Adenosine-induced maximal coronary hyperemia for myocardial fractional flow reserve measurements: comparison of administration by femoral venous versus antecubital venous access

Lindstaedt, Michael; Bojara, Waldemar; Holland‐Letz, Tim; Yazar, Aydan; Fadgyas, T.; Müller, Lucie; Mügge, Andreas; Germing, Alfried

doi:10.1007/s00392-009-0056-7

Cited by 21 publications

(8 citation statements)

References 17 publications

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“…The former approach has been shown in a single study to produce significantly lower FFR recordings when comparing an adenosine infusion rate of 140 mg/kg/min with a rate of 170 mg/kg/min via the antecubital fossa (13). The former approach has been shown in a single study to produce significantly lower FFR recordings when comparing an adenosine infusion rate of 140 mg/kg/min with a rate of 170 mg/kg/min via the antecubital fossa (13).…”

Section: Ffr In the Transradial Eramentioning

confidence: 99%

Fractional Flow Reserve in the Transradial Era: Will Hand Vein Adenosine Infusion Suffice?

Scott

Sirker

Dworakowski

et al. 2015

JACC: Cardiovascular Interventions

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Section: Ffr In the Transradial Eramentioning

confidence: 99%

Fractional Flow Reserve in the Transradial Era: Will Hand Vein Adenosine Infusion Suffice?

Scott

Sirker

Dworakowski

et al. 2015

JACC: Cardiovascular Interventions

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“…Second, we routinely induced hyperemia using adenosine through the forearm (antecubital) vein, and not through the central (femoral) vein. In the study by Lindstaedt et al,13) this method was slightly less effective than that of femoral vein infusion. However, recent studies by De Bruyne et al14) and Seo et al15) have shown that hyperemic efficacy of adenosine does not differ between infusion into the central vein and peripheral vein.…”

Section: Discussionmentioning

confidence: 92%

Prediction of Fractional Flow Reserve without Hyperemic Induction Based on Resting Baseline Pd/Pa

et al. 2013

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Background and ObjectivesThe purposes of this study are 1) to investigate the relationship between resting baseline Pd/Pa, determined by the ratio of the pressures proximal (Pa) and distal (Pd) to the target lesion before, inducing hyperemia and fractional flow reserve (FFR) and 2) to identify a resting baseline Pd/Pa range that might reliably preclude the need for hyperemic induction.Subjects and MethodsA total of 622 pressure wire data sets obtained from intermediate stenotic lesions were analyzed.ResultsThere was a good linear relationship between resting baseline Pd/Pa and FFR (r=0.746, p<0.001). Receiver-operating characteristic curves of the resting baseline Pd/Pa with FFR ≤0.80 as the reference variable showed an area under the curve of 0.89 (95% confidence intervals 0.863-0.914, p<0.001) with a diagnostic accuracy of 82.3% when the resting baseline Pd/Pa was ≤0.92. These results showed that certain cutoff values can reliably predict FFR, whether positive or negative. The resting baseline Pd/Pa >0.95 (n=257, 41.3%) had a negative predictive value (NPV) of 98.1% and a sensitivity of 97.3%. the resting baseline Pd/Pa ≤0.88 (n=65, 10.5%) had a positive predictive value (PPV) of 96.2% and a specificity of 99.8%. These were consistent regardless of coronary vessel, lesion location, lesion length, or degree of stenosis.ConclusionIn intermediate lesions, the resting baseline Pd/Pa was linearly related to FFR. A certain range of the resting baseline Pd/Pa values had an excellent NPV with high sensitivity or excellent PPV with high specificity for determining the lesion significance.

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“…Another alternative access for adenosine infusion can be a large peripheral vein. Lindstaedt et al 21 compared the hyperemic efficacy of adenosine infusion between the femoral vein and the antecubital vein. They found that a 140 g/kg/min infusion of adenosine via the antecubital vein was slightly less effective than the femoral vein infusion; however, the mean difference of FFR between the antecubital vein and femoral vein infusions was just 0.0126.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Hyperemic Efficacy Between Central and Peripheral Venous Adenosine Infusion for Fractional Flow Reserve Measurement

Seo

Koo

Kim

et al. 2012

Circ: Cardiovascular Interventions

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Background-Maximal hyperemia is a prerequisite for the accurate measurement of fractional flow reserve (FFR).Although continuous infusion of adenosine via the femoral vein is considered to be the gold standard, this requires an additional invasive procedure for femoral vein access and is difficult to use during transradial coronary catheterization. We performed this prospective study to evaluate the feasibility and efficacy of peripheral intravenous infusion of adenosine for FFR measurement. Methods and Results-Seventy-one patients were prospectively enrolled, and FFR was measured using a 0.014-inch coronary pressure wire. Hyperemic efficacy of adenosine was compared among intracoronary bolus injection and continuous IV infusion (140 g/min/kg) via the femoral and via the forearm vein. In 20 patients, hyperemic mean transit time and index of microcirculatory resistance were also measured. Mean FFR after bolus administration of adenosine was 0.81Ϯ0.

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Adenosine-induced maximal coronary hyperemia for myocardial fractional flow reserve measurements: comparison of administration by femoral venous versus antecubital venous access

Cited by 21 publications

References 17 publications

Fractional Flow Reserve in the Transradial Era: Will Hand Vein Adenosine Infusion Suffice?

Fractional Flow Reserve in the Transradial Era: Will Hand Vein Adenosine Infusion Suffice?

Prediction of Fractional Flow Reserve without Hyperemic Induction Based on Resting Baseline Pd/Pa

Comparison of Hyperemic Efficacy Between Central and Peripheral Venous Adenosine Infusion for Fractional Flow Reserve Measurement

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