Induction of pharmacological stress with adenosine receptor agonists

A method to diagnose coronary artery stenosis in a mammal comprising:

• (a) parenterally administering to said mammal an amount of a compound of formula (I):
• wherein (a) each R is individually hydrogen, C1-C6 alkyl, C3-C7 cycloalkyl, phenyl or phenyl(C1-C3)-alkyl;
• (b) X is —CH2OH, —CO2R2, —OC(O)R2, —CH2OC(O)R2 or C(O)NR3R4;
• (c) each of R2, R3 and R4 is individually H, C1-6-alkyl;
• C1-6-alkyl substituted with 1-3 C1-6-alkoxy, C3-C7-cycloalkyl, C1-6-alkylthio, halogen hydroxy, amino, mono(C1-6-alkyl)amino, di(C1-6-alkyl)amino, or C6-10-aryl, wherein aryl may be substituted with 1-3 halogen, C1-6-alkyl, hydroxy, amino, mono(C1-6-alkyl)amino, or di(C1-6-alkyl)amino;
• C6-10-aryl;
• or C6-10-aryl substituted with 1-3 halogen, hydroxy, amino, mono(C1-6-alkyl)amino, di(C1-6-alkyl)amino or C1-6-alkyl;
• (d) each of R3 and R4 is individually hydrogen, C3-7-cycloalkyl, or any of the meanings of R2;
• and
• (e) R1 is (X—(Z)—)n[(C3-C10)cycloalkyl]—(Z′)— wherein Z and Z′ are individually (C1-C6)alkyl, optionally interrupted by 1-3 S or nonperoxide O, or is absent, and n is 1-3;
• or a pharmaceutically acceptable salt thereof;
• wherein said amount is effective to provide coronary artery vasodilation;
• and
• (b) performing a technique on said mammal selected from the soup consisting of myocardial perfusion imaging, ventricular function imaging and a method for measuring coronary blood flow velocity, to detect the presence and/or assess the severity of said coronary artery stenosis.