Pulsatile coronary flow determination by digital angiography

Area of Science:

• Cardiovascular Imaging
• Hemodynamics
• Interventional Cardiology

Background:

• Accurate measurement of coronary arterial blood flow is crucial for diagnosing and managing cardiovascular diseases.
• Existing methods for assessing coronary blood flow have limitations in accuracy, reproducibility, or invasiveness.

Purpose of the Study:

• To develop and evaluate a new angiographic method for calculating absolute coronary arterial blood flow and its cyclic variations.
• To assess the feasibility, reproducibility, and accuracy of this novel method in simulations and preliminary clinical applications.

Main Methods:

• The method utilizes densitometric analysis of contrast propagation in digital angiographic images, applying the principle of conservation of contrast material.
• It involves standard arteriographic procedures and analysis of spatial and temporal contrast dynamics.
• Simulations were performed using a coronary arterial phantom with constant and pulsatile flow, validated against electromagnetic flow measurements.

Main Results:

• Excellent agreement was demonstrated between the new method and electromagnetic flow measurements in phantom studies (r = 0.993 for constant flow, r = 0.982 for pulsatile flow).
• Preliminary clinical results indicated reproducible assessment of coronary flow patterns after repeated injections in patients.
• Coronary flow patterns in baseline and hyperemic states were obtained in a coronary artery bypass graft, yielding consistent coronary flow reserve values.

Conclusions:

• The developed angiographic method is feasible, uncomplicated, and fast for assessing coronary blood flow and patterns.
• The technique demonstrates reproducible results and potential for clinical application in evaluating coronary flow reserve.
• Further animal and clinical validation is necessary to fully determine the applications, limitations, and accuracy of this novel method.