冠状动脉内注射腺苷对血压、心律的影响

The impact of intracoronary administration of adenosine on blood pressure and electrocardiographic variables

目的 评估冠状动脉 (冠脉 )血流储备测定时冠脉内注射腺苷对血压、心率和心律的影响。方法 6 0例胸痛、冠脉造影正常及 18例单支冠脉病变行冠脉内支架术患者测定冠脉血流储备 ,比较各例注射腺苷 (左冠脉 18μg ,右冠脉 12 μg)后血压、心电的变化。 结果 冠脉造影正常者注射腺苷后收缩压、舒张压及平均动脉压和心率显著降低 ;5例 (8 3% )于注射腺苷后出现Ⅲ度房室传导阻滞 (右冠脉 3例、左前降支 2例 ,P =0 0 0 5 ) ;单支冠脉病变患者于支架术前注射腺苷后血压、心率无显著变化 ,术后注射腺苷其血压、心率显著减低。

Objective To assess the impact of intracoronary bolus injection of adenosine(18μg left coronary system and 12μg right coronary system)on blood pressure and electrocardiographic variables.Methods Coronary flow reserve was determined in 60 patients with chest pain but normal coronary angiography(normal group)and 18 patients with single-vessel disease(CAD group)before and after coronary intervention.The blood pressure and electrocardiographic changes before and after adenosine administration were assessed.Results In normal group,after intracoronary adenosine blood pressure and heart rate were reduced,and 5 (8.3%) developed third-degree atrioventricular block (RCA in 3 and LAD in 2, P =0.005).Two female patients(3.3%)had coronary spasm during the passage of Doppler flow wire in RCA.In CAD group,before coronary stenting blood pressure and heart rate were not significantly changed after intracoronary adenosine.There were no severe rhythm changes and complications.Conclusion Intracoronary administration of adenosine can be safely used for the assessment of coronary flow reserve.