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Coronary thermodilution to assess flow reserve: experimental validation
B De Bruyne1, N H Pijls, L Smith
1Cardiovascular Center Aalst, Aalst, Belgium. bernard.de.bruyne@olvz-aalst.be
Circulation
|October 24, 2001
Summary
This study validates using a single pressure-temperature guidewire to measure coronary flow reserve (CFR) via thermodilution. This allows simultaneous assessment of CFR and fractional flow reserve (FFR), simplifying stenosis severity evaluation.
Area of Science:
- Cardiovascular Physiology
- Interventional Cardiology
- Medical Instrumentation
Background:
- Fractional flow reserve (FFR) and coronary flow reserve (CFR) assess stenosis severity.
- Current methods require separate guidewires for FFR and CFR.
- A novel approach using a single guidewire is needed.
Purpose of the Study:
- To validate the thermodilution principle for assessing CFR using a single pressure-temperature sensor-tipped guidewire.
- To determine if CFR can be measured simultaneously with FFR.
Main Methods:
- In vitro assessment of thermodilution curves and flow.
- In vivo study in dogs with induced stenoses.
- Comparison of thermodilution-derived CFR (CFR(thermo)) with Doppler-derived CFR (CFR(Doppler)).
Main Results:
- A strong correlation (r>0.95) was observed between absolute flow and inverse mean transit time (1/T(mn)) in vitro.
- A significant linear relationship was found between flow velocity and 1/T(mn) in dogs.
- CFR(thermo) significantly correlated with CFR(Doppler) (r=0.76, P<0.001).
Conclusions:
- The thermodilution principle is valid for assessing CFR.
- A single guidewire enables simultaneous measurement of CFR and FFR.
- This technique simplifies the assessment of coronary stenosis severity.
