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P1.13 Intracoronary and Intravenous Administration of Adenosine Achieve Comparable Maximal Hyperemia and Stenosis Pressure Gradient-Flow Velocity Relations

Abstract

Background

The aim of this study was to compare stenosis hemodynamics resulting from intravenous (iv) and intracoronary (ic) adenosine administration.

Methods

In 12 vessels with 25–57% DS (10 patients, 61 ± 8 years), aortic pressure, distal coronary pressure and flow velocity (v) were simultaneously measured during the hyperemic response to either ic injection (40µg bolus) or iv adenosine infusion (140µg/kg/min). Cycle-averaged stenosis pressure gradient (ΔP) and flow velocity were obtained to derive ΔP-v relations from baseline to maximal velocity. For each lesion, we defined v1 and v2 as the lowest and highest common flow velocity for ic and iv-derived ΔP-v relations. The equivalence of both adenosine administrations was assessed by the difference in ΔP at v1 and v2.

Results

Maximal flow velocity was 56 ± 19 cm/s for ic and 51 ± 15 cm/s for iv, p = NS. The stenosis ΔP-v relations largely overlapped (95% of the velocity range for ic injections; 85% of the flow velocity range for iv infusions). Common flow velocities ranged from v1 = 18 ± 5 cm/s to v2 = 50 ± 15 cm/s. The difference in pressure gradient (ivΔP icDP) at v1 was 0.2 ± 0.7 mmHg and 0.8 ± 3.2 mmHg at v2 (p = NS), with no trend for differences in ΔP with increasing velocity.

Conclusion

Stenosis ΔP-v relations are not affected by the mode of adenosine administration and comparable hyperemia can be achieved. Ic adenosine injections are preferable, since they are faster and easier to perform and iv infusion tends to induce systemic hemodynamic variability.

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Casadonte, L., Marques, K., Spaan, J. et al. P1.13 Intracoronary and Intravenous Administration of Adenosine Achieve Comparable Maximal Hyperemia and Stenosis Pressure Gradient-Flow Velocity Relations. Artery Res 8, 132 (2014). https://doi.org/10.1016/j.artres.2014.09.094

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  • DOI: https://doi.org/10.1016/j.artres.2014.09.094