Abstract 17254: Adenosine A2A Receptor Polymorphisms and Response to Regadenoson
Introduction: Activation of adenosine A2A receptors induces coronary vasodilation and sympathetic activation. Regadenoson is an A2A agonist used in pharmacologic cardiac nuclear stress testing, and exhibits large variability in hemodynamic response and incidence of side effects. Common genetic variants of A2A have been associated with functional differences in neurological phenotypes.
Hypothesis: We hypothesized that common polymorphisms of A2A may influence response to regadenoson during cardiac stress testing.
Methods: We prospectively enrolled 268 patients undergoing resting regadenoson stress testing. Five common A2A receptor variants were analyzed by Taqman genotyping assay. SPECT technetium nuclear stress tests were performed and analyzed using the 17-segment model. Blood pressure and heart rate changes were recorded prospectively after administration of regadenoson.
Results: Variants of A2A were associated with significant differences in heart rate (HR), peak systolic blood pressure (SBP), and summed stress score (Table). The association of rs2298383 (minor allele frequency (MAF)=0.49), rs5751876 (MAF=0.39), and rs3761422 (MAF=0.4) with heart rate and blood pressure at rest and peak remained significant after multivariate adjustment for demographics, race, and clinical variables. Similarly, carrier status of rs2298383, rs5751876, rs3761422, and rs2267076 (MAF=0.37) remained significantly associated with summed stress score (SSS) after multivariate adjustment.
Conclusion: Common genetic variants of A2A may be associated with variability in heart rate and blood pressure response to regadenoson
and extent of ischemia on nuclear myocardial perfusion imaging. Further studies are necessary to examine the influence of A2A receptor variants on diagnostic sensitivity of regadenoson nuclear stress testing.
Author Disclosures: R.P. Kreutz: None. R. Mastouri: None. R. Saab: None. S. Philips: None. T. Skaar: None.
- © 2014 by American Heart Association, Inc.