Document Detail


A randomized comparison of 4 doses of intracoronary adenosine in the assessment of fractional flow reserve.
MedLine Citation:
PMID:  12955409     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Fractional flow reserve (FFR) is a measure of coronary stenosis severity that is based on pressure measurements obtained at maximal hyperemia. Therefore, achievement of maximal vasodilatation of the coronary microcirculation is a prerequisite for the measurement of FFR. The study was designed to address the hypothesis that intracoronary adenosine yields more complete vasodilatation of the coronary microcirculation when high doses are used, resulting in a more accurate FFR measurement. METHODS: Thirty-six patients with 43 moderate lesions underwent determination of FFR during cardiac catheterization. FFR was calculated in all lesions as the ratio of the distal coronary pressure to the aortic pressure at hyperemia. Different incremental doses of intracoronary adenosine (16, 24, 32 and 40 microg for both coronary arteries) were administered in a randomized fashion. RESULTS: No adverse events occurred with any intracoronary adenosine bolus. At baseline there were no significant differences for mean aortic and distal coronary pressure, heart rate as well as FFR values between the different doses. FFR was not significantly altered from the different incremental adenosine doses. However, in 27 (63%) out of 43 lesions there was a further reduction of FFR up to 0.23 when a dose >16 microg was injected. CONCLUSIONS: This study suggests that doses of adenosine up to 40 microg are safe and can be used to achieve a more pronounced vasodilatation in individual patients compared to the standard doses. This may have therapeutic impact with FFR values near cut-off points in patients undergoing diagnostic coronary angiography as well as in patients in whom FFR is used to assess the outcome of interventions.
Authors:
G Casella; J Rieber; T M Schiele; H-U Stempfle; U Siebert; M Leibig; K Theisen; U Buchmeier; V Klauss
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Zeitschrift für Kardiologie     Volume:  92     ISSN:  0300-5860     ISO Abbreviation:  Z Kardiol     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-09-04     Completed Date:  2004-01-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0360430     Medline TA:  Z Kardiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  627-32     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Ospedale Maggiore, Bologna, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / administration & dosage*,  pharmacology
Adult
Aged
Aged, 80 and over
Coronary Angiography
Coronary Circulation* / drug effects,  physiology
Coronary Stenosis / diagnosis*,  physiopathology,  radiography
Coronary Vessels
Data Interpretation, Statistical
Female
Heart Catheterization
Heart Rate
Hemodynamics
Humans
Hyperemia / physiopathology
Injections, Intra-Arterial
Male
Microcirculation / physiology
Middle Aged
Vasodilation / physiology
Vasodilator Agents / administration & dosage*,  pharmacology
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 58-61-7/Adenosine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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