腺苷负荷与ATP负荷下血流储备分数评价冠状动脉疾病的比较

目的 探讨静脉泵入三磷酸腺苷(ATP)测得冠状动脉狭窄远端压力与主动脉根部压力的比值(Pd/Pa或FFR)与泵入腺苷测得血流储备分数(FFR)之间的关系,研究能否用ATP替代腺苷用于测定FFR.方法 23例患者25处病变接受静脉应用腺苷和ATP测定FFR,其中腺苷以140～180 μg·kg-1·min-1速度经肘静脉泵入,ATP以140～180 μg·kg-1·min-1速度经外周静脉泵入.测定注入两种药物时的FFR、主动脉压、心率和心电图.结果 所有病变平均狭窄程度(71±5.97)%(狭窄范围61%～83%),腺苷负荷下平均FFR值0.816±0.040(范围0.75～0.89),ATP负荷下平均FFR值0.814±0.041(范围0.75～0.89).静脉泵入ATP测得FFR值与静脉泵入腺苷测得FFR具有明显的线性相关[R=0.974,Y(腺苷负荷下FFR)=0.967X(ATP负荷下FFR)+0.029,P<0.001].结论 外周静脉泵入ATP与肘静脉泵入腺苷具有相同的作用,可以用于FFR值的测定.

Direct comparison of adenosine stress and adenosine triphosphate stress using fractional flow reserve in assessment of coronary artery disease

Objective To compare fractional flow reserve （FFR）obtained during maximal hyperemia by intravenous （, IV ） ATP and adenosine. Methods 23 patients with 25 lesions underwent determination of FFR with both IV adenosine and ATP. Adenosine and ATP was intravenously administered as a eontinuous infusion at a rate of 140 and 180 }xg/kg/min until the lowest FFR was achieved. FFR, aortie pressure, heart rate and ECG were registered. Results Mean rate of stenosis was （ 71 ＋ 5.97 ） % （ range 61% to 83% ）, mean FFR （ IV adenosine） was 0. 816 ：t： 0. 04 （ range 0. 75 to 0. 89）, and mean FFR （ IV ATP ） was 0. 814 ＋ 0. 04 1 （ range 0. 75 to 0. 89 ）. There was a strong linear correlation between FFR measured with IV adenosine and that with ATP [ R = 0. 974, Y （ FFR by IV adenosine） = 0. 967X（ FFR by IV ATP） ＋ 0. 029 ,P 〈 0. 0011- Conclusions IV ATP is equivalent to IV adenosine for the determination of FFR.