Evidence mapPaperPMID 42405304Full record

ArticleEuropean heart journal. Imaging methods and practice2026

Reduced regadenoson dose using heart rate-targeted titration in paediatric stress perfusion CMR.

Michael A Quail, Oliver Tann, Romina Linton, Elena G Milano, Kristian Mortensen, Andrew M Taylor, Vivek Muthurangu

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Article in European heart journal. Imaging methods and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Michael A QuailCentre for Cardiovascular Imaging, Heart and Lung Division, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1N 3JH, UK.ORCID https://orcid.org/0000-0002-7005-4720
Oliver TannCentre for Cardiovascular Imaging, Heart and Lung Division, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1N 3JH, UK.
Romina LintonCentre for Cardiovascular Imaging, Heart and Lung Division, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1N 3JH, UK.
Elena G MilanoCentre for Cardiovascular Imaging, Heart and Lung Division, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1N 3JH, UK.
Kristian MortensenCentre for Cardiovascular Imaging, Heart and Lung Division, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1N 3JH, UK.
Andrew M TaylorCentre for Cardiovascular Imaging, Heart and Lung Division, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1N 3JH, UK.
Vivek MuthuranguResearch Department of Children's Cardiovascular Disease, Institute of Cardiovascular Science, University College London, London WC1N 1DZ, UK.ORCID https://orcid.org/0000-0002-4292-6456

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aims: Weight-based regadenoson dosing for paediatric stress perfusion cardiac magnetic resonance (CMR) achieves coronary vasodilation but may result in excessive drug exposure in some patients. We evaluated the feasibility, safety, and diagnostic performance of heart rate-targeted regadenoson titration as an individualized alternative to fixed-based dosing. Methods and results: We performed a retrospective analysis of 31 consecutive regadenoson stress perfusion CMR studies (29 technically successful) in paediatric patients with known or suspected coronary artery disease (2015-2025). Regadenoson was administered incrementally, targeting ≥20% heart rate increase. Outcomes included achieved doses, haemodynamic responses, adverse events, image quality, and positivity rate. Results were compared with published weight-based dosing protocols.Mean age was 11.8 ± 4 years (range 3-18) and weight 50.4 ± 21 kg (range 14.9-91.8). Complete dosing data were available for 21/29 studies. Target heart rate response was achieved in all 29 studies (100% success) with a median dose 3.2 mcg/kg (range 1.6-8), representing 60% reduction compared with standard 8 mcg/kg protocols. Among patients >50 kg, 83% achieved adequate stress with ≤160 mcg (≤40% of the standard 400 mcg adult dose). Mean heart rate increased 42% (range 16-77%). Transient blood pressure reductions ≥10 mmHg occurred in nine patients. All studies yielded diagnostic-quality images. Stress-inducible perfusion defects were identified in 7/29 studies (24%). No major adverse events occurred. Conclusion: Heart rate-targeted regadenoson titration for paediatric stress perfusion CMR is feasible, achieving diagnostic-quality images with substantially reduced drug exposure. Consistent haemodynamic responses and positivity rates comparable to published series suggest adequacy of pharmacological stress, though prospective validation with quantitative perfusion measurement is required.

Indexed as

cardiac magnetic resonancecongenital heart diseasecoronary artery diseasekawasaki diseasepaediatric cardiologypharmacological stress testingregadenosonstress perfusion

Identifiers

PMID42405304
PMCPMC13332441

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.