Document Detail


Delineating the guide-wire flow obstruction effect in assessment of fractional flow reserve and coronary flow reserve measurements.
MedLine Citation:
PMID:  15734887     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hemodynamic analysis was conducted to determine uncertainty in clinical measurements of coronary flow reserve (CFR) and fractional flow reserve (FFR) over pathophysiological conditions in a patient group with coronary artery disease during angioplasty. The vasodilation-distal perfusion pressure (CFR-p(rh)) curve was obtained for 0.35- and 0.46-mm guide wires. Our hypothesis is that a guide wire spanning the lesions elevates the pressure gradient and reduces the flow during hyperemic measurements. Maximal CFR-p(rh) was uniquely determined by the intersection of measured CFR and calculated p(rh) of native and residual epicardial lesions in patients without microvascular disease, during angioplasty. Extrapolation of the linear curve gave a zero-coronary flow mean pressure (p(zf)) of approximately 20 mmHg and a corresponding p(rh) of 55 mmHg in the native lesions, which coincided with the level that causes ischemia in human hearts. On this linear curve, values of CFR and FFRmyo (pathophysiological condition) and CFRg and FFRmyog (in the presence of the guide wire) were obtained in native and residual lesions. A strong linear correlation was found between CFR and CFRg [CFR = CFRg x 0.689 + 1.271 (R2= 0.99) for 0.46 mm and CFR = CFRg x 0.757 + 1.004 (R2= 0.99) for 0.35 mm] and between FFRmyo and FFRmyog [FFRmyo = FFRmyog x 0.737 + 0.263 (R2= 0.99) for 0.46 mm and FFRmyo = FFRmyog x 0.790 + 0.210 (R2= 0.99) for 0.35 mm]. This study establishes a strong correlation between CFR and CFRg and between FFRmyo and FFRmyog, which could be used to obtain the true state of occlusion in the coronary artery during angioplasty.
Authors:
Abhijit Sinha Roy; Rupak K Banerjee; Lloyd H Back; Martin R Back; Saeb Khoury; Ronald W Millard
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-02-25
Journal Detail:
Title:  American journal of physiology. Heart and circulatory physiology     Volume:  289     ISSN:  0363-6135     ISO Abbreviation:  Am. J. Physiol. Heart Circ. Physiol.     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-06-17     Completed Date:  2005-08-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  H392-7     Citation Subset:  IM    
Affiliation:
Dept. of Mechanical Engineering, 688 Rhodes Hall, PO Box 210072, Cincinnati, OH 45221-0072, USA.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary / instrumentation*
Artifacts*
Blood Pressure
Blood Volume
Case-Control Studies
Coronary Circulation*
Coronary Stenosis / diagnosis*,  physiopathology,  therapy*
Hemodynamics
Humans
Linear Models
Models, Cardiovascular
Vasodilation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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