| Effects of increasing doses of intracoronary adenosine on the assessment of fractional flow reserve. | |
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MedLine Citation:
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PMID: 22017932 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The purpose of this study was to investigate the effects of increasing dose of intracoronary adenosine on fractional flow reserve (FFR) measurement. BACKGROUNDS: FFR is a validated method for the assessment of the severity of coronary artery stenosis. It is based on the change in the pressure gradient across the stenosis after the achievement of maximal hyperemia of the coronary microcirculation that may be obtained by either intracoronary bolus or intravenous infusion of adenosine. No study has explored so far the effects of very high doses of intracoronary adenosine on FFR. METHODS: FFR was assessed in 46 patients with 50 intermediate lesions during cardiac catheterization by pressure-recording guidewire (PrimeWire, Volcano, San Diego, California). FFR was calculated as the ratio of the distal coronary pressure to the aortic pressure at hyperemia. Increasing doses of adenosine were administrated (60, 120, 180, 360, and 720 μg) as intracoronary boluses. Exclusion criteria were: 1) allergy to adenosine; 2) baseline bradycardia (heart rate <50 beats/min); 3) hypotension (blood pressure <90 mm Hg); and 4) refusal to provide signed informed consent. RESULTS: High doses of intracoronary adenosine were well tolerated, with no major side effects. Increasing doses up to 720 μg progressively decreased FFR values and increased the percentage of patients showing an FFR <0.75. Among angiographic parameters, both percent stenosis and lesion length were independently associated with lower FFR values. CONCLUSIONS: This study shows that high doses of intracoronary adenosine (up to 720 μg) increased the sensitivity of FFR in the detection of hemodynamically relevant coronary stenoses. Furthermore, lesion length and stenosis severity were independent angiographic determinants of FFR. |
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Authors:
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Giuseppe De Luca; Luca Venegoni; Sergio Iorio; Livio Giuliani; Paolo Marino |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: JACC. Cardiovascular interventions Volume: 4 ISSN: 1876-7605 ISO Abbreviation: JACC Cardiovasc Interv Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-24 Completed Date: 2012-02-27 Revised Date: 2012-08-29 |
Medline Journal Info:
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Nlm Unique ID: 101467004 Medline TA: JACC Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 1079-84 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Cardiology, Ospedale Maggiore della Carità, Eastern Piedmont University, Novara, Italy. giuseppe.deluca@maggioreosp.novara.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenosine
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administration & dosage,
therapeutic use* Aged Bradycardia Coronary Angiography Coronary Stenosis / diagnosis*, pathology Coronary Vessels / pathology* Female Fractional Flow Reserve, Myocardial / drug effects* Hemodynamics Humans Hypotension Male Microcirculation Middle Aged Multivariate Analysis Severity of Illness Index Vasodilator Agents / administration & dosage, therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 58-61-7/Adenosine |
| Comments/Corrections | |
Comment In:
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JACC Cardiovasc Interv. 2012 Feb;5(2):245; author reply 245
[PMID:
22361612
]
JACC Cardiovasc Interv. 2011 Oct;4(10):1093-5 [PMID: 22017934 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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