Efficacy of combined administration of intracoronary papaverine plus intravenous adenosine 5'-triphosphate in assessment of fractional flow reserve

Journal of cardiology
Takeshi NishiYoshio Kobayashi

Abstract

Inducing maximal coronary hyperemia is important to measure fractional flow reserve (FFR) accurately. Intravenous adenosine and adenosine 5'-triphosphate (ATP) have been used to achieve maximal hyperemia. However, they may not induce maximal hyperemia in all patients. The present study evaluated the combined effect of intracoronary papaverine and intravenous ATP on FFR measurements. FFR measurements with administration of intracoronary papaverine (12mg in the left coronary artery and 8mg in the right coronary artery), intravenous ATP (140μg/kg/min), and combined administration of intracoronary papaverine and intravenous ATP were performed in 51 patients with 57 intermediate lesions. The mean FFR after intravenous ATP was higher compared to intracoronary papaverine and intravenous ATP plus intracoronary papaverine (0.76±0.13 vs. 0.75±0.13 vs. 0.75±0.13, p=0.01). FFR-positive lesions (FFR ≤0.80) were observed more frequently with intravenous ATP plus intracoronary papaverine compared to intravenous ATP (64.9% vs. 47.4%, p=0.02). Of 32 and 25 FFR-negative lesions with intravenous ATP and intracoronary papaverine, 11 (34%) and 7 (28%) had positive FFR after administration of intravenous ATP plus intracoronary papaverine. No ventric...Continue Reading

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Citations

May 26, 2016·Cardiovascular Intervention and Therapeutics·Hitoshi Matsuo, Yoshiaki Kawase
Jul 28, 2016·Trends in Cardiovascular Medicine·Jae Yoon ParkJoerg Herrmann
Oct 1, 2016·Current Atherosclerosis Reports·Ali E DenktasHani Jneid
Dec 8, 2017·Coronary Artery Disease·Takeshi NishiYoshio Kobayashi
Jan 16, 2020·Cardiovascular Intervention and Therapeutics·Masafumi NakayamaKiyotaka Iwasaki

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