{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T13:23:02Z","timestamp":1783171382685,"version":"3.54.6"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["MQ [FS\/ICRF\/22\/26046]"],"award-info":[{"award-number":["MQ [FS\/ICRF\/22\/26046]"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Great Ormond Street Hospital NHS Foundation Trust"},{"DOI":"10.13039\/501100001282","name":"UCL Great Ormond Street Institute of Child Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001282","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019256","name":"NIHR Great Ormond Street Hospital Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100019256","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>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\u20132025). Regadenoson was administered incrementally, targeting \u226520% 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 \u00b1 4 years (range 3\u201318) and weight 50.4 \u00b1 21\u2005kg (range 14.9\u201391.8). 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\u2005mcg\/kg (range 1.6\u20138), representing 60% reduction compared with standard 8\u2005mcg\/kg protocols. Among patients &amp;gt;50\u2005kg, 83% achieved adequate stress with \u2264160\u2005mcg (\u226440% of the standard 400\u2005mcg adult dose). Mean heart rate increased 42% (range 16\u201377%). Transient blood pressure reductions \u226510\u2005mmHg 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjimp\/qyag108","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T07:14:16Z","timestamp":1781507656000},"source":"Crossref","is-referenced-by-count":0,"title":["Reduced regadenoson dose using heart rate-targeted titration in paediatric stress perfusion CMR"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7005-4720","authenticated-orcid":false,"given":"Michael A","family":"Quail","sequence":"first","affiliation":[{"name":"Centre for Cardiovascular Imaging, Heart and Lung Division, Great Ormond Street Hospital for Children NHS Foundation Trust , Great Ormond Street, London WC1N 3JH ,","place":["UK"]},{"name":"Research Department of Children\u2019s Cardiovascular Disease, Institute of Cardiovascular Science, University College London , London WC1N 1DZ ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Tann","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Imaging, Heart and Lung Division, Great Ormond Street Hospital for Children NHS Foundation Trust , Great Ormond Street, London WC1N 3JH ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romina","family":"Linton","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Imaging, Heart and Lung Division, Great Ormond Street Hospital for Children NHS Foundation Trust , Great Ormond Street, London WC1N 3JH ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena G","family":"Milano","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Imaging, Heart and Lung Division, Great Ormond Street Hospital for Children NHS Foundation Trust , Great Ormond Street, London WC1N 3JH ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Mortensen","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Imaging, Heart and Lung Division, Great Ormond Street Hospital for Children NHS Foundation Trust , Great Ormond Street, London WC1N 3JH ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M","family":"Taylor","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Imaging, Heart and Lung Division, Great Ormond Street Hospital for Children NHS Foundation Trust , Great Ormond Street, London WC1N 3JH ,","place":["UK"]},{"name":"Research Department of Children\u2019s Cardiovascular Disease, Institute of Cardiovascular Science, University College London , London WC1N 1DZ ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4292-6456","authenticated-orcid":false,"given":"Vivek","family":"Muthurangu","sequence":"additional","affiliation":[{"name":"Research Department of Children\u2019s Cardiovascular Disease, Institute of Cardiovascular Science, University College London , London WC1N 1DZ ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"2026070409064431800_qyag108-B1","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/j.nuclcard.2007.02.016","article-title":"Regadenoson, a selective A2A adenosine receptor agonist, causes dose-dependent increases in coronary blood flow velocity in humans","volume":"14","author":"Lieu","year":"2007","journal-title":"J Nucl Cardiol"},{"key":"2026070409064431800_qyag108-B2","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1007\/s12350-017-1081-y","article-title":"Incidence of atrioventricular block with vasodilator stress SPECT: a meta-analysis","volume":"26","author":"Andrikopoulou","year":"2019","journal-title":"J Nucl Cardiol"},{"key":"2026070409064431800_qyag108-B3","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1007\/s00247-016-3762-0","article-title":"Myocardial stress perfusion magnetic resonance: initial experience in a pediatric and young adult population using regadenoson","volume":"47","author":"Noel","year":"2017","journal-title":"Pediatr Radiol"},{"key":"2026070409064431800_qyag108-B4","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1007\/s00246-018-1890-z","article-title":"Myocardial stress perfusion MRI: experience in pediatric and young-adult patients following arterial switch operation utilizing regadenoson","volume":"39","author":"Noel","year":"2018","journal-title":"Pediatr Cardiol"},{"key":"2026070409064431800_qyag108-B5","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1016\/j.amjcard.2019.06.033","article-title":"Regadenoson stress perfusion cardiac magnetic resonance imaging in children with kawasaki disease and coronary artery disease","volume":"124","author":"Doan","year":"2019","journal-title":"Am J Cardiol"},{"key":"2026070409064431800_qyag108-B6","doi-asserted-by":"crossref","first-page":"e190061","DOI":"10.1148\/ryct.2019190061","article-title":"Myocardial stress perfusion MRI using regadenoson: a weight-based approach in infants and young children","volume":"1","author":"Wilkinson","year":"2019","journal-title":"Radiol Cardiothorac Imaging"},{"key":"2026070409064431800_qyag108-B7","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.2165\/00003088-200645120-00005","article-title":"A population pharmacokinetic\/pharmacodynamic analysis of 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