Pressure-derived measurement of coronary flow reserve.

Details

Serval ID
serval:BIB_38260
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Pressure-derived measurement of coronary flow reserve.
Journal
Journal of the American College of Cardiology
Author(s)
MacCarthy P., Berger A., Manoharan G., Bartunek J., Barbato E., Wijns W., Heyndrickx G.R., Pijls N.H., De Bruyne B.
ISSN
0735-1097
Publication state
Published
Issued date
2005
Volume
45
Number
2
Pages
216-220
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Abstract
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 has suggested that the CFR may be derived from pressure measurements alone (the ratio of the square root of the pressure drop across an epicardial stenosis during hyperemia to that value at rest). This depends on the assumption that friction losses across a coronary stenosis are negligible. METHODS: We compared pressure-derived CFR values with those obtained by the thermodilution technique using the intracoronary pressure wire in 38 stenoses in 34 patients with significant coronary stenoses undergoing percutaneous intervention. We also compared these two techniques of measuring CFR in 25 stenoses (6 vessels) artificially created by inflating small balloons within a stented coronary artery after percutaneous intervention. RESULTS: There is a close linear relationship between pressure-derived and thermodilution CFR in native (r(2) = 0.52; p < 0.001) and artificial stenoses (r(2) = 0.54; p < 0.05), although the pressure-derived technique appears to systematically underestimate CFR values in both situations. This applies to native and artificial stenoses. CONCLUSIONS: Coronary flow reserve cannot be measured merely with pressure alone, and it cannot be safely assumed that friction losses are negligible across a native coronary stenosis. These data suggest that friction loss is an important determinant of the pressure gradient along an atherosclerotic coronary artery.
Keywords
Aged, Aged, 80 and over, Algorithms, Blood Flow Velocity/physiology, Blood Pressure/physiology, Cardiac Volume, Coronary Circulation/physiology, Coronary Stenosis/physiopathology, Female, Heart Catheterization, Humans, Hyperemia/physiopathology, Male, Middle Aged, Severity of Illness Index, Thermodilution
Pubmed
Web of science
Open Access
Yes
Create date
19/11/2007 12:36
Last modification date
20/08/2019 13:26
Usage data