Evaluation of Variability of FFR Measurements During a Single Reading Period Using Intravenous Adenosine–induced Hyperemia

Seto, Arnold H.; Tehrani, David M.; Bharmal, M; Kern, Morton J.

doi:10.1016/s0735-1097(13)61762-3

Cited by 1 publication

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“…In our study, when repeated FFR assessment was performed 5 minutes after the first measurement and with a high adenosine dose on‐board, Pd/Pa variation was significantly reduced in most of our cases. Increases in FFR value during standard dose infusion have been mostly attributed to Pd rising more than Pa following maximal hyperemia . High adenosine dose appears to significantly decrease this variation in Pd.…”

Section: Discussionmentioning

confidence: 98%

“…Increases in FFR value during standard dose infusion have been mostly attributed to Pd rising more than Pa following maximal hyperemia. 16 High adenosine dose appears to significantly decrease this variation in Pd. Variations of Pd/Pa seems, therefore, to be adenosine dose-dependent, confirming our initial hypothesis.…”

Section: High Adenosine Dose and Pd/pa Variabilitymentioning

confidence: 94%

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Effect of High (200 μg/kg per Minute) Adenosine Dose Infusion on Fractional Flow Reserve Variability

Alexopoulos

Xanthopoulou

Tsigkas

et al. 2016

JAHA

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BackgroundVariations in distal coronary pressure (Pd)/aortic pressure (Pa) ratio during steady‐state hyperemia with standard (140 μg/kg per minute) adenosine dose may hamper accurate fractional flow reserve assessment. This study investigated to what extent an increased adenosine dose can overcome Pd/Pa variation.Methods and ResultsIn a prospective, single‐arm study, out of 95 prospectively screened patients, 38 (40.0%) exhibited significant (≥0.05 difference of max Pd/Pa minus min Pd/Pa) variations in Pd/Pa from 15 s post Pd/Pa dip and until the end of a 3‐minute adenosine (140 μg/kg per minute) infusion. Thirty patients agreed to participate in a post 5‐minute repeat fractional flow reserve assessment using 200 μg/kg per minute 3‐minute adenosine infusion. The study's co‐primary end point of Pd/Pa coefficient of dispersion was lower for the high versus standard adenosine dose: 1.31 (1.13–2.72) versus 2.76 (2.38–5.60), P=0.002. The study's co‐primary end point of ΔPd/Pa was also lower for the high versus standard adenosine dose: 0.065 (0.038–0.10) versus 0.08 (0.06–0.11), P=0.002. This difference was mainly driven by the lowering effect of the high adenosine dose on the maximum Pd/Pa compared to the standard dose: 0.84 (0.81–0.93) versus 0.90 (0.83–0.95), P=0.007, while minimum Pd/Pa remained unaffected. High adenosine dose was adequately tolerated by all patients, without requiring infusion discontinuation in any case.ConclusionsPd/Pa variability is frequently observed during standard adenosine infusion and is significantly decreased following a high (200 μg/kg per minute) adenosine dose. This is achieved without a significant difference in the minimum Pd/Pa.Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT02350439.

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Section: Discussionmentioning

confidence: 98%

Section: High Adenosine Dose and Pd/pa Variabilitymentioning

confidence: 94%