Published Online
on October 20, 2003

A more recent version of this article appeared on November 4, 2003

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Submitted on August 12, 2003
Revised on September 16, 2003
Accepted on September 18, 2003

Comparison of Coronary Thermodilution and Doppler Velocity for Assessing Coronary Flow Reserve

William F. Fearon MD^*, H.M. Omar Farouque MB, BS, PhD, Leora B. Balsam MD, David T. Cooke MD, Robert C. Robbins MD, Peter J. Fitzgerald MD, PhD, Alan C. Yeung MD, and Paul G. Yock MD

From the Divisions of Cardiovascular Medicine (W.F.F., H.M.O.F., P.J.F., A.C.Y., P.G.Y.) and Cardiothoracic Surgery (L.B.B., D.T.C., R.C.R.), Stanford University Medical Center, Stanford, Calif.

^* To whom correspondence should be addressed. E-mail: wfearon{at}stanford.edu.

Background--Thermodilution coronary flow reserve (CFR_thermo) is a new technique for invasively measuring coronary flow reserve (CFR) with a coronary pressure wire and is based on the ability of the pressure transducer to also measure temperature changes. Whether CFR_thermo correlates well enough with absolute flow-derived CFR (CFR_flow) to replace Doppler wire-derived CFR (CFR_Doppler) remains unclear.

Methods and Results--In an open-chest pig model, CFR_thermo was measured in the left anterior descending (LAD) artery and compared with CFR_Doppler and CFR_flow, measured with an external flow probe placed around the LAD. In 9 pigs, CFR was measured simultaneously by all 3 means in the normal LAD and after creation of an epicardial LAD stenosis. To determine the added effect of microvascular disease, measurements of flow reserve were also performed after disruption of the coronary microcirculation with embolized microspheres. Intracoronary papaverine (20 mg) was used to induce hyperemia. In a total of 61 paired measurements, CFR_thermo correlated strongly with the reference standard CFR_flow (r=0.85, P<0.001). CFR_Doppler correlated less well with CFR_flow (r=0.72, P<0.001). Bland-Altman analysis showed a closer agreement between CFR_thermo and CFR_flow.

Conclusion--CFR_thermo correlates better with CFR_flow than does CFR_Doppler.

Key words: blood flow • coronary disease • microcirculation • pressure

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