Efficiencies of intracoronary sodium nitroprusside on fractional flow reserve measurement.
BACKGROUND
Fractional flow reserve (FFR) has certain advantages of assessing functional severity of coronary stenosis. Adenosine(AD) is the most widely used agents in FFR measurement but has the disadvantages of higher rate of complications. Sodium Nitroprusside (SNP) represents a valuable alternative.


RESULTS
In 75 patients with 86 moderate coronary stenosis, FFR values, heart rate and blood pressure were measured at baseline, after 0.6 μg boluses of intracoronary (IC) SNP, and after 140 μg/kg /min of continuous intravenous (IV) AD. FFR values decreased significantly after administering IV AD and IC SNP compared with the baseline Pd/Pa values (P < 0.001). Mean FFR induced by IV AD was not significantly different from that by IC SNP (t = 0.577, P = 0.566). The mean kappa value in the evaluation of two methods was 0.973 for FFR. There was a significant correlation between the FFR values of IV AD and IC SNP (R = 0.911, P < 0.001). Significant decreases in the blood pressures were found after agents were given compared to the baseline. No significant difference was found between AD and SNP. In addition, immediate complications occurred in 60.5% patients of IV AD in contrast to no adverse events after IC SNP.


CONCLUSIONS
SNP is a safe and effective agent and easy to use for the FFR measurement. Maximal hyperemia by IC SNP is equivalent to that by IV AD. IC SNP could be considered a potential alternative in patients with contraindications to AD administration.
Department of Cardiology, The General Hospital of Shenyang Military Region Shenyang 110840, Liaoning, China ; Department of Cardiology, The 230th Hospital of People's Liberation Army Dandong 118000, Liaoning, China.
Shaosheng
S
Li
Department of Cardiology, The General Hospital of Shenyang Military Region Shenyang 110840, Liaoning, China.
Jie
J
Deng
Department of Cardiology, The General Hospital of Shenyang Military Region Shenyang 110840, Liaoning, China.
Xiaozeng
X
Wang
Department of Cardiology, The General Hospital of Shenyang Military Region Shenyang 110840, Liaoning, China.
Xin
X
Zhao
Department of Cardiology, The General Hospital of Shenyang Military Region Shenyang 110840, Liaoning, China.
Yaling
Y
Han
Fractional flow reserve; coronary angiography; coronary artery disease