title: Use of regadenoson for measurement of fractional flow reserve.
abstract: OBJECTIVE
  To compare the use of regadenoson to adenosine for measurement of fractional flow reserve (FFR).
  
  
  BACKGROUND
  FFR is an accepted method to assess the functional significance of intermediate coronary artery stenoses and uses adenosine to induce maximal hyperemia. The use of the selective A2a receptor agonist regadenoson for FFR is not established.
  
  
  METHODS
  Fifty-seven patients undergoing clinically indicated FFR assessment of intermediate coronary stenoses were included. For the initial assessment of FFR, hyperemia was achieved by a standard intravenous adenosine infusion (140 mcg/kg/min). After a washout period of 10 min, FFR was reassessed using regadenoson as a single 0.4 mg intravenous bolus. FFR measurements were recorded at baseline and following maximal hyperemia with both agents.
  
  
  RESULTS
  Mean age was 57 ± 8 years and 47 were male. Sixty coronary lesions were evaluated and were located in the left anterior descending in 34, the left circumflex in 9, right coronary in 15, and left main coronary artery in 2. Mean ( ± SD) FFR following adenosine and regadenoson was 0.79 ( ± 0.09) and 0.79 (±0.09), respectively, P = NS. Time to FFR nadir was shorter with regadenoson compared to adenosine, 36.6 ± 24 versus 66 ± 0.19 sec, P < 0.0001, respectively. No patients experienced any significant side effects related to regadenoson.
  
  
  CONCLUSIONS
  Regadenoson is a viable alternative to intravenous adenosine for achieving maximal hyperemia during FFR assessment. Compared to adenosine, regadenoson has a similar hemodynamic response, achieves more rapid hyperemia, is easier to use, and has an excellent side-effect profile.
authors.affiliation: Division of Cardiovascular Medicine, University of Southern California, Los Angeles, California.
authors.forename: Aditya
authors.initials: A
authors.lastname: Prasad
authors.forename: Meena
authors.initials: M
authors.lastname: Zareh
authors.forename: Reece
authors.initials: R
authors.lastname: Doherty
authors.forename: Ambarish
authors.initials: A
authors.lastname: Gopal
authors.forename: Hita
authors.initials: H
authors.lastname: Vora
authors.forename: Keith
authors.initials: K
authors.lastname: Somma
authors.forename: Anilkumar
authors.initials: A
authors.lastname: Mehra
authors.forename: Leonardo C
authors.initials: LC
authors.lastname: Clavijo
authors.forename: Ray V
authors.initials: RV
authors.lastname: Matthews
authors.forename: David M
authors.initials: DM
authors.lastname: Shavelle
mesh_terms: D000241:Adenosine / Q000008:administration & dosage / Q000009:adverse effects; D058908:Adenosine A2 Receptor Agonists / Q000008:administration & dosage / Q000009:adverse effects; D000368:Aged; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006439:Hemodynamics; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011687:Purines / Q000008:administration & dosage / Q000009:adverse effects; D011720:Pyrazoles / Q000008:administration & dosage / Q000009:adverse effects; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D058908:Adenosine A2 Receptor Agonists; D011687:Purines; D011720:Pyrazoles; D014665:Vasodilator Agents; C430916:regadenoson; D000241:Adenosine
keywords: atherosclerosis; coronary angiography; fractional flow reserve