Abstract 18620: Comparison of Hyperemic Efficacy Between Central and Peripheral Venous Adenosine Infusion for Fractional Flow Reserve Measurement
Background: Various methods are used for inducing maximal hyperemia for physiologic studies. Continuous administration of adenosine by femoral vein is considered to be the gold-standard way of hyperemia. However, this requires additional procedure time and is difficult to use during trans-radial coronary catheterization. We performed this study to evaluate the efficacy of continuous peripheral intravenous (IV) infusion of adenosine for measurement of fractional flow reserve (FFR).
Methods: Fifty one patients with intermediate coronary artery stenosis were consecutively enrolled. FFR and index of microcirculatory resistance (IMR) were measured using a 0.014 in coronary pressure wire. Hyperemia was successively induced with intracoronary(IC) bolus adenosine injection (80 μg in LCA 40 μg in RCA), continuous intravenous IV adenosine infusion (140 μg·min–1·kg–1) via femoral vein and then via peripheral vein (140 μg·min–1·kg–1). FFR, IMR and the time to maximal hyperemia were compared. The time to maximal hyperemia was defined as the time needed to reach >90% of the maximal hyperemic efficacy with adenosine infusion.
Results: No difference in hyperemic efficacy was seen between central and peripheral infusion. There was no difference in FFR and IMR between the 2 groups (Table). The time to maximal hyperemia was longer with peripheral infusion than central venous infusion of adenosine. There were no differences in side effects between central versus peripheral venous adenosine infusion.
Conclusions: This study suggests that continuous IV peripheral adenosine infusion method is safe and effective in inducing steady-state hyperemia and more convenient in inducing optimal hyperemia than the standard IV central infusion method.
- © 2010 by American Heart Association, Inc.