Regadenoson Combined With Symptom-Limited Exercise in Patients Undergoing Myocardial Perfusion Imaging

Not infrequently, a physician is faced with uncertainty regarding the ability of a patient
to perform adequate exercise in the noninvasive evaluation of known or suspected coronary
artery disease (CAD) by the use of radionuclide stress myocardial perfusion imaging. In
selected patients, protocols that combine exercise (either low-level or symptom-limited)
with vasodilator stress agents have been found to be safe and effective in both
identification of the presence and severity of CAD as well as risk stratification for
adverse cardiac outcome. However, currently utilized combined stress protocols have
drawbacks. Further refinement of combined stress protocols would potentially lead to more
appropriate stress protocol selection for patients while enhancing laboratory efficiency.
The purpose of this prospective, randomized study will be to evaluate the relative merits of
combining regadenoson with symptom-limited exercise in patients clinically-referred for
vasodilator-exercise stress MPI for the assessment of known or suspected CAD. It is
hypothesized that combining regadenoson with symptom-limited exercise is a safe and feasible
stress testing modality which is non-inferior to that which combines symptom-limited
exercise with dipyridamole.