The EXXERT Study

Excerpt

The EXXERT Study, the largest randomized nuclear cardiology trial in decades, investigated the safety and efficacy of combining exercise and pharmacologic stress with regadenoson for SPECT imaging. The results, published in this edition of the Journal of Nuclear Cardiology, demonstrate that with careful monitoring for ischemia, regadenoson can be administered at 3 minutes into recovery in patients not achieving adequate stress during exercise MPI.1 The approach results in comparable assessment of ischemic perfusion defects and image quality and improved target to background ratio compared to SPECT imaging after standard (non-exercise) regadenoson stress. Importantly, the protocol offers improved laboratory efficiency, whereby patients can initially attempt to exercise, and if unable to achieve, an adequate heart rate and 5 METs, or an ischemic endpoint, can be rapidly converted to pharmacologic stress during recovery. Exercise duration and a patient’s response to exercise provide important clinical and prognostic information for those undergoing stress testing.2 Given the large and positive clinical experience accumulated in the EXXERT Trial (1147 patients), adoption of this approach is expected to be of interest to many. An additional explanation of the details of the protocol is in order. …