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However, an exercise stress test may provide more information about exercise tolerance than a pharmacologic stress test. [37] Commonly used agents include: Vasodilators acting as adenosine receptor agonists, such as adenosine itself, and dipyridamole (Persantine), [38] which acts indirectly at the receptor.
Cardiac magnetic resonance imaging perfusion (cardiac MRI perfusion, CMRI perfusion), also known as stress CMR perfusion, [1] is a clinical magnetic resonance imaging test performed on patients with known or suspected coronary artery disease to determine if there are perfusion defects in the myocardium of the left ventricle that are caused by narrowing of one or more of the coronary arteries.
When given to dilate the arteries, such as in a "stress test", the dosage is typically 0.14 mg/kg/min, administered for 4 or 6 minutes, depending on the protocol. The recommended dose may be increased in patients on theophylline since methylxanthines prevent binding of adenosine at receptor sites.
Regadenoson, sold under the brand name Lexiscan among others, is an A 2A adenosine receptor agonist that is a coronary vasodilator that is commonly used in pharmacologic stress testing. It produces hyperemia quickly and maintains it for a duration that is useful for radionuclide myocardial perfusion imaging . [ 1 ]
In a cardiac stress test, an ST depression of at least 1 mm after adenosine administration indicates a reversible ischaemia, while an exercise stress test requires an ST depression of at least 2 mm to significantly indicate reversible ischaemia. [6]
Myocardial perfusion imaging or scanning (also referred to as MPI or MPS) is a nuclear medicine procedure that illustrates the function of the heart muscle (). [1]It evaluates many heart conditions, such as coronary artery disease (CAD), [2] hypertrophic cardiomyopathy and heart wall motion abnormalities.
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Aminophylline is used to reverse regadenoson, dipyridamole or adenosine based infusions during nuclear cardiology stress testing. Aminophylline has also been reported to be effective in preventing slow heart rates during complex cardiovascular interventions (atherectomy of the right coronary artery). [ 5 ]