Adequate intracoronary adenosine doses to achieve maximum hyperaemia in coronary functional studies by pressure derived fractional flow reserve: a dose response study.

C oronary pressure derived fractional flow reserve (FFR) is an increasingly used invasive index of the functional significance of coronary lesions. FFR expresses maximum achievable blood flow to the myocardium, supplied by a stenotic artery, as a fraction of normal maximum flow. 2 Achievement of maximal hyperaemia is essential for calculation of FFR. Intracoronary adenosine is widely used to obtain maximal hyperaemia. Although standard doses of intracoronary adenosine to achieve maximal hyperaemia have been well established in previous studies (15–40 mg left coronary artery, 10–30 mg right coronary artery), doubts about maximal hyperaemia achieved with these doses have led to the empirical use of higher than standard doses in clinical practice. 5 The aim of this study was to analyse the effects of incremental doses of intracoronary adenosine on FFR measurements.