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Assessment of increasing intravenous adenosine dose in fractional flow reserve

Sparv, David LU ; Götberg, Matthias LU ; Harnek, Jan LU ; Persson, Tobias; Madsen-Härdig, Bjarne LU and Erlinge, David LU (2017) In BMC Cardiovascular Disorders 17(1). p.1-9
Abstract

Background: Effects of increased adenosine dose in the assessment of fractional flow reserve (FFR) were studied in relation to FFR results, hemodynamic effects and patient discomfort. FFR require maximal hyperemia mediated by adenosine. Standard dose is 140 μg/kg/min administrated intravenously. Higher doses are commonly used in clinical practice, but an extensive comparison between standard intravenous dose and a high dose (220 μg/kg/min) has previously not been performed. Methods: Seventy-five patients undergoing FFR received standard dose adenosine, followed by high dose adenosine. FFR, mean arterial pressure (MAP) and heart rate (HR) were analyzed. Patient discomfort measured by Visual Analogue Scale (VAS) was assessed. Results: No... (More)

Background: Effects of increased adenosine dose in the assessment of fractional flow reserve (FFR) were studied in relation to FFR results, hemodynamic effects and patient discomfort. FFR require maximal hyperemia mediated by adenosine. Standard dose is 140 μg/kg/min administrated intravenously. Higher doses are commonly used in clinical practice, but an extensive comparison between standard intravenous dose and a high dose (220 μg/kg/min) has previously not been performed. Methods: Seventy-five patients undergoing FFR received standard dose adenosine, followed by high dose adenosine. FFR, mean arterial pressure (MAP) and heart rate (HR) were analyzed. Patient discomfort measured by Visual Analogue Scale (VAS) was assessed. Results: No significant difference was found between the doses in FFR value (0.85 [0.79-0.90] vs 0.85 [0.79-0.89], p = 0.24). The two doses correlated well irrespective of lesion severity (r = 0.86, slope = 0.89, p = <0.001). There were no differences in MAP or HR. Patient discomfort was more pronounced using high dose adenosine (8.0 [5.0-9.0]) versus standard dose (5.0 [2.0-7.0]), p = <0.001. Conclusions: Increased dose adenosine does not improve hyperemia and is associated with increased patient discomfort. Our findings do not support the use of high dose adenosine. Trial registration: Retrospective Trial registration: Current Controlled Trials ISRCTN14618196. Registered 15 December 2016.

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author
organization
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type
Contribution to journal
publication status
published
subject
keywords
Adenosine, Coronary heart disease, Fractional flow reserve, Visual analogue scale
in
BMC Cardiovascular Disorders
volume
17
issue
1
pages
1 - 9
publisher
BioMed Central
external identifiers
  • scopus:85012882155
  • wos:000410197100001
ISSN
1471-2261
DOI
10.1186/s12872-016-0463-4
language
English
LU publication?
yes
id
f8a82e36-fd6a-4731-91f4-e0be95d4373e
date added to LUP
2017-02-27 12:44:52
date last changed
2018-01-16 13:24:22
@article{f8a82e36-fd6a-4731-91f4-e0be95d4373e,
  abstract     = {<p>Background: Effects of increased adenosine dose in the assessment of fractional flow reserve (FFR) were studied in relation to FFR results, hemodynamic effects and patient discomfort. FFR require maximal hyperemia mediated by adenosine. Standard dose is 140 μg/kg/min administrated intravenously. Higher doses are commonly used in clinical practice, but an extensive comparison between standard intravenous dose and a high dose (220 μg/kg/min) has previously not been performed. Methods: Seventy-five patients undergoing FFR received standard dose adenosine, followed by high dose adenosine. FFR, mean arterial pressure (MAP) and heart rate (HR) were analyzed. Patient discomfort measured by Visual Analogue Scale (VAS) was assessed. Results: No significant difference was found between the doses in FFR value (0.85 [0.79-0.90] vs 0.85 [0.79-0.89], p = 0.24). The two doses correlated well irrespective of lesion severity (r = 0.86, slope = 0.89, p = &lt;0.001). There were no differences in MAP or HR. Patient discomfort was more pronounced using high dose adenosine (8.0 [5.0-9.0]) versus standard dose (5.0 [2.0-7.0]), p = &lt;0.001. Conclusions: Increased dose adenosine does not improve hyperemia and is associated with increased patient discomfort. Our findings do not support the use of high dose adenosine. Trial registration: Retrospective Trial registration: Current Controlled Trials ISRCTN14618196. Registered 15 December 2016.</p>},
  articleno    = {60},
  author       = {Sparv, David and Götberg, Matthias and Harnek, Jan and Persson, Tobias and Madsen-Härdig, Bjarne and Erlinge, David},
  issn         = {1471-2261},
  keyword      = {Adenosine,Coronary heart disease,Fractional flow reserve,Visual analogue scale},
  language     = {eng},
  month        = {02},
  number       = {1},
  pages        = {1--9},
  publisher    = {BioMed Central},
  series       = {BMC Cardiovascular Disorders},
  title        = {Assessment of increasing intravenous adenosine dose in fractional flow reserve},
  url          = {http://dx.doi.org/10.1186/s12872-016-0463-4},
  volume       = {17},
  year         = {2017},
}