Intracoronary continuous adenosine infusion.
BACKGROUND
Various methods are used to induce maximal hyperemia for physiologic studies, but the feasibility and efficacy of continuous intracoronary (IC) infusion of adenosine for measurement of fractional flow reserve (FFR) has not been well-defined.


RESULTS
Patients with intermediate coronary artery stenosis were consecutively enrolled. In the phase I study, FFR was measured after 3 dosages of IC adenosine infusion (180, 240 and 300 microg/min) in 30 patients. The phase II study was performed to compare the hyperemic efficacy of IC infusion (240 microg/min) with IC bolus injection (40, 80 microg) and intravenous (IV) infusion (140 microg x kg (-1) x min(-1)) of adenosine in 20 patients. In the phase I study, no significant differences in FFR were observed with the 3 different doses of IC infusion (p = 0.06). In the phase II study, FFR after an IC bolus injection (0.83+/-0.06) was significantly higher than with IV (0.79+/-0.07) or IC (0.78+/-0.09) infusion (p < 0.01). However, no difference in FFR was observed for IC and IV infusions.


CONCLUSIONS
IC infusion of adenosine seems to be a safe and effective method of inducing maximal hyperemia for FFR measurement.
Koo
Bon-Kwon
BK
Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Cardiovascular Center, Seoul.
Kim
Cheol-Ho
CH
Na
Sang-Hun
SH
Youn
Tae-Jin
TJ
Chae
In-Ho
IH
Choi
Dong-Ju
DJ
Kim
Hyo-Soo
HS
Lee
Myoung-Mook
MM
Oh
Byung-Hee
BH
Park
Young-Bae
YB
Choi
Yun-Shik
YS
Tahk
Seung-Jae
SJ
D000241:Adenosine / Q000008:administration & dosage*; D000368:Aged; D001783:Blood Flow Velocity / Q000187:drug effects; D003326:Coronary Circulation / Q000187:drug effects*; D023921:Coronary Stenosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000139:chemically induced*; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged
D000241:Adenosine