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Intracoronary versus intravenous adenosine-induced maximal coronary hyperemia for fractional flow reserve measurements.

Khashaba A, Mortada A, Omran A - Clin Med Insights Cardiol (2014)

Bottom Line: FFR values, symptoms, and development of atrioventricular block were recorded. 150 μg doses of IC adenosine were well tolerated and associated with fewer symptoms than IV adenosine.Intracoronary adenosine doses induced a significant decrease of FFR compared with baseline levels (P < 0.01).Larger randomized studies with cross-over design are necessary to verify the results.

View Article: PubMed Central - PubMed

Affiliation: Ain Shams University, Cardiology Department Cairo, Egypt.

ABSTRACT

Background: Maximal hyperemia is the critical prerequisite for fractional flow reserve (FFR) assessment. Despite intravenous (IV) adenosine currently being the recommended approach, intracoronary (IC) administration of adenosine constitutes a valuable alternative in everyday practice. However, it is surprisingly unclear which IC strategy allows the achievement of FFR values that are comparable to IV adenosine.

Objectives: This study sought to compare increasing doses of IC adenosine versus IV adenosine for FFR.

Methods: 30 intermediate coronary stenoses undergoing FFR measurement were prospectively and consecutively enrolled. Hyperemia was sequentially induced by bolus of IC adenosine (ADN; 150 μg) followed by IV adenosine (IVADN) infusion over 3 minutes at dose of (140 μg/kg/min). FFR values, symptoms, and development of atrioventricular block were recorded.

Results: 150 μg doses of IC adenosine were well tolerated and associated with fewer symptoms than IV adenosine. Intracoronary adenosine doses induced a significant decrease of FFR compared with baseline levels (P < 0.01). Among the 6 patients with FFR values less than 0.80 identified by IVADN, 4 were correctly identified also by 150 μg bolus IC adenosine. Larger randomized studies with cross-over design are necessary to verify the results.

Conclusions: This small pilot study suggests that IC adenosine might be an alternative to IV adenosine. Larger randomized studies with a cross-over design are necessary.

No MeSH data available.


Related in: MedlinePlus

mFFR recorded values.
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f1-cmc-8-2014-017: mFFR recorded values.

Mentions: IC adenosine dose induced a significant decrease in FFR compared with baseline distal coronary pressure/aortic pressure (P < 0.05), (mean baseline FFR 0.94 ± 0.05, mean IVADN 0.85 ± 0.08, and Mean ICADN 0.84 ± 0.09) with mean values illustrated in Table 3 and Figure 1.


Intracoronary versus intravenous adenosine-induced maximal coronary hyperemia for fractional flow reserve measurements.

Khashaba A, Mortada A, Omran A - Clin Med Insights Cardiol (2014)

mFFR recorded values.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3928055&req=5

f1-cmc-8-2014-017: mFFR recorded values.
Mentions: IC adenosine dose induced a significant decrease in FFR compared with baseline distal coronary pressure/aortic pressure (P < 0.05), (mean baseline FFR 0.94 ± 0.05, mean IVADN 0.85 ± 0.08, and Mean ICADN 0.84 ± 0.09) with mean values illustrated in Table 3 and Figure 1.

Bottom Line: FFR values, symptoms, and development of atrioventricular block were recorded. 150 μg doses of IC adenosine were well tolerated and associated with fewer symptoms than IV adenosine.Intracoronary adenosine doses induced a significant decrease of FFR compared with baseline levels (P < 0.01).Larger randomized studies with cross-over design are necessary to verify the results.

View Article: PubMed Central - PubMed

Affiliation: Ain Shams University, Cardiology Department Cairo, Egypt.

ABSTRACT

Background: Maximal hyperemia is the critical prerequisite for fractional flow reserve (FFR) assessment. Despite intravenous (IV) adenosine currently being the recommended approach, intracoronary (IC) administration of adenosine constitutes a valuable alternative in everyday practice. However, it is surprisingly unclear which IC strategy allows the achievement of FFR values that are comparable to IV adenosine.

Objectives: This study sought to compare increasing doses of IC adenosine versus IV adenosine for FFR.

Methods: 30 intermediate coronary stenoses undergoing FFR measurement were prospectively and consecutively enrolled. Hyperemia was sequentially induced by bolus of IC adenosine (ADN; 150 μg) followed by IV adenosine (IVADN) infusion over 3 minutes at dose of (140 μg/kg/min). FFR values, symptoms, and development of atrioventricular block were recorded.

Results: 150 μg doses of IC adenosine were well tolerated and associated with fewer symptoms than IV adenosine. Intracoronary adenosine doses induced a significant decrease of FFR compared with baseline levels (P < 0.01). Among the 6 patients with FFR values less than 0.80 identified by IVADN, 4 were correctly identified also by 150 μg bolus IC adenosine. Larger randomized studies with cross-over design are necessary to verify the results.

Conclusions: This small pilot study suggests that IC adenosine might be an alternative to IV adenosine. Larger randomized studies with a cross-over design are necessary.

No MeSH data available.


Related in: MedlinePlus