Author + information
- Received April 13, 2011
- Revision received July 1, 2011
- Accepted July 21, 2011
- Published online October 1, 2011.
- Pradeep K. Nair, MD⁎,
- Oscar C. Marroquin, MD⁎,†,
- Suresh R. Mulukutla, MD⁎,†,
- Sameer Khandhar, MD⁎,
- Vijay Gulati, MD⁎,
- John T. Schindler, MD⁎ and
- Joon S. Lee, MD⁎,†,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Joon S. Lee, Division of Cardiology, University of Pittsburgh, 200 Lothrop Street, Presbyterian University Hospital, Room A-333.1, Pittsburgh, Pennsylvania 15213
Objectives The aim of this study was to evaluate the efficacy of regadenoson, in comparison with adenosine, for assessing fractional flow reserve (FFR) of intermediate coronary artery stenoses (CAS).
Background Fractional flow reserve is an established invasive method for assessing the physiological significance of CAS. Regadenoson, a selective A2A receptor agonist, is an approved hyperemic agent for pharmacological stress imaging, but its role for measuring FFR is unknown.
Methods This prospective, single-center study enrolled 25 consecutive patients with intermediate CAS discovered during elective angiography (25 lesions). In each patient, FFR of the CAS was measured first by IV adenosine (140 μg/kg/min), followed by IV regadenoson (400 μg bolus). The intrapatient FFR correlation between adenosine and regadenoson was evaluated.
Results The mean age was 63 ± 11 years, and mean left ventricular ejection fraction was 58 ± 11%. Most patients were male (52%) and had hypertension (84%) and dyslipidemia (84%), with 24% having diabetes mellitus and 20% chronic obstructive pulmonary disease. The CAS was visually estimated during angiography (mean 58 ± 9%) and most often found in the left anterior descending coronary artery (48%). A strong, linear correlation of FFR was noted with adenosine and regadenoson (r = 0.985, p < 0.001). A hemodynamically significant lesion (FFR ≤0.80) was present in 52% with no reclassification of significance between adenosine and regadenoson. No serious events occurred with administration of either drug.
Conclusions Our results suggest that a single IV bolus of regadenoson is as effective as an intravenous infusion of adenosine for measuring FFR and, given its ease of use, should be considered for FFR measurement in the catheterization laboratory.
Funding for this work has been provided by the UPMC Heart and Vascular Institute. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received April 13, 2011.
- Revision received July 1, 2011.
- Accepted July 21, 2011.
- American College of Cardiology Foundation