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Feasibility, safety and effectiveness in measuring microvascular resistance with regadenoson.

Abstract
AIMThe study aims to test whether simultaneous measurement of fractional flow reserve (FFR), coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) is feasible, safe and effective during regadenoson-induced hyperemia.METHODS AND RESULTSFFR, CFR and IMR were measured simultaneously during regadenoson (Rapiscan 400 μg) -induced hyperemia in 50 patients with stable coronary artery disease with a SYNTAX score of <22. Simultaneous measurement of FFR, CFR and IMR was technically feasible in all cases (50/50). No side effects occurred and even patients fulfilling classical contraindications for the use of adenosine (10/50) could be included. Regadenoson-induced hyperemia remained stable after maximal pressure drop for more than 35 sec as measured by systemic aortic and distal coronary pressure. There was a significant drop in transit mean time from baseline to hyperemia of more than 50% (1.0 ± 0.6 s vs. 0.4 ± 0.2 s, p <  0.01). Patients' mean IMR value was 23.4, and IMR values above 75th percentile significantly correlated with metformin demanding diabetes mellitus with OR 21.76 and nicotine abuse with OR 10.28.CONCLUSIONA single intravenous regadenoson bolus via peripheral line increases coronary blood flow without harmful systemic side effects enabling interventionists to simultaneously assess FFR, CFR and IMR in patients with stable coronary artery disease.
AuthorsVera Lachmann, Marc Heimann, Christian Jung, Tobias Zeus, Pablo Emilio Verde, Malte Kelm, Florian Bönner
JournalClinical hemorheology and microcirculation (Clin Hemorheol Microcirc) Vol. 71 Issue 3 Pg. 299-310 ( 2019) ISSN: 1875-8622 [Electronic] Netherlands
PMID30103305 (Publication Type: Journal Article)
Chemical References
  • Adenosine A2 Receptor Agonists
  • Purines
  • Pyrazoles
  • regadenoson
Topics
  • Adenosine A2 Receptor Agonists (pharmacology, therapeutic use)
  • Aged
  • Coronary Artery Disease (drug therapy, physiopathology)
  • Feasibility Studies
  • Female
  • Fractional Flow Reserve, Myocardial
  • Humans
  • Male
  • Microcirculation (physiology)
  • Purines (pharmacology, therapeutic use)
  • Pyrazoles (pharmacology, therapeutic use)

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