Safety and optimal dose of intracoronary adenosine 5'-triphosphate for the measurement of coronary flow reserve.
Safety and optimal dose of intracoronary adenosine 5'-triphosphate for the measurement of coronary flow reserve.
复制标题
冠状动脉内注射 5-三磷酸腺苷用于测量冠状动脉血流储备的安全性和最佳剂量。
DOI：
10.1016/s0002-8703(98)70277-7
复制
发表时间：
1998
影响因子：
4.8
通讯作者：
A. Kuroiwa
中科院分区：
文献类型：
--
作者：
S. Sonoda;M. Takeuchi;Y. Nakashima;A. Kuroiwa
背景：与罂粟碱相比，三磷酸腺苷(ATP)在测量冠状动脉血流储备方面具有相似的血管扩张剂效力和更少的血流动力学或心电图紊乱。然而，关于其最佳剂量及其对心肌乳酸代谢的影响的数据很少。方法用多普勒导丝连续监测冠状动脉左前降支血流速度，观察18例冠状动脉正常患者左冠状动脉内注射50μg三磷酸腺苷和10 mg罂粟碱前后血流动力学、心电图和心肌乳酸代谢的变化。为了确定左冠状动脉血流储备的最佳剂量，我们测量了另外7名患者在冠状动脉内注射5种递增剂量的三磷酸腺苷(0.5、5、15、30和50μg)和10 mg罂粟碱时的冠状动脉血流速度。结果与罂粟碱相比，三磷酸腺苷对血流动力学和心电图无明显影响。两种药物的冠脉血流速度增加相似。虽然所有患者在服用罂粟碱后都有乳酸产生，但只有3名患者在服用三磷酸腺苷后出现乳酸产生(p<；0.001)。≥15μg的冠脉流量储备与罂粟碱相似。≥-5-μ-g测定的冠脉血流储备与罂粟碱测定的冠脉血流储备显著相关。结论对于冠状动脉正常的患者，冠脉内注射≥15μg可安全地获得最大程度的左冠状动脉扩张。(《美国心脏病杂志》1998；135：621-7。)
Background Adenosine 5'-triphosphate (ATP) has been demonstrated to have similar vasodilator potency and fewer hemodynamic or electrocardiographic derangements compared with papaverine in the measurement of coronary flow reserve. However, there is little data about its optimal dose and the effect on myocardial lactate metabolism. Methods Under continuous monitoring of the left anterior descending coronary flow velocity with a Doppler guide wire, we investigated the changes of hemodynamics, electrocardiogram, and myocardial lactate metabolism before and after the administration of 50 μg ATP and 10 mg papaverine into the left coronary artery in 18 patients with normal coronary arteries. To determine the optimal dose of ATP for the coronary flow reserve in the left coronary artery, we measured coronary flow velocity with five incremental doses of intracoronary ATP (0.5, 5, 15, 30, and 50 μg) and 10 mg of papaverine in another seven patients. Results In contrast to papaverine, ATP did not produce any significant changes in hemodynamics or the electrocardiogram. The increase in the coronary flow velocity of the two agents was similar. Although all patients showed lactate production after the administration of papaverine, only three patients showed lactate production after ATP (p < 0.001). The coronary flow reserve derived from ≥15 μg of ATP was similar to that derived from papaverine. There was a significant correlation between the coronary flow reserve obtained with ≥5 μg of ATP and that obtained with papaverine. Conclusions These results suggest that maximal coronary vasodilation in the left coronary artery can be safely obtained with doses ≥15 μg of intracoronary ATP in patients with normal coronary arteries. (Am Heart J 1998;135:621-7.)
多形性室性心动过速：冠状动脉内注射罂粟碱的副作用。
影响因子：
24
作者：
Talman,CL;Winniford,MD;Rossen,JD;Simonetti,I;Kienzle,MG;Marcus,ML
通讯作者：
Marcus,ML
冠状动脉内注射罂粟碱后出现严重的室性心律失常。
DOI：
10.1016/0002-9149(88)90281-0
发表时间：
1988
期刊：
The American journal of cardiology
影响因子：
--
作者：
Wilson,RF;White,CW
通讯作者：
White,CW