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Effect of adenosine triphosphate on human coronary circulation
1First Department of Internal Medicine, Hiroshima University School of Medicine.
Internal Medicine (Tokyo, Japan)
|December 5, 1998
Summary
Intracoronary adenosine triphosphate (ATP) safely induces maximal coronary vasodilation in humans. Intravenous ATP infusions achieve near-maximal hyperemia, but can cause significant drops in blood pressure.
Area of Science:
- Cardiology
- Pharmacology
- Physiology
Background:
- Adenosine triphosphate (ATP) is a potent vasodilator.
- Assessing its efficacy and safety in coronary circulation is crucial for clinical applications.
Purpose of the Study:
- To investigate the effects of intracoronary and intravenous adenosine triphosphate (ATP) on coronary and systemic hemodynamics.
- To compare the vasodilatory capacity of ATP with papaverine in humans with normal coronary arteries.
Main Methods:
- Adenosine triphosphate (ATP) was administered via intracoronary bolus (4-16 microg) or intravenous infusion (25-200 microg/kg/min) in human subjects.
- Coronary blood flow velocity (CBFV) was measured, and hemodynamic and electrocardiogram (ECG) variables were monitored.
- Papaverine was used as a reference for maximal coronary hyperemia.
Main Results:
- Intracoronary ATP bolus (12 microg) induced maximal coronary hyperemia comparable to papaverine.
- Intravenous ATP infusion (150 microg/kg/min) decreased coronary resistance index similarly to papaverine but with a slower increase in CBFV.
- Intracoronary ATP caused minimal hemodynamic changes, while intravenous ATP led to significant hypotension in 40% of patients.
Conclusions:
- Intracoronary administration of ATP is a safe method for achieving maximal coronary vasodilation.
- Intravenous ATP infusions at 150 microg/kg/min can induce near-maximal coronary hyperemia in most patients.
- Careful monitoring of blood pressure is recommended during intravenous ATP administration due to potential hypotensive effects.