title: Myocardial resistance assessed by guidewire-based pressure-temperature measurement: in vitro validation.
abstract: By injecting a few cubic centimeters of saline into the coronary artery and using thermodilution principles, mean transit time (T(mn)) of the injectate can be calculated and is inversely proportional to coronary blood flow. Because microvascular resistance equals distal coronary pressure (P(d)) divided by myocardial flow, the product P(d). T(mn) provides an index of myocardial resistance (IMR). In this in vitro study in a physiologic model of the coronary circulation, we compared IMR to true myocardial resistance (TMR) at different degrees of myocardial resistance and at different degrees of epicardial stenosis. Absolute blood flow was varied from 42 to 203 ml/min and TMR varied from 0.39 to 1.63 dynes. sec/cm(5). Inverse mean transit time correlated well to absolute blood flow (R(2) = 0.93). Furthermore, an excellent correlation was found between IMR and TMR (R(2) = 0.94). IMR was independent on the severity of epicardial stenosis and thus specific for myocardial resistance. Thus, using one single guidewire, both fractional flow reserve and IMR can be measured simultaneously as indexes of epicardial and microvascular disease, respectively, enabling separate assessment of both coronary arterial and microvascular disease.
authors.affiliation: Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands.
authors.forename: Wilbert
authors.initials: W
authors.lastname: Aarnoudse
authors.forename: Petra
authors.initials: P
authors.lastname: van den Berg
authors.forename: Frans
authors.initials: F
authors.lastname: van de Vosse
authors.forename: Maartje
authors.initials: M
authors.lastname: Geven
authors.forename: Marcel
authors.initials: M
authors.lastname: Rutten
authors.forename: Mark
authors.initials: M
authors.lastname: Van Turnhout
authors.forename: William
authors.initials: W
authors.lastname: Fearon
authors.forename: Bernard
authors.initials: B
authors.lastname: de Bruyne
authors.forename: Nico
authors.initials: N
authors.lastname: Pijls
mesh_terms: D001831:Body Temperature / Q000502:physiology*; D003326:Coronary Circulation / Q000502:physiology; D023921:Coronary Stenosis / Q000503:physiopathology; D006801:Humans; D008955:Models, Cardiovascular; D009206:Myocardium / Q000737:chemistry*; D010496:Pericardium / Q000503:physiopathology; D012720:Severity of Illness Index; D013223:Statistics as Topic; D014655:Vascular Resistance / Q000502:physiology*; D017725:Ventricular Pressure / Q000502:physiology*