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A novel flow-based parameter of collateral function assessed by intracoronary thermodilution
Markus Lindner1, Stephan B Felix, Klaus Empen
1Klinik und Poliklinik für Innere Medizin B, Universitätsmedizin Greifswald, Ernst-Moritz-Arndt-Universität Greifswald, Ferdinand-Sauerbruch-Str, 17485 Greifswald, Germany. ThorstenReffelmann@web.de.
A new thermodilution-based method accurately measures coronary collateral blood flow (CBFI), offering a dynamic, flow-based alternative to pressure-derived indices for assessing coronary artery stenosis. This approach shows promise for improved evaluation of collateral function.
Area of Science:
- Cardiovascular research
- Medical imaging and diagnostics
- Hemodynamics
Background:
- Current methods for coronary collateral function assessment rely on pressure measurements, which may not fully capture dynamic collateral flow.
- A novel approach utilizing thermodilution principles is proposed to evaluate coronary collateral function based on blood flow dynamics.
Purpose of the Study:
- To evaluate a novel flow-based parameter for coronary collateral function using thermodilution principles.
- To compare this new index with established pressure-based measures in patients with coronary artery stenosis.
Main Methods:
- The study involved 26 patients with high-grade coronary artery stenosis.
- Intracoronary hemodynamics were analyzed using the RadiAnalyzer system, measuring fractional flow reserve (FFR), index of microcirculatory resistance (IMR), and pressure-based collateral flow index (CFI).
- A room-temperature saline bolus was administered, and the subsequent temperature change distal to an occluded balloon was measured to calculate the coronary blood flow index (CBFI).
Main Results:
- The coefficient of variation for CBFI measurements was 11 ± 2%.
- CBFI demonstrated a significant correlation with CFI (r = 0.65; P<.001).
- Patients with lower microvascular resistance showed a steeper slope for CBFI versus CFI, indicating more effective collateral flow.
Conclusions:
- A novel, flow-based index derived from thermodilution (CBFI) shows potential for assessing coronary collateral function.
- This index may offer advantages over traditional pressure-based measurements by accounting for dynamic flow characteristics.
- Further studies are warranted to validate the clinical utility of this new collateral flow index.
