Author + information
- Received August 28, 2001
- Revision received February 13, 2002
- Accepted February 26, 2002
- Published online May 15, 2002.
- Koen M.J Marques, MD*,* (, )
- Hugo J Spruijt, MSEE*,
- Christa Boer, PhD†,
- Nico Westerhof, PhD†,
- Cees A Visser, MD, PhD, FACC* and
- Frans C Visser, MD, PhD*
- ↵*Reprint requests and correspondence:
Dr. Koen Marques, VU University Medical Center, Department of Cardiology, De Boelelaan 1117, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
Objectives We assessed the feasibility and reproducibility of the instantaneous diastolic coronary flow velocity-pressure gradient relation to characterize different degrees of coronary stenoses.
Background Assessment of the hemodynamic significance of coronary stenoses can be difficult. Using sensor-tipped guidewires, various physiologic indexes can be determined in the catheterization laboratory. Each of the current methods, however, has limitations.
Methods After positioning a Doppler flow wire and a pressure wire distal of a coronary stenosis, the flow velocity signals and the proximal and distal pressure were sampled simultaneously, at baseline and after intracoronary administration of adenosine. The instantaneous diastolic flow velocity and pressure gradient of single cardiac cycles at baseline, at maximal and intermediate hyperemia were plotted. Data were fitted with a regression line using the equation: ΔP= 0 +kv+Sv2. Measurements were performed in 11 normal coronary arteries, 20 intermediate stenoses and in 7 severe stenoses before and after percutaneous transluminal coronary angioplasty plus stenting.
Results We found significant differences between normal coronary arteries, intermediate and severe stenoses. Percutaneous transluminal coronary angioplasty nearly normalized the highly abnormal flow-pressure gradient relation in the severe stenoses. A high degree of reproducibility was observed. In 3% of the measurements, analysis was not possible due to the occurrence of pressure drift or bad flow velocity signals.
Conclusions It is feasible to assess the diastolic flow velocity-pressure gradient relation over a wide range of stenoses. It characterizes the hemodynamics of epicardial coronary stenoses and allows discrimination between normal coronary arteries, intermediate and severe stenoses.
- Received August 28, 2001.
- Revision received February 13, 2002.
- Accepted February 26, 2002.
- American College of Cardiology Foundation