertain impact on survival."

Clinical • Acute Coronary Syndrome • Acute Myelogenous Leukemia • Atherosclerosis • Chronic Obstructive Pulmonary Disease • Dyslipidemia • Fatigue • Genito-urinary Cancer • Hematological Malignancies • Hypertension • Immunology • Leukemia • Myocardial Infarction • Oncology • Prostate Cancer • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases • Solid Tumor • Thrombosis

SUPRAVENTRICULAR TACHYCARDIA AS A COMPLICATION OF REGADENOSON NUCLEAR STRESS TESTING: A CALL FOR CAUTION (CHEST 2025) - "He was started on amiodarone, initiated on norepinephrine, and transferred to the cardiac care unit (CCU) for monitoring. Regadenoson-induced SVT is a potentially serious but underappreciated complication of nuclear stress testing, particularly in elderly patients with underlying cardiovascular risk factors. Enhanced pre-test risk stratification is crucial to identify high-risk individuals who may benefit from alternative ischemic evaluations. Awareness of these complications allows for prompt recognition and management, ultimately improving patient outcomes."

Atrial Fibrillation • Cardiovascular • Coronary Artery Disease • Diabetes • Heart Failure • Hypertension • Metabolic Disorders • Musculoskeletal Diseases • Orthopedics • Type 2 Diabetes Mellitus • Ventricular Tachycardia

Differential Association of Heart Rate Response to Regadenoson with Death and Heart Failure Hospitalizations According to Ejection Fraction in Patients Undergoing PET MPI. (PubMed, J Nucl Cardiol) - "The prognostic value of HRR after pharmacological stress testing for death and HF hospitalization is most pronounced in patients with a preserved EF and is independent of traditional risk factors and PET parameters, including myocardial flow reserve."

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure

Prognostic Significance of Transient Ischemic Dilatation with Adenosine 99mTc Sestamibi SPECT/CT in Diabetic Patients with Normal Myocardial Perfusion (EANM 2025) - "Aim The prognostic value of transient ischemic dilatation (TID) with otherwise normal perfusion in patients undergoing adenosine/regadenoson stress remains controversial with limited data pertaining to diabetic patients...Similarly, cardiac event-free survivals were similar in patients with AC TID ≥ and < 1.18 (2.0% vs. 5.6%, p = .076), ≥ and < 1.21 (2.6% vs. 5.3%, p = .252) and ≥ and < 1.36 (3.2% vs. 4.9%, p = .577). Conclusion TID, whether based on attenuation or non-attenuation corrected scans, does not confer adverse prognosis in diabetic patients with normal perfusion on adenosine stress/rest 99mTc-sestamibi SPECT/CT irrespective of the threshold used for its definition."

Clinical • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Coronary Artery Disease • Diabetes • Dyslipidemia • Endocrine Disorders • Heart Failure • Hypertension • Metabolic Disorders

Myocardial Perfusion Scintigraphy with Regadenoson and Correlation with the Findings of Coronary Angiography (EANM 2025) - "Conclusion Regadenoson MPS is a safe, well-tolerated, and effective tool for assessing myocardial ischemia in patients unable to perform exercise testing. Despite statistically significant correlations with CA, the weak association highlights the importance of combining both functional and anatomical imaging techniques for a more comprehensive and reliable CAD evaluation."

Cardiovascular • Coronary Artery Disease • Myocardial Ischemia

Prediction of Cardiac Events in Patients with Diabetes Using Stress Myocardial Blood Flow and Coronary Flow Reserve (EANM 2025) - "Acquisition was performed at rest and after maximal vasodilation with an injection of 400 mg regadenoson over 10 seconds, followed by administration of Tc-99m sestamibi (rest 3 MBq/kg and stress 9 MBq/kg)...However, the addition of CFR to stress MBF did not demonstrate a clearly significant incremental prognostic value in this cohort. These findings may support a potential simplification of the dynamic SPECT protocol, favoring a stress-first or stress-only approach, which could facilitate broader MBF quantification and improve accessibility for a larger patient population."

Clinical • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Coronary Artery Disease • Diabetes • Heart Failure • Metabolic Disorders • Myocardial Infarction

Myocardial Blood Flow and Ejection Fraction Measurement in Rb82-PET/CT shows high inter-observer reliability (EANM 2025) - "Stress conditions were simulated using 400 µg Regadenoson...Additionally this study first demonstrates an increase in inter-observer reliability as an effect of user experience. Perfusion-PET-based EF evaluation as a parameter of left ventricular function shows a similar reliability as echocardiography."

Cardiovascular • Coronary Artery Disease • Myocardial Ischemia

PET MPI With F-18 FlurpiridazVersus Rb-82: Insights Into Blood Flow and Splenic Switch-Off. (PubMed, JACC Case Rep) - "F-18 flurpiridaz PET MPI demonstrated superior image quality compared with Rb-82 PET MPI. Splenic switch-off was more visually and quantitatively pronounced with F-18 flurpiridaz, potentially improving the ability to distinguish responders to regadenoson from nonresponders. Stress myocardial blood flow and myocardial flow reserve were higher with F-18 flurpiridaz, in part owing to its higher myocardial extraction fraction."

Journal • Cardiovascular • Coronary Artery Disease • Myocardial Ischemia

Network and pharmacophore guided and BCL2 and HSP90AA1 targeted drug repurposable approaches against rheumatoid arthritis mediated diffuse large B-cell lymphoma. (PubMed, Int J Biol Macromol) - "Pharmacophore-based screening revealed lapatinib and itraconazole as superior BCL2 inhibitors [-7.621 and -7.075] kcal/mol compared to FDA-approved venetoclax [-6.546] kcal/mol, while voriconazole and regadenoson demonstrated robust HSP90AA1 binding [-7.279 and -7.268] kcal/mol, outperforming FDA-approved cromolyn [-5.304] kcal/mol. These findings establish BCL2 and HSP90AA1 as promising dual-purpose therapeutic targets, providing a foundation for addressing both RA management and RA-mediated DLBCL prevention."

Journal • B Cell Lymphoma • Diffuse Large B Cell Lymphoma • Hematological Malignancies • Immunology • Inflammatory Arthritis • Lymphoma • Non-Hodgkin’s Lymphoma • Oncology • Rheumatoid Arthritis • Rheumatology • BCL2 • CDC37 • HSP90AA1

Simultaneous 13N-ammonia and gadolinium perfusion using integrated PET-MRI: diagnostic accuracy in coronary microvascular dysfunction. (PubMed, Front Med (Lausanne)) - "Thirty patients with suspected CMD underwent simultaneous MRI and 13N-ammonia PET scans at rest and regadenoson-stress on an integrated PET-MRI scanner...Nevertheless, MRI measurements of rest and stress MBF showed only poor to modest agreement to those obtained with 13N-ammonia PET. Therefore, although quantitative MRI has clinical utility, further refinements are still required."

Journal

Early quantitative stress-CMR identifies microvascular dysfunction as a potential mechanism of myocardial injury in patients with working diagnosis MINOCA and otherwise normal CMR scan. (ESC-WCC 2025) - " Since 2021, consecutive patients with a working diagnosis of MINOCA, referred for CMR have undergone perfusion CMR after pharmacological provocation with regadenosone and at rest, using dual sequence technique... Early performed quantitative stress perfusion CMR scan revealed significant impairment of maximal myocardial blood flow during stress and perfusion reserve in patients with a working diagnosis of MINOCA and otherwise normal CMR scans, compared with healthy controls. More than one third of these patients fulfilled the criteria for microvascular dysfunction as a potential pathomechanism of myocardial injury."

Clinical • Cardiovascular • Dyslipidemia • Hypertension • Myocardial Infarction

Dynamic CT perfusion to identify hemodynamically significant coronary artery disease- preliminary results of a one-stop-shop approach (ESC-WCC 2025) - "Perfusion scans were performed on a 192-slice scanner, using regadenoson as stressor agent... Performing stress CTP in patients with ≥50% stenosis on CCTA seems to streamline diagnosis by decreasing downstream ischemia testing, negative invasive angiographies, and time to diagnosis. After accounting for these, the overall effective radiation dose is not increased by using this strategy."

Cardiovascular • Coronary Artery Disease

Residual myocardial hyperemia in regadenoson stress/rest quantitative perfusion cardiac magnetic resonance. (PubMed, Radiol Med) - "Despite the use of euphylline to counteract the vasodilator effect, MBF does not completely revert to resting values and MBFrecovery cannot be used as a substitute for MBFrest when regadenoson is used. Consequently, a rest/stress protocol is advised for quantitative CMR perfusion to obtain accurate MBF and MPR parameters."

Journal • Cardiovascular • Coronary Artery Disease • Myocardial Infarction

Reserve of global constructive work for early diagnosis of myocardial ischemia and risk stratification in chronic coronary syndrome. (PubMed, Front Cardiovasc Med) - "All patients underwent regadenoson stress echocardiography, with early ischemia indicated by coronary flow velocity reserve (CFVR) <2.5...The incorporation of △GCW and hemoglobin into the prediction model enhances its ability to estimate myocardial ischemia risk. △GCW offered higher sensitivity and incremental diagnostic value in detecting myocardial ischemia in the heterogeneous CCS population."

Journal • Cardiovascular • Myocardial Ischemia

Blunted Hemodynamic Response to Pharmacological Stress is Predictive of Mortality in Liver Transplant Candidates. (PubMed, J Nucl Cardiol) - "In this retrospective cohort analysis, LTCs exhibited a reduced hemodynamic response detected as lower delta HR, SBP and DBP as well as fewer symptoms in response to regadenoson during stress testing. Reduced hemodynamic response was significantly associated with mortality and provided incremental prognostic value in addition to MELD score. Further prospective studies are required to validate these findings."

Journal • Cardiovascular • CNS Disorders • Coronary Artery Disease • Hepatology • Transplantation

AI-Derived Splenic Response in Cardiac PET Predicts Mortality: A Multi-Site Study. (PubMed, medRxiv) - "To evaluate the prognostic value of artificial intelligence (AI)-derived SR in a large multicenter 82 Rb-PET cohort undergoing regadenoson stress testing...Incorporating automated SR into PET MPI interpretation may enhance risk stratification and identify patients who could benefit from intensified preventive care, particularly when traditional imaging markers appear reassuring. These findings support SR as a clinically meaningful, easily integrated biomarker in stress PET imaging."

Journal • Cardiovascular • Coronary Artery Disease • Diabetes • Dyslipidemia • Hypertension • Metabolic Disorders • Preventive care

Hemiplegic Migraine in a Patient With Neurologic Symptoms After Regadenoson Administration. (PubMed, Clin Case Rep) - "Regadenoson may be associated with hemodynamic instability and lowering of the seizure threshold. Patients should be screened for neurologic risk factors prior to receiving regadenoson to determine if alternate modalities for ischemic evaluation are more suitable."

Journal • Cardiovascular • CNS Disorders • Epilepsy • Migraine • Pain • ADORA2A