title: Comparison of the novel vasodilator uridine triphosphate and adenosine for the measurement of fractional flow reserve.
abstract: OBJECTIVE
  Examination of the fractional flow reserve (FFR) responses of intravenous (IV) adenosine with increasing doses of intracoronary (IC) adenosine versus IC uridine triphosphate (UTP) in patients with coronary artery disease.
  
  
  RESULTS
  We measured FFR in 25 patients during continuous IV and IC infusion (using a microcatheter in the coronary ostium). Standard IV adenosine infusion (140 μg/kg/min) was compared to 8 equimolar incremental doses of IC UTP and IC adenosine (20, 40, 60, 80, 160, 240, 320 and 640 μg/min) in a randomized order. Across all doses, ΔFFR[IC UTP - IC adenosine] was -0.038 ± 0.008, P<.001. At the highest dose of IC UTP, FFR was significantly lower (FFR[IC UTP] = 0.62 ± 0.04) than during IV adenosine (FFR[IV adenosine] = 0.72 ± 0.05; P=.02) and IC adenosine (FFR[IC adenosine] = 0.68 ± 0.05; P=.03). Furthermore, UTP had significantly fewer side effects compared to IV (P<.001) and IC adenosine (P<.05).
  
  
  CONCLUSIONS
  IC UTP lowered FFR significantly more than both IV and IC adenosine and with fewer side effects, and could be a more precise alternative to adenosine.
authors.affiliation: Copenhagen University Hospital, Bispebjerg, Department of Cardiology, Bispebjerg Bakke 23, Copenhagen N, 2400, Denmark. jaya@dadlnet.dk.
authors.forename: Jacob
authors.initials: J
authors.lastname: Sivertsen
authors.forename: Jan
authors.initials: J
authors.lastname: Jensen
authors.forename: Søren
authors.initials: S
authors.lastname: Galatius
authors.forename: Jakob
authors.initials: J
authors.lastname: Raunsø
authors.forename: Jaya
authors.initials: J
authors.lastname: Rosenmeier
mesh_terms: D000241:Adenosine / Q000009:adverse effects / Q000627:therapeutic use*; D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000188:drug therapy*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005260:Female; D053805:Fractional Flow Reserve, Myocardial / Q000187:drug effects*; D006801:Humans; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D014544:Uridine Triphosphate / Q000009:adverse effects / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents; D000241:Adenosine; D014544:Uridine Triphosphate