Artikel ; Online: Evaluation of the risk factors for ventricular arrhythmias secondary to QT prolongation induced by papaverine injection during coronary flow reserve studies using a 4 Fr angio-catheter.
2018 Band 33, Heft 11, Seite(n) 1358–1364
Abstract: Estimation of the fractional flow reserve (FFR) is considered to be an established method by which to assess stable coronary artery stenosis. Induction of maximal coronary hyperemia is important during the FFR procedure. Papaverine has been reported to ... ...
| Abstract | Estimation of the fractional flow reserve (FFR) is considered to be an established method by which to assess stable coronary artery stenosis. Induction of maximal coronary hyperemia is important during the FFR procedure. Papaverine has been reported to increase the risk of ventricular arrhythmia (VA). The purpose of the present study was to discover predictors of papaverine-induced VAs developing during FFR measurement. A total of 213 clinically stable patients were included in the study. FFRs were determined after intracoronary papaverine administration (12 mg into the left and 8 mg into the right coronary arteries). We compared patients in whom VA did and did not develop in terms of clinical and electrocardiogram characteristics. FFR measurements were performed on 244 lesions (133 in the left anterior descending arteries, 43 in the left circumflex arteries, and 68 in the right coronary arteries). We found that the QTc interval was prolonged in all patients after papaverine administration (average post-administration QTc interval = 569 ± 89 ms; average ΔQTc interval = 144 ± 80 ms). VA developed in three patients with significantly prolonged QT intervals (average post-administration QTc interval = 639 ± 19 ms, average ΔQTc interval = 220 ± 64 ms, p < 0.02) and transitioned from torsade de pointes to ventricular fibrillation. Bradycardia (< 50 beats/min), hypokalemia (serum K < 3.5 mEp/L), and low left ventricular function (ejection fraction (EF) < 50%) were associated with VA (bradycardia, p < 0.01; hypokalemia, p < 0.01; low left ventricular function, p < 0.01). Three-vessel disease was significantly predictive of VA (p < 0.003). In the three-vessel group, the complications of low left ventricular function, hypokalemia, and bradycardia were significantly associated with VA (p < 0.045). Three-vessel disease is a predictor of the development of VA during FFR measurement performed with the aid of papaverine, especially if accompanied by one or more of the following: low left ventricular function, hypokalemia, or bradycardia. |
|---|---|
| Mesh-Begriff(e) | Aged ; Cardiac Catheters ; Coronary Angiography ; Coronary Stenosis/complications ; Coronary Stenosis/diagnosis ; Coronary Stenosis/physiopathology ; Coronary Vessels/diagnostic imaging ; Coronary Vessels/drug effects ; Coronary Vessels/physiopathology ; Electrocardiography/drug effects ; Female ; Fractional Flow Reserve, Myocardial/physiology ; Humans ; Incidence ; Injections, Intra-Arterial ; Japan/epidemiology ; Male ; Papaverine/administration & dosage ; Papaverine/adverse effects ; Risk Factors ; Vasodilator Agents/administration & dosage ; Vasodilator Agents/adverse effects ; Ventricular Fibrillation/chemically induced ; Ventricular Fibrillation/epidemiology ; Ventricular Fibrillation/physiopathology ; Ventricular Function, Left/physiology |
| Chemische Substanzen | Vasodilator Agents ; Papaverine (DAA13NKG2Q) |
| Sprache | Englisch |
| Erscheinungsdatum | 2018-04-30 |
| Erscheinungsland | Japan |
| Dokumenttyp | Journal Article |
| ZDB-ID | 89678-0 |
| ISSN | 1615-2573 ; 0910-8327 ; 0935-736X |
| ISSN (online) | 1615-2573 |
| ISSN | 0910-8327 ; 0935-736X |
| DOI | 10.1007/s00380-018-1175-8 |
| Datenquelle | MEDical Literature Analysis and Retrieval System OnLINE |
Volltext online
Zusatzmaterialien
Kategorien
Verfügbar in ZB MED Köln/Königswinter
| Zs.A 2049: Hefte anzeigen | Standort: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG) |
Über subito bestellen
Dieser Service ist kostenpflichtig (siehe Lieferbedingungen von subito). Bestellungen, die einen Artikel nebst Supplementary Material umfassen, werden grundsätzlich wie mehrfache Bestellungen bearbeitet. Gebühren fallen in diesen Fällen für jede einzelne Bestellung an.