Regadenoson as a pharmacologic stressor in cardiac magnetic resonance imaging in congenital and acquired pediatric heart disease: initial experience

Background Adenosine has traditionally been utilized for coronary hyperemia during myocardial perfusion assessment in adults, however regadenoson has recently become more popular [1]. With improved survival of congenital heart disease (CHD), and increased diagnosis of acquired heart disease (AHD), there’s an increasing need for assessment of myocardial perfusion in pediatrics [2]. Only dipyridamole and adenosine have reportedly been utilized as hyperemia stressors in CHD patients. As a selective A2A agonist, regadenoson has a more favorable side-effect profile and less stimulation of receptors associated with bronchospasm, and decreased chronotropy [1]. It is administered as an intravenous (IV) bolus and thus only a single IV is required. Peak onset is at 60-90 seconds, with hyperemia lasting up to 6 minutes allowing additional wall motion assessment [3].