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Coronary flow reserve measurements with a new Judkins-style Doppler angiographic catheter
A Chauhan1, P A Mullins, S Thuraisingham
1Cardiac Unit, Papworth Hospital, Cambridge, England.
Insights
Judkins-style Doppler catheters provide a quick, safe, and accurate alternative for measuring coronary flow velocity and reserve compared to traditional intracoronary Doppler. This technique shows comparable results in patients with normal coronary arteries.
Area of Science:
- Cardiology
- Medical Devices
- Hemodynamics
Background:
- Coronary artery disease assessment relies on accurate flow measurements.
- Intracoronary Doppler catheters are standard but can be invasive.
- Novel catheter designs aim to simplify and improve accuracy.
Purpose of the Study:
- To compare coronary flow velocity measurements using Judkins-style Doppler catheters versus standard intracoronary Doppler.
- To evaluate the accuracy and feasibility of Judkins-style Doppler for assessing coronary hemodynamics.
Main Methods:
- 42 patients with normal coronary arteries underwent simultaneous flow velocity measurements.
- Judkins-style Doppler and intracoronary Doppler catheters were used.
- Measurements were taken at rest and during hyperemia induced by papaverine.
Main Results:
- Judkins-style Doppler showed significantly higher resting and hyperemic flow velocities.
- Coronary flow reserve measurements were strongly correlated between both methods (r = 0.85).
- Results in heart transplant patients also showed strong correlation, though not always statistically significant.
Conclusions:
- Judkins-style Doppler catheters offer a viable, accurate alternative to intracoronary Doppler.
- This technique is potentially faster and safer for evaluating coronary blood flow.
- Further validation may support its routine clinical use.
Abstract:
The authors assessed whether measurements obtained by Judkins-style Doppler catheters are comparable to those achieved with the intracoronary Doppler technique in 42 patients with normal coronary arteries on angiography (19 syndrome X and 23 heart transplant patients). Resting coronary flow velocity and response to a hyperemic intracoronary dose of papaverine was measured with a Judkins-style, 8F Doppler-tipped catheter positioned in the left coronary ostium and a 3.6F intracoronary Doppler catheter positioned in the proximal left anterior descending artery. Mean coronary flow velocity at rest was significantly higher with the Judkins Doppler (10.1 +/- 4.6 vs 6.3 +/- 4.5 cm/sec, p < 0.01). The mean coronary flow velocity at peak hyperemia was also significantly higher with the Judkins Doppler (33.7 +/- 14.1 vs 19.7 +/- 11.5 cm/sec, p < 0.01). Coronary flow reserve was 3.57 +/- 1.3 with the Judkins Doppler and 3.47 +/- 1.2 with the intracoronary Doppler (r = 0.85). A second study was performed in 14 heart transplant patients with the intracoronary Doppler positioned in the left main coronary artery. The resting and hyperemic flow velocities were again higher with the Judkins Doppler but the differences were not statistically significant. There was again a strong correlation between the Doppler catheters for coronary flow reserve measurements. The Judkins-style Doppler technique appears to be a quick, safe, and accurate alternative to the intracoronary Doppler technique.