An alternative to radioactive microspheres for measuring regional myocardial blood flow, part 2: Laser-doppler perfusion monitor

Abstract

To compare measurements of regional myocardial blood flow volume between microsphere measurement of regional flow (0.5- to 2- g tissue sampling) and a potential alternative measure, local flow (1 mm3) in the microcirculation measured by laser-Doppler perfusion monitor. Prospective, randomized, controlled. University research laboratory. Pigs. After anesthetization, in 5 pigs (25 to 30 kg), the left anterior descending coronary artery was isolated and its resting flow measured by a perivascular-Doppler flowmeter. Left ventricular pressure and first time derivative of left ventricular pressure were measured. The laser-Doppler probe needle (type N) (Model ALF-21, Transonic Systems, Inc, Ithaca, NY) was inserted 2 to 3 mm into the wall of the left ventricle, parallel to the coronary artery. All 5 pigs were subjected to 0 (control), 50% , 75%, and 100% constriction of the left anterior coronary artery. Measurements by radio-active microspheres correlated poorly with those by laser-Doppler and extremely poorly with those by perivascular Doppler flowmeter. For percent change from baseline in the constricted arterial zone, radioactive measurements correlated well with those by laser-Doppler but not those by Doppler flowmeter. Also, radioactive measurements of percent change in flow in the circumflex (nonconstricted) zone and laser-Doppler measurements in the constricted arterial zone did not correlate well. Laser-Doppler can be recommended for experimental research to monitor local flow. These measurements may relate to change in regional flow during normal perfusion and hypoperfusion. Before the laser-Doppler perfusion monitor can be used clinically, tissue trauma from the 0.55-mm needle needs to be evaluated.