Safety and optimal dose of intracoronary adenosine 5'-triphosphate for the measurement of coronary flow reserve

American Heart Journal
S SonodaA Kuroiwa

Abstract

Adenosine 5'-triphosphate (ATP) has been demonstrated to have similar vasodilator potency and fewer hemodynamic or electrocardiographic derangements compared with papaverine in the measurement of coronary flow reserve. However, there is little data about its optimal dose and the effect on myocardial lactate metabolism. Under continuous monitoring of the left anterior descending coronary flow velocity with a Doppler guide wire, we investigated the changes of hemodynamics, electrocardiogram, and myocardial lactate metabolism before and after the administration of 50 microg ATP and 10 mg papaverine into the left coronary artery in 18 patients with normal coronary arteries. To determine the optimal dose of ATP for the coronary flow reserve in the left coronary artery, we measured coronary flow velocity with five incremental doses of intracoronary ATP (0.5, 5, 15, 30, and 50 microg) and 10 mg of papaverine in another seven patients. In contrast to papaverine, ATP did not produce any significant changes in hemodynamics or the electrocardiogram. The increase in the coronary flow velocity of the two agents was similar. Although all patients showed lactate production after the administration of papaverine, only three patients showed lac...Continue Reading

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Citations

Dec 14, 2011·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Tomoaki Murakami, Nobuhiro Tanaka
Mar 11, 2008·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Ross J McGeoch, Keith G Oldroyd
Sep 11, 2007·The American Journal of Cardiology·Takashi AshikagaMitsuaki Isobe
Jan 13, 2009·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Valeria MagniAntonio Colombo
May 13, 2015·Chinese Medical Journal·Yohanes Adiputra, Shao-Liang Chen
Feb 27, 2007·Journal of the American College of Cardiology·Jonathan TobisLeo Slavin
Mar 12, 2003·Journal of the American College of Cardiology·Yoshiteru AbeHitoshi Tanio
Dec 21, 2014·Purinergic Signalling·Geoffrey Burnstock, Amir Pelleg
Dec 18, 2001·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·M J Kern
Feb 22, 2008·Journal of Cardiovascular Pharmacology and Therapeutics·Takashi AshikagaMitsuaki Isobe
Sep 10, 2003·International Journal of Cardiovascular Interventions·Steven C HerrmannMorton J Kern
Mar 10, 2001·AACN Clinical Issues·B C OxhornI L Buxton
Aug 31, 2006·Circulation·Morton J KernUNKNOWN American Heart Association Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiolog
Dec 18, 2013·Pharmacological Reviews·Geoffrey Burnstock, Vera Ralevic

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