Catheter-Based Measurements of Absolute Coronary Blood Flow and Microvascular Resistance: Feasibility, Safety, and Reproducibility in Humans.

Details

Serval ID
serval:BIB_6C861AA61D23
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Catheter-Based Measurements of Absolute Coronary Blood Flow and Microvascular Resistance: Feasibility, Safety, and Reproducibility in Humans.
Journal
Circulation. Cardiovascular interventions
Author(s)
Xaplanteris P., Fournier S., Keulards DCJ, Adjedj J., Ciccarelli G., Milkas A., Pellicano M., Van't Veer M., Barbato E., Pijls NHJ, De Bruyne B.
ISSN
1941-7632 (Electronic)
ISSN-L
1941-7640
Publication state
Published
Issued date
03/2018
Peer-reviewed
Oui
Volume
11
Number
3
Pages
e006194
Language
english
Notes
Publication types: Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
The principle of continuous thermodilution can be used to calculate absolute coronary blood flow and microvascular resistance (R). The aim of the study is to explore the safety, feasibility, and reproducibility of coronary blood flow and R measurements as measured by continuous thermodilution in humans.
Absolute coronary flow and R can be calculated by thermodilution by infusing saline at room temperature through a dedicated monorail catheter. The temperature of saline as it enters the vessel, the temperature of blood and saline mixed in the distal part of the vessel, and the distal coronary pressure were measured by a pressure/temperature sensor-tipped guidewire. The feasibility and safety of the method were tested in 135 patients who were referred for coronary angiography. No significant adverse events were observed; in 11 (8.1%) patients, bradycardia and concomitant atrioventricular block appeared transiently and were reversed immediately on interruption of the infusion. The reproducibility of measurements was tested in a subgroup of 80 patients (129 arteries). Duplicate measurements had a strong correlation both for coronary blood flow (ρ=0.841, P<0.001; intraclass correlation coefficient=0.89, P<0.001) and R (ρ=0.780, P<0.001; intraclass correlation coefficient=0.89, P<0.001). In Bland-Altman plots, there was no significant bias or asymmetry.
Absolute coronary blood flow (in L/min) and R (in mm Hg/L/min or Wood units) can be safely and reproducibly measured with continuous thermodilution. This approach constitutes a new opportunity for the study of the coronary microcirculation.
Keywords
Acute Coronary Syndrome/diagnosis, Acute Coronary Syndrome/diagnostic imaging, Acute Coronary Syndrome/physiopathology, Angina, Stable/diagnosis, Angina, Stable/diagnostic imaging, Angina, Stable/physiopathology, Blood Flow Velocity, Cardiac Catheterization/instrumentation, Cardiac Catheters, Coronary Angiography, Coronary Artery Disease/diagnosis, Coronary Artery Disease/diagnostic imaging, Coronary Artery Disease/physiopathology, Coronary Circulation, Coronary Vessels/diagnostic imaging, Coronary Vessels/physiopathology, Feasibility Studies, Humans, Microcirculation, Predictive Value of Tests, Referral and Consultation, Reproducibility of Results, Thermodilution/instrumentation, Vascular Resistance, coronary angiography, fractional flow reserve, microvascular angina, microvessels, myocardial, reproducibility of results, temperature, thermodilution
Pubmed
Web of science
Open Access
Yes
Create date
26/08/2019 17:34
Last modification date
27/08/2019 6:26
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