Intracoronary ATP safely achieved maximal coronary vasodilation similar to papaverine, whereas intravenous infusion caused near-maximal hyperemia but serious hypotension in 40% of patients.
Does adenosine triphosphate (ATP) safely induce maximal coronary hyperemia compared to papaverine in patients with normal coronary arteries?
Intracoronary ATP is a safe and effective alternative to papaverine for inducing maximal coronary hyperemia during catheterization, avoiding the risk of QT prolongation.
We investigated in humans the effects of adenosine triphosphate (ATP), administered by intracoronary bolus (4-16 microg) or intravenous infusion (25-200 microg/kg/min), on coronary and systemic hemodynamics and electrocardiogram (ECG) variables. All patients had normal epicardial coronary arteries. The maximal coronary blood flow velocity (CBFV) was determined with intracoronary bolus of papaverine. A 12 microg bolus of ATP (n=12) caused maximal coronary hyperemia similar to that caused by papaverine. Intracoronary boluses caused a small brief decrease in arterial pressure but no significant changes in HR or ECG variables. Intravenous infusion of ATP at 150 microg/kg/min (n=15) caused a decrease in the coronary resistance index similar to that caused by papaverine, but the rate of increase in CBFV by ATP was smaller than that caused by papaverine. No patients had a significant change in ECG variables, but some patients (40%) had a serious decrease in arterial pressure. These studies suggest that maximal coronary vasodilation can be achieved safely with intracoronary ATP administration and that intravenous infusions at 150 microg/kg/min cause near-maximal coronary hyperemia in most patients.
Shiode et al. (Thu,) conducted a other in Normal epicardial coronary arteries (n=27). Adenosine triphosphate (ATP) vs. Papaverine was evaluated on Coronary and systemic hemodynamics and electrocardiogram (ECG) variables. Intracoronary ATP safely achieved maximal coronary vasodilation similar to papaverine, whereas intravenous infusion caused near-maximal hyperemia but serious hypotension in 40% of patients.