title: Impact of alpha- and beta-adrenergic receptor blockers on fractional flow reserve and index of microvascular resistance.
abstract: We investigated the effect of β- and α-adrenergic blockers on fractional flow reserve (FFR) and index of microvascular resistance (IMR). In 43 patients (pts) with intermediate stenoses, we measured FFR and IMR before and after nonselective β-blocker propranolol (30 μg/kg, n = 20) and selective β1-blocker metoprolol (40 μg/kg, n = 23) IC; (b) In additional 21 pts after percutaneous coronary intervention (PCI), FFR and IMR were measured before and after α-blocker phentolamine (3 mg) IC. Neither propranolol nor metoprolol changed values of FFR and IMR. Phentolamine slightly decreased FFR (from 0.88 ± 0.05 to 0.87 ± 0.06, p = 0.025) but did not change IMR. FFR decreased from >0.80 to ≤0.80 in 3 pts (14%), but in none, the value decreased to <0.75. β-blockers do not affect FFR and IMR in intermediate stenoses. After PCI, a mild decrease in FFR occurs after α-blockers, though of limited clinical impact.
authors.affiliation: Cardiovascular Center Aalst, OLV Clinic, Moorselbaan, 164, B-9300, Aalst, Belgium, barba22@hotmail.com.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Barbato
authors.forename: Giovanna
authors.initials: G
authors.lastname: Sarno
authors.forename: Catalina Trana
authors.initials: CT
authors.lastname: Berza
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Gioia
authors.forename: Jozef
authors.initials: J
authors.lastname: Bartunek
authors.forename: Marc
authors.initials: M
authors.lastname: Vanderheyden
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Serafino
authors.forename: William
authors.initials: W
authors.lastname: Wijns
authors.forename: Bruno
authors.initials: B
authors.lastname: Trimarco
authors.forename: Bernard
authors.initials: B
authors.lastname: De Bruyne
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000494:pharmacology*; D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000368:Aged; D006328:Cardiac Catheterization / Q000379:methods; D005260:Female; D053805:Fractional Flow Reserve, Myocardial / Q000187:drug effects*; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000494:pharmacology; D010646:Phentolamine / Q000494:pharmacology; D011433:Propranolol / Q000494:pharmacology; D014655:Vascular Resistance / Q000187:drug effects*
chemical_list: D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D011433:Propranolol; D008790:Metoprolol; D010646:Phentolamine