Trial Outcomes & Findings for Myocardial Blood Flow by PET and N-13 Ammonia During Regadenoson vs Adenosine Stress (NCT NCT01370265)

NCT ID: NCT01370265

Last Updated: 2013-09-05

Results Overview

MBF is the rate of blood supplied to the myocardium, or heart muscle. Hyperemic MBF is the rate of myocardial blood flow in the heart muscle during either regadenoson or adenosine stress. Myocardial blood flow was calculated using commercial software (PMOD Technologies, version 2.4). The Hyperemic MBF was measured approximately 4 hours after arrival in the PET unit.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

12 participants

Primary outcome timeframe

Day 2, approximately 4 hours after arrival in positron emission tomography (PET) unit

Results posted on

2013-09-05

Participant Flow

From June 30 to December 27, 2011 subjects were recruited at Mayo Clinic in Rochester, Minnesota.

Participant milestones

Participant milestones
Measure
Regadenoson, Then Adenosine
Regadenoson (0.4 mg/5 ml IV) was administered intravenously over 10 seconds, followed immediately by saline flush and N-13 ammonia (10-20 MCi) injection and an additional saline flush in the first intervention period. Adenosine (140 μg/kg/min) was administered intravenously over 6 minutes in the second intervention period (after washout period). Three minutes after the start of adenosine infusion, N-13 ammonia (10-20 mCi) was administered.
Adenosine, Then Regadenoson
Adenosine (140 μg/kg/min) was administered intravenously over 6 minutes in the first intervention period. Three minutes after the start of adenosine infusion, N-13 ammonia (10-20 mCi) was administered. After a washout period, Regadenoson (0.4 mg/5 ml IV) was administered intravenously over 10 seconds, followed immediately by saline flush and N-13 ammonia (10-20 MCi) injection and an additional saline flush in the second intervention period.
Resting Myocardial Blood Flow (MBF)
STARTED
6
6
Resting Myocardial Blood Flow (MBF)
COMPLETED
6
6
Resting Myocardial Blood Flow (MBF)
NOT COMPLETED
0
0
Washout Period (50-minute Period Decay)
STARTED
5
5
Washout Period (50-minute Period Decay)
COMPLETED
5
5
Washout Period (50-minute Period Decay)
NOT COMPLETED
0
0
First Intervention
STARTED
6
6
First Intervention
COMPLETED
5
5
First Intervention
NOT COMPLETED
1
1
Second Intervention
STARTED
5
5
Second Intervention
COMPLETED
5
5
Second Intervention
NOT COMPLETED
0
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Regadenoson, Then Adenosine
Regadenoson (0.4 mg/5 ml IV) was administered intravenously over 10 seconds, followed immediately by saline flush and N-13 ammonia (10-20 MCi) injection and an additional saline flush in the first intervention period. Adenosine (140 μg/kg/min) was administered intravenously over 6 minutes in the second intervention period (after washout period). Three minutes after the start of adenosine infusion, N-13 ammonia (10-20 mCi) was administered.
Adenosine, Then Regadenoson
Adenosine (140 μg/kg/min) was administered intravenously over 6 minutes in the first intervention period. Three minutes after the start of adenosine infusion, N-13 ammonia (10-20 mCi) was administered. After a washout period, Regadenoson (0.4 mg/5 ml IV) was administered intravenously over 10 seconds, followed immediately by saline flush and N-13 ammonia (10-20 MCi) injection and an additional saline flush in the second intervention period.
First Intervention
Adverse Event
1
1

Baseline Characteristics

Myocardial Blood Flow by PET and N-13 Ammonia During Regadenoson vs Adenosine Stress

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Entire Study Population
n=12 Participants
Includes groups randomized to receive Regadenoson first and Adenosine first.
Age Continuous
44 years
STANDARD_DEVIATION 8 • n=5 Participants
Sex: Female, Male
Female
6 Participants
n=5 Participants
Sex: Female, Male
Male
6 Participants
n=5 Participants
Region of Enrollment
United States
12 participants
n=5 Participants
Body Mass Index
26.1 kg/m^2
STANDARD_DEVIATION 4.3 • n=5 Participants

PRIMARY outcome

Timeframe: Day 2, approximately 4 hours after arrival in positron emission tomography (PET) unit

Population: Analysis per protocol; one participant in each group experienced an ischemic ECG with the first stress drug, and they were withdrawn from the study. This is a per intervention presentation.

MBF is the rate of blood supplied to the myocardium, or heart muscle. Hyperemic MBF is the rate of myocardial blood flow in the heart muscle during either regadenoson or adenosine stress. Myocardial blood flow was calculated using commercial software (PMOD Technologies, version 2.4). The Hyperemic MBF was measured approximately 4 hours after arrival in the PET unit.

Outcome measures

Outcome measures
Measure
Regadenoson
n=10 Participants
Regadenoson (0.4 mg/5 ml IV) was administered intravenously over 10 seconds, followed immediately by saline flush and N-13 ammonia (10-20 MCi) injection and an additional saline flush.
Adenosine
n=10 Participants
Adenosine (140 μg/kg/min) was administered intravenously over 6 minutes. Three minutes after the start of adenosine infusion, N-13 ammonia (10-20 mCi) was administered.
Global Hyperemic Myocardial Blood Flow (MBF)
3.1 mL/min/gm
Standard Deviation 1.4
3.1 mL/min/gm
Standard Deviation 1.2

SECONDARY outcome

Timeframe: Day 2, approximately 35 minutes after arrival in positron emission tomography (PET) unit

Population: Resting MBF was measured on all subjects prior to the interventions.

MBF is the rate of blood supplied to the myocardium, or heart muscle. Global Myocardial blood flow was calculated using commercial software (PMOD Technologies, version 2.4). Regional MBFs were calculated using commercial software (PMOD Technologies, version 2.4). After the apical and basal slices of the left ventricular myocardium were chosen, the software automatically defined 4 myocardial regions of interest (segments) in the apical planes.

Outcome measures

Outcome measures
Measure
Regadenoson
n=10 Participants
Regadenoson (0.4 mg/5 ml IV) was administered intravenously over 10 seconds, followed immediately by saline flush and N-13 ammonia (10-20 MCi) injection and an additional saline flush.
Adenosine
Adenosine (140 μg/kg/min) was administered intravenously over 6 minutes. Three minutes after the start of adenosine infusion, N-13 ammonia (10-20 mCi) was administered.
Resting Global MBF and Resting Segmental MBF
Resting Global MBF
0.8 ml/min/gm
Standard Deviation 0.2
Resting Global MBF and Resting Segmental MBF
Resting Anterior MBF
0.7 ml/min/gm
Standard Deviation 0.2
Resting Global MBF and Resting Segmental MBF
Resting Septum MBF
0.9 ml/min/gm
Standard Deviation 0.2
Resting Global MBF and Resting Segmental MBF
Resting Inferior MBF
0.8 ml/min/gm
Standard Deviation 0.2
Resting Global MBF and Resting Segmental MBF
Resting Lateral MBF
0.8 ml/min/gm
Standard Deviation 0.2

SECONDARY outcome

Timeframe: Day 2, approximately 4 hours after arrival in positron emission tomography (PET) unit

Population: Analysis per protocol, one participant in each group experienced an ischemic ECG with the first stress drug, and they were withdrawn from the study. This is a per intervention presentation.

Cardiac Flow Rate was calculated using the equation: hyperemic MBF/resting MBF.

Outcome measures

Outcome measures
Measure
Regadenoson
n=10 Participants
Regadenoson (0.4 mg/5 ml IV) was administered intravenously over 10 seconds, followed immediately by saline flush and N-13 ammonia (10-20 MCi) injection and an additional saline flush.
Adenosine
n=10 Participants
Adenosine (140 μg/kg/min) was administered intravenously over 6 minutes. Three minutes after the start of adenosine infusion, N-13 ammonia (10-20 mCi) was administered.
Global Cardiac Flow Rate
3.8 ratio
Standard Deviation 1.5
4.0 ratio
Standard Deviation 1.4

SECONDARY outcome

Timeframe: Day 2, approximately 4 hours after arrival in positron emission tomography (PET) unit

Population: Analysis per protocol; one participant in each group experienced an ischemic ECG with the first stress drug, and they were withdrawn from the study. This is a per intervention presentation.

Regional MBFs were calculated using commercial software (PMOD Technologies, version 2.4). After the apical and basal slices of the left ventricular myocardium were chosen, the software automatically defined 4 myocardial regions of interest (segments) in the apical planes. The hyperemic MBF was measured approximately 4 hours after arrival in the PET unit, depending on the randomization.

Outcome measures

Outcome measures
Measure
Regadenoson
n=10 Participants
Regadenoson (0.4 mg/5 ml IV) was administered intravenously over 10 seconds, followed immediately by saline flush and N-13 ammonia (10-20 MCi) injection and an additional saline flush.
Adenosine
n=10 Participants
Adenosine (140 μg/kg/min) was administered intravenously over 6 minutes. Three minutes after the start of adenosine infusion, N-13 ammonia (10-20 mCi) was administered.
Hyperemic Segmental MBF
Hyperemic MBF Anterior
2.5 mL/min/gm
Standard Deviation 0.5
2.6 mL/min/gm
Standard Deviation 0.8
Hyperemic Segmental MBF
Hyperemic MBF Septum
3.1 mL/min/gm
Standard Deviation 0.8
3.2 mL/min/gm
Standard Deviation 1.4
Hyperemic Segmental MBF
Hyperemic MBF Inferior
3.5 mL/min/gm
Standard Deviation 1.6
3.6 mL/min/gm
Standard Deviation 1.3
Hyperemic Segmental MBF
Hyperemic MBF Lateral
2.9 mL/min/gm
Standard Deviation 0.6
2.9 mL/min/gm
Standard Deviation 1.1

SECONDARY outcome

Timeframe: Day 2, approximately 4 hours after arrival in positron emission tomography (PET) unit

Population: Analysis per protocol, one participant in each group experienced an ischemic ECG with the first stress drug, and they were withdrawn from the study. This is a per intervention presentation.

CFR was calculated using the equation: hyperemic MBF/resting MBF.

Outcome measures

Outcome measures
Measure
Regadenoson
n=10 Participants
Regadenoson (0.4 mg/5 ml IV) was administered intravenously over 10 seconds, followed immediately by saline flush and N-13 ammonia (10-20 MCi) injection and an additional saline flush.
Adenosine
n=10 Participants
Adenosine (140 μg/kg/min) was administered intravenously over 6 minutes. Three minutes after the start of adenosine infusion, N-13 ammonia (10-20 mCi) was administered.
Segmental CFR
CFR Anterior
3.4 ratio
Standard Deviation 1.1
3.7 ratio
Standard Deviation 1.0
Segmental CFR
CFR Septum
3.5 ratio
Standard Deviation 0.7
3.6 ratio
Standard Deviation 1.6
Segmental CFR
CFR Inferior
4.4 ratio
Standard Deviation 1.4
4.6 ratio
Standard Deviation 1.3
Segmental CFR
CFR Lateral
3.9 ratio
Standard Deviation 1.0
4.0 ratio
Standard Deviation 1.1

SECONDARY outcome

Timeframe: Day 2, approximately 35 minutes and approximately 4 hours after arrival in the PET unit

Population: Analysis per protocol; one participant in each group experienced an ischemic ECG with the first stress drug, and they were withdrawn from the study. This is a per intervention presentation.

The resting heart rate was measured approximately 35 minutes after arrival in the PET unit. The hyperemic heart rate was measured approximately 4 hours after arrival in the PET unit, depending on the randomization.

Outcome measures

Outcome measures
Measure
Regadenoson
n=10 Participants
Regadenoson (0.4 mg/5 ml IV) was administered intravenously over 10 seconds, followed immediately by saline flush and N-13 ammonia (10-20 MCi) injection and an additional saline flush.
Adenosine
n=10 Participants
Adenosine (140 μg/kg/min) was administered intravenously over 6 minutes. Three minutes after the start of adenosine infusion, N-13 ammonia (10-20 mCi) was administered.
Heart Rate (Beats Per Minute (BPM))
Resting heart rate
62 bpm
Standard Deviation 10
60 bpm
Standard Deviation 9
Heart Rate (Beats Per Minute (BPM))
Hyperemic heart rate
98 bpm
Standard Deviation 16
93 bpm
Standard Deviation 15

SECONDARY outcome

Timeframe: Day 2, approximately 4 hours after arrival in the PET unit

Population: Analysis per protocol; one participant in each group experienced an ischemic ECG with the first stress drug, and they were withdrawn from the study. This is a per intervention presentation.

Blood pressure was measured approximately 4 hours after arrival in the PET unit, depending on the randomization.

Outcome measures

Outcome measures
Measure
Regadenoson
n=10 Participants
Regadenoson (0.4 mg/5 ml IV) was administered intravenously over 10 seconds, followed immediately by saline flush and N-13 ammonia (10-20 MCi) injection and an additional saline flush.
Adenosine
n=10 Participants
Adenosine (140 μg/kg/min) was administered intravenously over 6 minutes. Three minutes after the start of adenosine infusion, N-13 ammonia (10-20 mCi) was administered.
Hyperemic Blood Pressure (mmHg)
Systolic
130 mmHg
Standard Deviation 17
132 mmHg
Standard Deviation 23
Hyperemic Blood Pressure (mmHg)
Diastolic
72 mmHg
Standard Deviation 11
75 mmHg
Standard Deviation 17

Adverse Events

Regadenoson

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Adenosine

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Regadenoson
n=12 participants at risk
Regadenoson (0.4 mg/5 ml IV) was administered intravenously over 10 seconds, followed immediately by saline flush and N-13 ammonia (10-20 MCi) injection and an additional saline flush.
Adenosine
n=12 participants at risk
Adenosine (140 μg/kg/min) was administered intravenously over 6 minutes. Three minutes after the start of adenosine infusion, N-13 ammonia (10-20 mCi) was administered.
Cardiac disorders
Ischemic ECG findings
8.3%
1/12 • Number of events 1 • Subjects were monitored for adverse events for the time while on study, approximately 4 weeks.
8.3%
1/12 • Number of events 1 • Subjects were monitored for adverse events for the time while on study, approximately 4 weeks.

Additional Information

Dr. Panithaya Chareonthaitawee

Mayo Clinic

Phone: 507-284-1648

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place