Validation study of a Doppler-tipped angiographic catheter for measurement of coronary flow reserve

Abstract

There has been increasing interest in the use of coronary flow reserve measurements to define pathophysiology in various patient groups and to make individual patient management decisions. The concept of coronary flow reserve has provided a method for describing the capacity to conduct maximal hyperemic blood flow. Coronary flow reserve is the ratio of maximal to resting coronary blood flow. The study of coronary circulation in humans has been made possible through the development of several methods. 1–6Currently, the most extensively used and validated method is the transluminal, subselective measurement of coronary blood flow velocity and vasodilator reserve. 1 The use of intracoronary Doppler catheters permits rapid and accurate measurements of coronary vasodilator responses to various pharmacologic and physiologic stimuli. 7,9 However, the major limitation of this technique is instrumentation of the coronary artery with an angioplasty guide wire and the Doppler catheter, which requires considerable operator experience and also has the possibility of potential serious vascular complications such as dissection, vasospasm and thrombosis. Systemic heparinization is also required. Recently a new Judkins-style Doppler-tipped angiographic catheter has been developed to facilitate a more rapid and safe measurement of coronary flow reserve. 6 We assessed whether the coronary flow reserve measurements obtained with these catheters are comparable to those achieved with the intracoronary Doppler catheter technique.