Steady-state hyperaemia: many routes, one goal

The HYPEREMIC trial by Elghamaz et al1 describes the use of a 3 Fr over-the-wire microcatheter for inducing maximal coronary hyperaemia during fractional flow reserve (FFR) measurement.

Forty-one patients sequentially received intravenous and intracoronary adenosine in a randomly alternated order. The data indicate that intracoronary administration of adenosine through the microcatheter allows a total dose reduction of two magnitudes and makes it possible to reach maximal hyperaemia in half the time compared to conventional intravenous administration. Patient discomfort is also markedly reduced when the intracoronary route is used. The authors do not provide analysis data about test-retest variability but ...