Impact of vessel volume on thermodilution measurements in patients with coronary microvascular dysfunction.

Details

Serval ID
serval:BIB_ED323ED831E5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of vessel volume on thermodilution measurements in patients with coronary microvascular dysfunction.
Journal
Catheterization and cardiovascular interventions
Author(s)
Sakai K., Storozhenko T., Mizukami T., Ohashi H., Bouisset F., Tajima A., van Hoe L., Gallinoro E., Botti G., Mahendiran T., Pardaens S., Brouwers S., Fawaz S., Keeble T.R., Davies J.R., Sonck J., De Bruyne B., Collet C.
ISSN
1522-726X (Electronic)
ISSN-L
1522-1946
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Two invasive methods are available to estimate microvascular resistance: bolus and continuous thermodilution. Comparative studies have revealed a lack of concordance between measurements of microvascular resistance obtained through these techniques.
This study aimed to examine the influence of vessel volume on bolus thermodilution measurements.
We prospectively included patients with angina with non-obstructive coronary arteries (ANOCA) undergoing bolus and continuous thermodilution assessments. All patients underwent coronary CT angiography to extract vessel volume. Coronary microvascular dysfunction was defined as coronary flow reserve (CFR) < 2.0. Measurements of absolute microvascular resistance (in Woods units) and index of microvascular resistance (IMR) were compared before and after volumetric adjustment.
Overall, 94 patients with ANOCA were included in this study. The mean age was 64.7 ± 10.8 years, 48% were female, and 19% had diabetes. The prevalence of CMD was 16% based on bolus thermodilution, while continuous thermodilution yielded a prevalence of 27% (Cohen's Kappa 0.44, 95% CI 0.23-0.65). There was no correlation in microvascular resistance between techniques (r = 0.17, 95% CI -0.04 to 0.36, p = 0.104). The adjustment of IMR by vessel volume significantly increased the agreement with absolute microvascular resistance derived from continuous thermodilution (r = 0.48, 95% CI 0.31-0.63, p < 0.001).
In patients with ANOCA, invasive methods based on coronary thermodilution yielded conflicting results for the assessment of CMD. Adjusting IMR with vessel volume improved the agreement with continuous thermodilution for the assessment of microvascular resistance. These findings strongly suggest the importance of considering vessel volume when interpreting bolus thermodilution assessment.
Keywords
absolute coronary flow, bolus thermodilution, coronary microvascular dysfunction, microvascular resistance, vessel lumen volume
Pubmed
Web of science
Create date
05/04/2024 10:31
Last modification date
13/04/2024 7:05
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