Gender-related differences in side-effects and hemodynamic response to regadenoson in patients undergoing SPECT myocardial perfusion imaging

  • Athanasios KatsikisEmail author
  • Elena Kyrozi
  • Vasiliki Manira
  • Athanasios Theodorakos
  • Julia Malamitsi
  • Virginia Tsapaki
  • Ioannis Iakovou
  • Vasilios Voudris
  • Genovefa Kolovou
  • Maria Koutelou
Original Article
Part of the following topical collections:
  1. Cardiology



To evaluate differences in side-effects and hemodynamic response between men and women undergoing regadenoson-stress SPECT myocardial perfusion imaging (MPI).


The initial population of the study included 858 consecutive patients who underwent regadenoson-stress MPI at our institution. These patients underwent prospective assessment and classification of regadenoson-induced side-effects in six categories and recording of heart rate (HR) and blood pressure (BP) before and after regadenoson administration. From this initial population, after adjustment with 1:1 propensity matching using gender as the dependent variable and age, BMI, diabetes mellitus, hypertension, smoking, presence of coronary artery disease, LVEF, baseline systolic and diastolic blood pressure (BP) and HR, on-going use of cardio-active medications during test, and abnormal MPI scan as independent variables, a population of 279 pairs of opposite gender was formed and studied.


Compared with men, women had a significantly higher rate of any side-effect (71% vs. 58%, p = 0.002), chest pain (23% vs. 12%, p < 0.001), gastrointestinal discomfort (20% vs. 12%, p = 0.01), dizziness (12% vs. 5%, p = 0.002), and headache (20% vs. 13%, p = 0.03) and similar rates of dyspnea and other side-effects. Women demonstrated a higher median HR-response compared with men (41% (− 8, 127) vs. 34% (− 5, 106), p = 0.001) while men demonstrated a lower median systolic BP response (− 3% (− 27, 48) vs. 0% (− 36, 68), p = 0.02) compared with women.


Gender is independently associated with a differential response to regadenoson with regard to overall side-effects and HR-response. These observations have the potential of important management and prognostic implications respectively.


Regadenoson Gender Heart rate response Side-effects 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the present study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Athanasios Katsikis
    • 1
    Email author
  • Elena Kyrozi
    • 2
  • Vasiliki Manira
    • 2
  • Athanasios Theodorakos
    • 2
  • Julia Malamitsi
    • 3
  • Virginia Tsapaki
    • 2
  • Ioannis Iakovou
    • 4
  • Vasilios Voudris
    • 4
  • Genovefa Kolovou
    • 4
  • Maria Koutelou
    • 2
  1. 1.Cardiology Department401 General Military Hospital of AthensAthensGreece
  2. 2.Nuclear Medicine DepartmentOnassis Cardiac Surgery CenterAthensGreece
  3. 3.Medical Physics departmentNational and Kapodistrian University of AthensAthensGreece
  4. 4.Cardiology DepartmentOnassis Cardiac Surgery CenterKalitheaGreece

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