doi: 10.1161/hc4201.099223
(Circulation. 2001;104:2003-2006.)
© 2001 American Heart Association, Inc.
Brief Rapid Communications |
Coronary Thermodilution to Assess Flow Reserve
Experimental Validation
From the Cardiovascular Center Aalst, Aalst, Belgium (B.D.B., G.R.H.); the Cardiology Department, Catharina Hospital, and the Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (N.H.J.P.); and Radi Medical Systems, Uppsala, Sweden (L.S., M.W.).
Correspondence to Bernard De Bruyne, MD, PhD, Cardiovascular Center Aalst, Moorselbaan 164, B-9300 Aalst, Belgium. E-mail bernard.de.bruyne{at}olvz-aalst.be
Background— Fractional flow reserve (FFR) and coronary flow reserve (CFR) are indices of coronary stenosis severity that provide the clinician with complementary information on the contribution of epicardial arteries and microcirculation to total resistance to myocardial blood flow. At present, FFR and CFR can only be obtained by 2 separate guidewires. The present study tested the validity of the thermodilution principle in assessing CFR with one pressure-temperature sensor-tipped guidewire.
Methods and Results— In an in vitro model, absolute flow was compared with the inverse mean transit time (1/Tmn) of a thermodilution curve obtained after a bolus injection of 3 mL of saline at room temperature. A very close correlation (r>0.95) was found between absolute flow and 1/Tmn when the sensor was placed 
6 cm from the injection site. In 6 chronically instrumented dogs (60 stenoses; FFR from 0.19 to 0.98), a significant linear relation was found between flow velocity and 1/Tmn. A significant correlation was found between CFRDoppler, which was calculated from the ratio of hyperemic to resting flow velocities, and CFRthermo, which was calculated from the ratio of resting to hyperemic Tmn (r=0.76; SEE=0.24; P<0.001).
Conclusion— The present findings demonstrate the validity of the thermodilution principle to assess CFR. Because the pressure-temperature sensor was mounted in a commercially available angioplasty guidewire, this technique permits simultaneous measurements of CFR and FFR.
Key Words: thermodilution • blood flow • microcirculation • coronary disease
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