Development and Validation of a Novel Angiography-derived Index of Absolute Coronary Blood Flow and Resistance

Overview

Journal Int J Cardiovasc Imaging

Publisher Springer

Specialty Radiology

Date 2024 Aug 22

PMID 39172316

Authors

Federico Marin

Samer Fawaz

Rafail A Kotronias

Jason Chai

Miao Chu

Grigoris V Karamasis

Christopher M Cook

Sarosh Khan

John R Davies

Keith Channon

Adrian P Banning

Thomas R Keeble

Giovanni Luigi De Maria

Affiliations

Soon will be listed here.

Abstract

Intracoronary continuous thermodilution has been recently proposed as an invasive method to quantify absolute coronary flow (Q) and resistance (R) in vivo. The aim of the present study is to develop and validate of a novel pressure-wire- and microcatheter-free surrogate of coronary flow and resistance derived from a standard coronary angiogram. Angiography derived coronary flow (Q) and resistance (R was prospectively validated in a two-center cohort of patients from Oxford Heart Centre and the Essex Cardiothoracic Centre. Q and R were measured during resting and hyperemic conditions with continuous thermodilution using the Rayflow microcatheter. Q and R were computed from the diagnostic coronary angiogram in a blinded fashion in resting and hyperemic conditions. A total of 62 patients and 115 vessels were included in the present analysis. The median Q at rest was 75 ml/min (53-95) and 151 ml/min (105-203) during hyperemia; Q at rest was 84 ml/min (66-108) and 154 ml/min (115-195) during hyperemia. There was a strong correlation between Q and Q (R = 0,72; p < 0.001, R = 0,86; p < 0.001 respectively) with satisfactory interclass correlation (0.841, 95% CI 0.509-0.957; p = 0.0003). The median R was 1111 mmHg/(L/min) (830-1581.4) at rest and 454 mmHg/(L/min) (348-610) during hyperemia; angiographic resistance (R) was 937.4 mmHg/(L/min) (695.4-1261.9) at rest and 492.4 mmHg/(L/min) (406-697) during hyperemia. There was a strong correlation between R and R in both conditions (R = 0,81; p < 0.001 and R = 0,78; p < 0.001 respectively). The was a good correlation between absolute coronary flow reserve (CFR) and angiography-derived CFR (R = 0,61; p < 0.001) and between absolute microvascular resistance reserve (MRR) and angiography-derived MRR (R = 0,49; p < 0.001).

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