Introduction
Methods
Study population
Study protocol
Analysis
Subgroup analyses
Statistical analysis
Results
Healthy controls
Haemodynamic response
Adenosine dosing | ||||
---|---|---|---|---|
Standard dose: 140 µg/kg/min 4 min duration | High dose: 210 µg/kg/min 4 min duration | Long dose: 140 µg/kg/min 8 min duration | p | |
Rest HR (bpm) | 71 ± 15 | 71 ± 14 | 71 ± 13 | 0.962 |
Rest SBP (mmHg) | 117 ± 12 | 118 ± 14 | 117 ± 13 | 0.481 |
Stress HR (bpm) | 102 ± 19† | 108 ± 16† | 106 ± 19† | 0.017* |
Stress SBP (mmHg) | 121 ± 16† | 121 ± 16 | 124 ± 17‡ | 0.195 |
Change in HR (bpm) | 30 ± 12 | 37 ± 11 | 35 ± 13 | 0.045* |
Change in SBP (mmHg) | 5 ± 6 | 3 ± 9 | 7 ± 11 | 0.072 |
Stress MBF (ml/g/min) | 2.50 ± 0.74 | 2.66 ± 0.59 | 2.59 ± 0.64 | 0.323 |
MPR | 3.52 ± 0.93 | 3.82 ± 0.83 | 3.72 ± 1.00 | 0.191 |
MBF
Patients
Group 1 | Group 2 | Group 3 | p | |
---|---|---|---|---|
n | 20 | 16 | 24 | |
Sex—male | 17 (85%) | 8 (50%) | 17 (71%) | 0.074 |
Age | 62.9 ± 8.7 | 63.5 ± 16.3 | 65.1 ± 12.7 | 0.344 |
Diabetes mellitus | 4 (20%) | 0 | 6 (25%) | 0.102 |
Beta blocker usage | 14 (70%) | 12 (75%) | 17 (71%) | 0.940 |
LVEF | 57.5 ± 7.9 | 48.1 ± 5.2 | 26.2 ± 7.0 | < 0.001 |
Haemodynamic response
CAD n = 20 | HF LVEF ≥ 40% n = 16 | HF LVEF < 40% n = 24 | Comparison between groups (p) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Standard dose | High dose | p | Standard dose | High dose | p | Standard dose | High dose | p | Standard dose | High dose | |
Rest HR (bpm) | 62 ± 10 | 63 ± 9 | 0.534 | 65 ± 14 | 65 ± 13 | 1.000 | 75 ± 12 | 77 ± 14 | 0.547 | 0.002 | 0.001 |
Rest SBP (mmHg) | 132 ± 17 | 131 ± 16 | 0.735 | 124 ± 16 | 124 ± 17 | 0.320 | 119 ± 16 | 119 ± 16 | 0.526 | 0.066 | 0.089 |
Stress HR (bpm) | 75 ± 13‡ | 78 ± 13‡ | 0.027* | 79 ± 20‡ | 80 ± 17‡ | 0.659 | 87 ± 16‡ | 90 ± 18‡ | 0.418 | 0.039 | 0.038 |
Stress SBP (mmHg) | 124 ± 15 | 121 ± 12 | 0.219 | 124 ± 11 | 120 ± 13 | 0.005** | 122 ± 18 | 124 ± 19 | 0.391 | 0.597 | 0.970 |
Change in HR (bpm) | 12 ± 10 | 15 ± 8 | 0.112 | 14 ± 14 | 15 ± 9 | 0.637 | 12 ± 12 | 13 ± 19 | 0.751 | 0.875 | 0.889 |
Change in SBP | − 2 ± 10 | − 6 ± 11 | 0.455 | − 2 ± 13 | − 2 ± 11 | 0.139 | 2 ± 8 | 3 ± 13 | 0.700 | 0.377 | 0.072 |
Non-responders (< 10 bpm) (%) | 8 (40%) | 4 (20%) | 0.168 | 6 (38%) | 3 (19%) | 0.433 | 10 (42%) | 11 (46%) | 0.771 | 0.966 | 0.097 |
Failed splenic switch off (%) | 2 (10%) | 0 | 0.487 | 1 (6%) | 0 | 1 | 2 (8%) | 2 (8%) | 1 | 1.0 | 0.334 |
MBF and MPR
Subgroup analyses
Heart rate response to adenosine
Standard dose | High dose | p | |
---|---|---|---|
Non-responders (n = 24) | |||
Rest HR (bpm) | 67 ± 16 | 68 ± 14 | 0.789 |
Stress HR (bpm) | 70 ± 14 | 75 ± 12 | 0.034 |
Increase in HR (bpm) | 3 ± 6 | 7 ± 11 | 0.053 |
Stress MBF (ml/g/min) | 1.35 ± 0.49 | 1.45 ± 0.46 | 0.188 |
MPR | 1.93 ± 0.77 | 2.05 ± 0.70 | 0.215 |
Adequate HR response (n = 36) | |||
Rest HR (bpm) | 69 ± 12 | 70 ± 13 | 0.461 |
Stress HR (bpm) | 88 ± 15 | 89 ± 18 | 0.762 |
Increase in HR (bpm) | 19 ± 9 | 19 ± 13 | 0.838 |
Stress MBF (ml/g/min) | 1.48 ± 0.60 | 1.59 ± 0.43 | 0.103 |
MPR | 2.32 ± 0.86 | 2.53 ± 0.63 | 0.073 |