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Blood velocity measurements during selective coronary angiography before and after percutaneous transluminal coronary
R A Nishimura1, D R Holmes, A A Bove
1Mayo Clinic, Rochester, MN 55905.
Insights
Measuring coronary flow velocity using routine angiography accurately assesses blood flow after angioplasty. This reproducible technique offers a valuable index of myocardial perfusion, independent of vessel territory size.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Imaging
Background:
- Coronary artery blood flow velocity can indicate myocardial perfusion.
- Assessing perfusion typically requires measuring the volume of myocardium supplied by a vessel.
- A simpler index of perfusion is needed, especially for evaluating interventions.
Purpose of the Study:
- To evaluate coronary flow velocity as an index of myocardial perfusion.
- To assess the feasibility and reproducibility of measuring coronary flow velocity from routine coronary angiography.
- To determine if coronary flow velocity changes after percutaneous transluminal coronary angioplasty (PTCA).
Main Methods:
- Coronary angiography was performed on 15 patients.
- The velocity of contrast material's leading edge was measured before and after PTCA.
- Measurements were derived from digitized images of routine coronary angiography.
- Interobserver and intraobserver variability were assessed.
Main Results:
- Mean coronary flow velocity increased significantly from 11.9 cm/s before PTCA to 21.7 cm/s after PTCA (P < 0.01).
- A strong correlation (r = 0.65; P < 0.001) was found between the percent change in velocity and the change in percent stenosis.
- Low interobserver (2.1 cm/s) and intraobserver (1.8 cm/s) variability confirmed reproducibility.
Conclusions:
- Coronary flow velocity measurement using routine angiography is a simple and reproducible technique.
- This method provides a valuable index of myocardial perfusion.
- It can be effectively used to assess the results of interventions like PTCA.
Abstract:
The velocity of blood flowing down a coronary artery may provide an index of myocardial perfusion, independent of the need for measuring the amount of myocardium supplied by a vessel. The velocity of the leading edge of contrast material was therefore measured before and after percutaneous transluminal coronary angioplasty in 15 patients utilizing digitized images from routine coronary angiography. The velocity (mean +/- SD) before percutaneous transluminal coronary angioplasty in the 15 patients was 11.9 +/- 6.0 cm/s, increasing to 21.7 +/- 8.7 cm/s after (P less than 0.01). There was a correlation between the percent change in velocity and the change in percent stenosis before and after percutaneous transluminal coronary angioplasty (r = 0.65; P less than 0.001). The mean absolute interobserver and intraobserver variabilities for the velocity measurements were 2.1 and 1.8 cm/s, respectively. Measurement of coronary flow velocity from data obtained at the time of routine coronary angiography is an easily performed reproducible technique, which may be used to assess the results of an intervention such as percutaneous transluminal coronary angioplasty.