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BMC Cardiovascular Disorders
Published in: BMC Cardiovascular Disorders 1/2017

Open Access 01-12-2017 | Research article

Assessment of increasing intravenous adenosine dose in fractional flow reserve

Authors: David Sparv, Matthias Götberg, Jan Harnek, Tobias Persson, Bjarne Madsen Hardig, David Erlinge

Published in: BMC Cardiovascular Disorders | Issue 1/2017

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Abstract

Background

Effects of increased adenosine dose in the assessment of fractional flow reserve (FFR) were studied in relation to FFR results, hemodynamic effects and patient discomfort. FFR require maximal hyperemia mediated by adenosine. Standard dose is 140 μg/kg/min administrated intravenously. Higher doses are commonly used in clinical practice, but an extensive comparison between standard intravenous dose and a high dose (220 μg/kg/min) has previously not been performed.

Methods

Seventy-five patients undergoing FFR received standard dose adenosine, followed by high dose adenosine. FFR, mean arterial pressure (MAP) and heart rate (HR) were analyzed. Patient discomfort measured by Visual Analogue Scale (VAS) was assessed.

Results

No significant difference was found between the doses in FFR value (0.85 [0.79–0.90] vs 0.85 [0.79–0.89], p = 0.24). The two doses correlated well irrespective of lesion severity (r = 0.86, slope = 0.89, p = <0.001). There were no differences in MAP or HR. Patient discomfort was more pronounced using high dose adenosine (8.0 [5.0–9.0]) versus standard dose (5.0 [2.0–7.0]), p = <0.001.

Conclusions

Increased dose adenosine does not improve hyperemia and is associated with increased patient discomfort. Our findings do not support the use of high dose adenosine.

Trial registration

Retrospective Trial registration: Current Controlled Trials ISRCTN14618196. Registered 15 December 2016.
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Metadata
Title
Assessment of increasing intravenous adenosine dose in fractional flow reserve
Authors
David Sparv
Matthias Götberg
Jan Harnek
Tobias Persson
Bjarne Madsen Hardig
David Erlinge
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2017
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-016-0463-4

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