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Direct volumetric blood flow measurement in coronary arteries by 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.

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  • Authors+Show Affiliations

    ,

    Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands.

    , , , , , , , , ,

    Source

    Journal of the American College of Cardiology 50:24 2007 Dec 11 pg 2294-304

    MeSH

    Adult
    Aged
    Animals
    Blood Volume Determination
    Cardiac Catheterization
    Coronary Circulation
    Coronary Stenosis
    Dogs
    Female
    Humans
    Infusions, Intra-Arterial
    Male
    Middle Aged
    Reproducibility of Results
    Sodium Chloride
    Thermodilution

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    18068038

    Citation

    TY - JOUR T1 - Direct volumetric blood flow measurement in coronary arteries by thermodilution. AU - Aarnoudse,Wilbert, AU - Van't Veer,Marcel, AU - Pijls,Nico H J, AU - Ter Woorst,Joost, AU - Vercauteren,Steven, AU - Tonino,Pim, AU - Geven,Maartje, AU - Rutten,Marcel, AU - van Hagen,Eduard, AU - de Bruyne,Bernard, AU - van de Vosse,Frans, Y1 - 2007/11/26/ PY - 2007/02/13/received PY - 2007/08/21/revised PY - 2007/08/28/accepted PY - 2007/12/11/pubmed PY - 2008/1/8/medline PY - 2007/12/11/entrez SP - 2294 EP - 304 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 50 IS - 24 N2 - 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. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/18068038/full_citation/Direct_volumetric_blood_flow_measurement_in_coronary_arteries_by_thermodilution L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(07)02990-7 ER -