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KMID : 0616619980040020257
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Journal of Soonchunhyang Medical College
1998 Volume.4 No. 2 p.257 ~ p.263
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Effect of Coronary Artery Pressure after Intravenous Administration of Adenosine in Patients with Ischemic Heart Disease
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Abstract
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Background Adenosine interacts with Al receptors present on the extracellular surface of cardiac cells, activating K+channels in a fashion. It produces coronary vasodilatation and AV nodal block The half-time is one t0 six second and has ultra-short action. In ischemic heart disease, fractional flow reserve(FFR) can be achieved safely with intravenous adenosine infusions at a rate of 150 u g/kg/min which cause maximal coronary hyperemia.
Purpose We investigated the patients who have had ischemic heart disease(n=8). After adenosine intravenous administra6on(150 u g/kg/min), the effect cause maximal hyperemia of coronary artery. During peak maximal hyperena, we reported clinical findings, coronary herodynamics and electrocardiogram findings.
Methods: After diagnostic coronary angiography and left ventriculography, catheter was advanced into the ostium of coronary artery. We investigated coronary hemodynamics such as systolic coronary artery pressure, diastolic coronary artery pressure, mean coronary artery pressure and heart rate. To assess the use of adenosine for determination of fractional flow reserve, hemodynamics and electrocardiogram were measured at basal state and during peak maximal hyperemia
Results: Symptoms developed 1.5-2 minute after adenosine intravenous administration and each symptom disappeared 2-25 minute after adenosine administration. Two patients represented asymptomatic appearance and six patients complained of flushing, chest pain, palpitation and headache.
In eight patients with ischemic heart disease, 1.5 minute after venous administration of 150 u g/kg/min of adenosine, coronary artery pressure decreased and heart rate increased significantly. Conduction abnormalities after administration of 150ug1kg/min of adenosine were transient 2nd degree AV block 2 cases(259/6).
Conclusions: Adenosine is a potent ultra short-acting vasodilator. Although coronary artery pressure decreased and heart rate increased and mild cardiovascular symptoms occurred after continuous infusion of 150 ti 8ncg/min of adenosine, it is useful as an agent for determination of fractional flow reserve.
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