| Coronary hyperemic dose responses of intracoronary sodium nitroprusside. | |
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MedLine Citation:
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PMID: 14993141 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Sodium nitroprusside is one of several agents considered effective for treating the no-reflow phenomenon during acute coronary interventions. However, the coronary hyperemic dose responses and systemic hemodynamic effects of intracoronary nitroprusside have yet to be determined in humans. The purpose of this study was to compare the hyperemic and hemodynamic responses of intracoronary nitroprusside to intracoronary adenosine in patients during cardiac catheterization with angiographically normal anterior descending arteries. METHODS AND RESULTS: In 21 patients, coronary blood flow velocity (0.014-inch Doppler flow wire), heart rate, and blood pressure were measured in unobstructed left anterior descending coronary arteries at rest, after intracoronary adenosine (30- to 50-microg boluses), and after 3 serial doses (0.3-, 0.6-, and 0.9-microg/kg boluses) of intracoronary nitroprusside. Coronary reserve was calculated as hyperemia/basal coronary flow velocity. In an additional 9 patients with intermediate stenoses (53+/-7%), 14 fractional flow reserve (FFR) measurements (using 0.014-inch pressure wire) were performed with both intracoronary adenosine and nitroprusside (0.6 microg/kg). Intracoronary nitroprusside produced equivalent coronary hyperemia with a longer duration ( approximately 25%) compared with intracoronary adenosine. Intracoronary nitroprusside (0.9 microg/kg) decreased systolic blood pressure by <20%, with minimal change in heart rate, whereas intracoronary adenosine had no effect on these parameters. FFR measurements with intracoronary nitroprusside were identical to those obtained with intracoronary adenosine (r=0.97). CONCLUSIONS: Compared with adenosine, intracoronary nitroprusside produces an equivalent but more prolonged coronary hyperemic response in normal coronary arteries. Intracoronary nitroprusside, in doses commonly used for the treatment of the no-reflow phenomenon, can produce sustained coronary hyperemia without detrimental systemic hemodynamics. On the basis of FFR measurements compared with adenosine, sodium nitroprusside also appears to be a suitable hyperemic stimulus for coronary physiological measurements. |
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Authors:
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Walter A Parham; Andre Bouhasin; Jeffrey P Ciaramita; Souheil Khoukaz; Steven C Herrmann; Morton J Kern |
Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article Date: 2004-03-01 |
Journal Detail:
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Title: Circulation Volume: 109 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2004 Mar |
Date Detail:
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Created Date: 2004-03-16 Completed Date: 2004-06-28 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 1236-43 Citation Subset: AIM; IM |
Affiliation:
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J. Gerard Mudd Cardiac Catheterization Laboratory, St Louis University Health Sciences Center, St Louis, Mo, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenosine
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administration & dosage,
diagnostic use,
pharmacology Adult Aged Blood Pressure / drug effects Comorbidity Coronary Angiography Coronary Circulation / drug effects* Coronary Disease / physiopathology*, radiography Coronary Stenosis / physiopathology, radiography Coronary Vessels Female Heart Catheterization* Hemodynamics / drug effects Humans Hyperemia / chemically induced* Injections, Intra-Arterial Male Middle Aged Nitroprusside / administration & dosage, diagnostic use, pharmacology* Risk Factors Stroke Volume / drug effects Vasodilator Agents / administration & dosage, diagnostic use, pharmacology* |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 15078-28-1/Nitroprusside; 58-61-7/Adenosine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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