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A new angiographic method to assess coronary flow reserve—Validation in humans
Author(s) -
Rittger Harald,
Kuper Asher,
Breithardt OleAlexander,
Kuon Eberhardt,
Schmidt Martin,
Sinha AnilMartin,
Blüm Barbara,
Jakob Axel,
Brachmann Johannes
Publication year - 2009
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.22251
Subject(s) - medicine , coronary flow reserve , cardiology , cardiac catheterization , doppler effect , coronary circulation , reactive hyperemia , fractional flow reserve , densitometry , blood flow , coronary angiography , myocardial infarction , physics , astronomy
Background : Coronary flow reserve (CFR) is defined as the ratio between coronary artery flow during maximal hyperemia and rest. It is considered as a marker for the integrity of the epicardial coronary circulation and the microcirculation. CFR measurement typically requires the introduction of a guide wire into a diseased coronary artery. We tested a new algorithm, which allows to estimate CFR by analysis of coronary angiograms without the need for direct intracoronary measurements. Methods : Twenty seven patients (10 female, mean age 64 ± 11 years) underwent diagnostic cardiac catheterization for the evaluation of chest pain. A Doppler wire was introduced into the diseased coronary artery and CFR doppler was calculated by the flow velocity ratio between rest and maximal hyperemia, induced by intravenous administration of 140 μg of adenosine per kg bodyweight. This was compared to the angiographically determined CFR (CFR angio ) under the same conditions (rest and induced maximal hyperemia) by densitometry. CFR angio was based on the creation of two time density curves representing the disappearance of contrast over time. CFR angio was the resulting ratio between the density values during hyperemia and rest. Results : An excellent correlation was found between CFR doppler and CFR angio : CFR angio = 1 × CFR doppler ( r = 0.87; P < 0.0001). The average absolute difference between both indeces was 0.36 ± 0.31. Conclusion : Measurement of CFR angio by densitometry is feasible and provides results, which are comparable to Doppler‐derived intracoronary flow velocity measurements. © 2009 Wiley‐Liss, Inc.