title: Comparison of fractional flow reserve measurements using intracoronary adenosine versus intracoronary sodium nitroprusside infusions in moderately stenotic coronary artery lesions.
abstract: BACKGROUND
  The aim of this study was to investigate the efficacy and safety of intracoronary (IC) sodium nitroprusside infusion in comparison to IC adenosine for fractional flow reserve (FFR) measurement in moderately diseased coronary artery lesions for functional assessment.
  
  
  METHODS
  During a nine month period, a consecutive of 98 patients with suspected or known coronary artery disease with moderate stenosis found during angiography (40% to 70% stenosis), were enrolled in this study. Hyperemia was induced by bolus doses of IC adenosine followed by sodium nitroprusside for FFR measurement.
  
  
  RESULTS
  Both IC adenosine and IC sodium nitroprusside induced similar and significant reduction in FFR. There was no statistically difference in FFR values between adenosine vs sodium nitroprusside infusions (mean FFR 84.3±6.3 vs 85.7±6.2, p=0.1) respectively. Furthermore, comparing different FFR cut-off points between the groups (FFR<0.75, 0.75-0.8 and >0.8) showed no significant differences (p value=0.7).
  
  
  CONCLUSIONS
  An IC bolus of sodium nitroprusside (0.6μg/kg) infusion induces a similar degree of hyperemia to IC bolus of 100-300μg of adenosine. Therefore, IC sodium nitroprusside could be considered as an alternative drug to adenosine for FFR measurement with lower side effect profile.
authors.affiliation: Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Morteza
authors.initials: M
authors.lastname: Safi
authors.affiliation: Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Hasan
authors.initials: MH
authors.lastname: Namazi
authors.affiliation: Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Esfandiar
authors.initials: E
authors.lastname: Fooladi
authors.affiliation: Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Vakili
authors.affiliation: Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Saeed Alipour
authors.initials: SA
authors.lastname: Parsa
authors.affiliation: Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Isa
authors.initials: I
authors.lastname: Khaheshi
authors.affiliation: Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Amin
authors.initials: MA
authors.lastname: Abbasi
authors.affiliation: CareMore, Arizona, Tucson, AZ, USA; University of Arizona, Sarver Heart Center, Tucson, AZ, USA. Electronic address: rmova@aol.com.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Movahed
mesh_terms: D000241:Adenosine / Q000008:administration & dosage* / Q000009:adverse effects; D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000503:physiopathology; D003331:Coronary Vessels; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009599:Nitroprusside / Q000008:administration & dosage* / Q000009:adverse effects; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D014665:Vasodilator Agents; D009599:Nitroprusside; D000241:Adenosine
keywords: Fractional flow reserve; Functional study; Ischemia evaluation; Nitroprusside