Coronary thermodilution to assess flow reserve: validation in humans.
نویسندگان
چکیده
BACKGROUND Guide wire-based simultaneous measurement of fractional flow reserve (FFR) and coronary flow reserve (CFR) is important to understand microvascular disease of the heart. The aim of this study was to investigate the feasibility of simultaneous measurement of FFR and CFR by one pressure-temperature sensor-tipped guide wire with the use of coronary thermodilution and to compare CFR by thermodilution (CFR(thermo)) with simultaneously measured Doppler CFR (CFR(Doppl)). METHODS AND RESULTS In 103 coronary arteries in 50 patients, a pressure-temperature sensor-tipped 0.014-inch floppy guide wire and a 0.014-inch Doppler guide wire were introduced. Both normal vessels and a wide range of stenotic vessels were included. With 3 mL of saline at room temperature used as an indicator, by hand-injection, thermodilution curves in the coronary artery were obtained in triplicate, both at baseline and at intravenous adenosine-induced maximum hyperemia. After adequate curve-fitting, CFR(thermo) was calculated from the ratio of inverse mean transit times and compared with CFR(Doppl) calculated by velocities at hyperemia and baseline. Adequate sets of thermodilution curves and corresponding CFR(thermo) could be obtained in 87% of the arteries versus 91% for Doppler CFR and 100% for FFR. CFR(thermo) correlated fairly well to CFR(Doppl) (CFR(thermo)=0.84 CFR(Doppl)+0.17; r=0.80; P<0.001), although individual differences of >20% between both indexes were seen in a quarter of all arteries. CONCLUSIONS This study shows the feasibility of simultaneous measurement of FFR (by coronary pressure) and CFR (by coronary thermodilution) in humans by one single guide wire in a practical and straightforward way and will facilitate assessment of microvascular disease.
منابع مشابه
A simple thermodilution technique to assess coronary endothelium-dependent microvascular function in humans: validation and comparison with coronary flow reserve.
AIMS To validate a novel method for assessment of coronary endothelium-dependent microvascular function and compare this index with the adenosine-derived coronary flow reserve (CFR). METHODS AND RESULTS We validated use of intra-coronary pressure wire-derived thermodilution to assess changes in coronary flow compared to Doppler flow-wire/quantitative coronary angiography- (QCA) derived data i...
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BACKGROUND Fractional flow reserve (FFR) and coronary flow reserve (CFR) are indices of coronary stenosis severity that provide the clinician with complementary information on the contribution of epicardial arteries and microcirculation to total resistance to myocardial blood flow. At present, FFR and CFR can only be obtained by 2 separate guidewires. The present study tested the validity of th...
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OBJECTIVES We aimed to validate the technique of measuring the coronary flow reserve (CFR) with coronary pressure measurements against an established thermodilution technique. BACKGROUND The CFR has traditionally required measurement of coronary blood flow velocity with the Doppler wire and, more recently, using a thermodilution technique with the coronary pressure wire. However, recent work ...
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ورودعنوان ژورنال:
- Circulation
دوره 105 21 شماره
صفحات -
تاریخ انتشار 2002