caa a22 4500 606221166 CHVBK 20210128101127.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00380-014-0508-5 doi (NATIONALLICENCE)springer-10.1007/s00380-014-0508-5 Feasibility and safety of intracoronary nicorandil infusion as a novel hyperemic agent for fractional flow reserve measurements [Elektronische Daten] [Daiki Kato, Hiroaki Takashima, Katsuhisa Waseda, Akiyoshi Kurita, Yasuo Kuroda, Takashi Kosaka, Yasushi Kuhara, Hirohiko Ando, Kazuyuki Maeda, Soichiro Kumagai, Shinichiro Sakurai, Akihiro Suzuki, Yukiko Toda, Atsushi Watanabe, Shigeko Sato, Masanobu Fujimoto, Tomofumi Mizuno, Tetsuya Amano] Fractional flow reserve (FFR) is a useful modality to assess the functional significance of coronary stenoses. Although adenosine triphosphate (ATP) is generally used as the hyperemic stimulus, we sometimes encounter adverse events like hypotension during FFR measurement. Nicorandil, an ATP-sensitive potassium channel opener, recognized as an epicardial and resistance vessel dilator, has not been fully evaluated as a possible alternative hyperemic agent. The aim of this study was to evaluate the feasibility and safety of intracoronary nicorandil infusion compared to intravenous ATP for FFR measurement in patients with coronary artery disease. A total of 102 patients with 124 intermediate lesions (diameter stenosis >40 and <70% by visual assessment) were enrolled. All vessels underwent FFR measurements with both ATP (150μg/kg/min) and nicorandil (2.0mg) stimulus. FFR, hemodynamic values, and periprocedural adverse events between the two groups were evaluated. A strong correlation was observed between FFR with ATP and FFR with nicorandil (r=0.954, p<0.001). The agreement between the two sets of measurements was also high, with a mean difference of 0.01±0.03. The mean aortic pressure drop during pharmacological stimulus was significantly larger with ATP compared to nicorandil (9.6±9.6 vs. 5.5±5.8mmHg, p<0.001). During FFR measurement, transient atrioventricular block was frequently observed with ATP compared to nicorandil (4.0 vs. 0%, p=0.024). This study suggests that intracoronary nicorandil infusion is associated with clinical utility and safety compared to ATP as an alternative hyperemic agent for FFR measurement. Springer Japan, 2014 Fractional flow reserve nationallicence Nicorandil nationallicence Hyperemic agent nationallicence Kato Daiki Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut Takashima Hiroaki Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut Waseda Katsuhisa Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut Kurita Akiyoshi Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut Kuroda Yasuo Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut Kosaka Takashi Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut Kuhara Yasushi Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut Ando Hirohiko Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut Maeda Kazuyuki Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut Kumagai Soichiro Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut Sakurai Shinichiro Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut Suzuki Akihiro Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut Toda Yukiko Department of Cardiology, Narita Memorial Hospital, Toyohashi, Japan aut Watanabe Atsushi Department of Cardiology, Narita Memorial Hospital, Toyohashi, Japan aut Sato Shigeko Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut Fujimoto Masanobu Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut Mizuno Tomofumi Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut Amano Tetsuya Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut Heart and Vessels Springer Japan 30/4(2015-07-01), 477-483 0910-8327 30:4<477 2015 30 380 https://doi.org/10.1007/s00380-014-0508-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00380-014-0508-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kato Daiki Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Takashima Hiroaki Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Waseda Katsuhisa Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Kurita Akiyoshi Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Kuroda Yasuo Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Kosaka Takashi Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Kuhara Yasushi Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Ando Hirohiko Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Maeda Kazuyuki Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Kumagai Soichiro Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Sakurai Shinichiro Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Suzuki Akihiro Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Toda Yukiko Department of Cardiology, Narita Memorial Hospital, Toyohashi, Japan aut NATIONALLICENCE 700 1- Watanabe Atsushi Department of Cardiology, Narita Memorial Hospital, Toyohashi, Japan aut NATIONALLICENCE 700 1- Sato Shigeko Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Fujimoto Masanobu Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Mizuno Tomofumi Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 700 1- Amano Tetsuya Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, 480-1195, Nagakute, Aichi, Japan aut NATIONALLICENCE 773 0- Heart and Vessels Springer Japan 30/4(2015-07-01), 477-483 0910-8327 30:4<477 2015 30 380