Safety of Adenosine for Acute Pulmonary Vasoreactivity Testing in Pulmonary Hypertension
Journal Title: Multidisciplinary Cardiovascular Annals - Year 2016, Vol 7, Issue 1
Abstract
Background Acute pulmonary vasoreactivity testing (APVT) is performed during right heart catheterization (RHC) in patients with pulmonary arterial hypertension (PAH) to identify those who may benefit from long-term calcium channel blocker (CCB) therapy. Inhaled nitric oxide (iNO) is the most commonly used agent. However, a few other agents such as intravenous (i.v.) epoprostenol or i.v. adenosine can also be used. At present, intravenous prostaglandins and iNO are expensive and not-easily available in most Iranian medical facilities. Indeed intravenous adenosine is less expensive and available in all hospital settings. Objectives We aimed to investigate the safety profile of adenosine in a group of Iranian PAH patients undergoing APVT. Methods In this prospective study, a total of 57 consecutive patients with PAH who were scheduled to undergo RHC were enrolled. Acute reactivity testing was performed in 56 patients. Results Twenty (36%) patients had positive APVT. In all cases, adenosine administration was limited by the occurrence of drug-induced minor side effects including chest pressure or tightness, flushing and dyspnea. The maximal tolerated dose of adenosine was 225 ± 25 µg/kh/min (range 200 - 300 µg/kh/min) in the study population. Only 2 patients developed atrioventricular block at doses of 100 µg/kh/min and 150 µg/kh/min, respectively. Both patients spontaneously converted to sinus rhythm within one minute of discontinuation of adenosine infusion. Conclusions Intravenous adenosine can be safely used for APVT in Iran.
Authors and Affiliations
Ahmad Amin, Hossein Navid, Mitra Chitsazan, Bahar Ghaleshi, Sepideh Taghavi, Nasim Naderi
Keywords
Related Articles
- EP ID EP229223
- DOI 10.17795/mcardia.9324
- Views 84
- Downloads 0
Safety of Adenosine for Acute Pulmonary Vasoreactivity Testing in Pulmonary Hypertension
Background Acute pulmonary vasoreactivity testing (APVT) is performed during right heart catheterization (RHC) in patients with pulmonary arterial hypertension (PAH) to identify t...
Quilty Effect: Its Definition and Significance, in Post-Cardiac Transplant Endomyocardial Biopsies with Focus on Our Experience
Background The recent trend of cardiac transplantation has been dramatic in our center, thus entailing the interpretation of endomyocardial biopsies in such patients. Objectives W...
Tricuspid Regurgitation Dilemma: A Comparison Study between Surgical Versus Medical Management of Patients with Tricuspid Regurgitation
Background The management of the medical and surgical treatment of tricuspid regurgitation (TR) is still controversial because of the contradictory outcomes of relevant studies. T...
Ocular Complication in Cardiac Surgery
Visual loss after nonocular surgery is rare but devastating. Peak rates of perioperative visual loss are with heart and spine surgery. The two possible main causes of visual loss...
Cryoablative Cox Maze Procedure and Pulmonary Vein Isolation for Treatment of Atrial Fibrillation in Rheumatic Heart Disease Undergoing Mitral Valve Surgery
Introduction The cox-maze procedure (CMP) is considered the gold standard surgical therapy for atrial fibrillation (AF), however, cryosurgical ablations are changing daily practic...