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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Intracoronary continuous adenosine infusion

Bon-Kwon Koo1, Cheol-Ho Kim, Sang-Hun Na

  • 1Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Cardiovascular Center, Seoul.

Circulation Journal : Official Journal of the Japanese Circulation Society
|July 26, 2005
PubMed

Insights

Continuous intracoronary infusion of adenosine is a safe and effective method for inducing maximal hyperemia during fractional flow reserve (FFR) measurements, offering a reliable approach for physiologic studies.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Physiologic Measurements

Background:

  • Maximal hyperemia induction is crucial for accurate physiologic studies.
  • The efficacy of continuous intracoronary (IC) adenosine infusion for fractional flow reserve (FFR) measurement requires further definition.

Purpose of the Study:

  • To evaluate the feasibility and efficacy of continuous IC adenosine infusion for FFR measurement.
  • To compare the hyperemic efficacy of IC adenosine infusion versus IC bolus injection and intravenous (IV) infusion.

Main Methods:

  • Phase I: Assessed FFR using three doses of IC adenosine infusion (180, 240, 300 µg/min) in 30 patients.
  • Phase II: Compared hyperemic efficacy of IC infusion (240 µg/min) with IC bolus (40, 80 µg) and IV infusion (140 µg/kg/min) in 20 patients.

Main Results:

  • Phase I showed no significant FFR differences across IC adenosine infusion doses (p = 0.06).
  • Phase II revealed significantly higher FFR with IC bolus injection compared to IV or IC infusion (p < 0.01).
  • No significant FFR difference was found between IC and IV adenosine infusions.

Conclusions:

  • Continuous IC adenosine infusion is a safe and effective method for inducing maximal hyperemia.
  • This method supports accurate FFR measurement in patients with intermediate coronary artery stenosis.
Abstract

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