O042 Coronary sinus filling and emptying time: a new parameter to assess coronary microcirculation by a simple angiographic frame count

Abstract

Introduction: Functional assessment of coronary microcirculation has been difficult for various reasons. Nuclear imaging, PET scan have been used to assess the viability of microcirculation and myocyte perfusion . Digital frame counting of coronary angiograms (CAG) has been used to measure the transit time of dye across the coronary artery . Myocardial blush scores is an subjective method to assess myocardial perfusion based on visual acuity .There is no simple method available to assess the integrity of the coronary microcirculation. The transit time between the coronary artery to the coronary sinus(CS) would indicate the microcirculatory time. Video images obtained during routine CAG provides us an opportunity to measure this time Objectives: We hypothized , coronary sinus filling time(CFT) , coronary sinus emptying time(CET), Coronary sinus emptying velocity(CEV) will give a simple index of micro circulatory state. Methods: Patients who were undergoing routine CAG in our cath lab were the subjects of the study . Twenty normal angiograms with well delineated CS were analysed. ( Ten without CAD and ten with positive stress test). CAG was done and assessed with Philips digital Integris workstation. CAG was performed with 12.5 frames/sec. Coronary sinus filling time(CFT) was estimated by the difference between the frames of maximum LAD system opacification to maximal opacificaton of CS . Coronary sinus emptying time (CET)was the difference in frame count between maximal visualization of CS to complete emptying of CS. The Coronary sinus emptying velocity (CEV) was calculated by estimating the time taken for the dye to traverse two reference points across CS. The normal values were defined. Results: