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Comparison of the intracoronary continuous infusion method using a microcatheter and the intravenous continuous adenosine infusion method for inducing maximal hyperemia for fractional flow reserve measurement.

Authors
Yoon, MH; Tahk, SJ; Yang, HM; Park, JS; Zheng, M; Lim, HS; Choi, BJ; Choi, SY; Choi, UJ; Hwang, JW; Kang, SJ; Hwang, GS; Shin, JH
Citation
American heart journal, 157(6):1050-1056, 2009
Journal Title
American heart journal
ISSN
0002-87031097-6744
Abstract
BACKGROUND: Inducing stable maximal coronary hyperemia is essential for measurement of fractional flow reserve (FFR). We evaluated the efficacy of the intracoronary (IC) continuous adenosine infusion method via a microcatheter for inducing maximal coronary hyperemia.



METHODS: In 43 patients with 44 intermediate coronary lesions, FFR was measured consecutively by IC bolus adenosine injection (48-80 microg in left coronary artery, 36-60 microg in the right coronary artery) and a standard intravenous (IV) adenosine infusion (140 microg x min(-1) x kg(-1)). After completion of the IV infusion method, the tip of an IC microcatheter (Progreat Microcatheter System, Terumo, Japan) was positioned at the coronary ostium, and FFR was measured with increasing IC continuous adenosine infusion rates from 60 to 360 microg/min via the microcatheter.



RESULTS: Fractional flow reserve decreased with increasing IC adenosine infusion rates, and no further decrease was observed after 300 microg/min. All patients were well tolerated during the procedures. Fractional flow reserves measured by IC adenosine infusion with 180, 240, 300, and 360 microg/min were significantly lower than those by IV infusion (P < .05). Intracoronary infusion at 180, 240, 300, and 360 microg/min was able to shorten the times to induction of optimal and steady-stable hyperemia compared to IV infusion (P < .05). Functional significances were changed in 5 lesions by IC infusion at 240 to 360 microg/min but not by IV infusion.



CONCLUSIONS: The results of this study suggest that an IC adenosine continuous infusion method via a microcatheter is safe and effective in inducing steady-state hyperemia and more potent and quicker in inducing optimal hyperemia than the standard IV infusion method.
MeSH terms
Adenosine/administration & dosage*AgedCoronary Circulation*/drug effectsCoronary Vessels/drug effectsDiagnostic Techniques, Cardiovascular*FemaleHemodynamicsHumansHyperemia/chemically induced*Infusions, Intra-ArterialInfusions, IntravenousMaleMiddle AgedVasodilation/drug effectsVasodilator Agents/administration & dosage*
DOI
10.1016/j.ahj.2009.03.012
PMID
19464416
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
AJOU Authors
윤, 명호탁, 승제양, 형모박, 진선임, 홍석최, 병주최, 소연강, 수진황, 교승신, 준한
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