| Title | Direct volumetric blood flow measurement in coronary arteries by thermodilution. | | Author(s) | Aarnoudse W, Van't Veer M, Pijls NH, Ter Woorst J, Vercauteren S, Tonino P, Geven M, Rutten M, van Hagen E, de Bruyne B, van de Vosse F | | Institution | Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands. | | Source | J Am Coll Cardiol 2007 Dec 11; 50(24):2294-304. | | MeSH | Adult
Aged
Animals
Blood Volume Determination
Coronary Circulation
Coronary Stenosis
Dogs
Female
Heart Catheterization
Humans
Infusions, Intra-Arterial
Male
Middle Aged
Reproducibility of Results
Sodium Chloride
Thermodilution
| | Abstract | OBJECTIVES: This study sought to validate a new method for direct volumetric blood flow measurement in coronary arteries in animals and in conscious humans during cardiac catheterization.
BACKGROUND: Direct volumetric measurement of blood flow in selective coronary arteries would be useful for studying the coronary circulation.
METHODS: Based on the principle of thermodilution with continuous low-rate infusion of saline at room temperature, we designed an instrumental setup for direct flow measurement during cardiac catheterization. A 2.8-F infusion catheter and a standard 0.014-inch sensor-tipped pressure/temperature guidewire were used to calculate absolute flow (Q(thermo)) in a coronary artery from the infusion rate of saline, temperature of the saline at the tip of the infusion catheter, and distal blood temperature during infusion. The method was tested over a wide range of flow rates in 5 chronically instrumented dogs and in 35 patients referred for physiological assessment of a coronary stenosis or for percutaneous coronary intervention.
RESULTS: Thermodilution-derived flow corresponded well with true flow (Q) in all dogs (Q(thermo) = 0.73 Q + 42 ml/min; R(2) = 0.72). Reproducibility was excellent (Q(thermo,)(1) = 0.96 x Q(thermo,)(2) + 3 ml/min; R(2) = 0.89). The measurements were independent of infusion rate and sensor position as predicted by theory. In the humans, a good agreement was found between increase of thermodilution-derived volumetric blood flow after percutaneous coronary intervention and increase of fractional flow reserve (R(2) = 0.84); reproducibility of the measurements was excellent (Q(thermo,)(1) = 1.0 Q(thermo,)(2) + 0.9 ml/min, R(2) = 0.97), and the measurements were independent of infusion rate and sensor position.
CONCLUSIONS: Using a suitable infusion catheter and a 0.014-inch sensor-tipped guidewire for measurement of coronary pressure and temperature, volumetric blood flow can be directly measured in selective coronary arteries during cardiac catheterization. | | Language | eng | | Pub Type(s) | Journal Article
Research Support, Non-U.S. Gov't
| | PubMed ID | 18068038 |
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