Original Research

DOI: 10.4244/EIJ-D-24-00215

Simplification of continuous intracoronary thermodilution

Thabo Mahendiran1,2, BMBCh, MD; Samer Fawaz3, BMBS; Michele Viscusi1, MD; Danielle Keulards4, MD, PhD; Caïa Crooijmans5, MD; Tijn P.J. Jansen5, MD; Henk Everaars6, MD; Emanuele Gallinoro1, MD, PhD; Alessandro Candreva7, MD; Frederic Bouisset1, MD; Takuya Mizukami1, MD, PhD; Dario Bertolone1, MD; Marta Belmonte1, MD; Ruiko Seki1, MD; Johan Svanerud8; Jeroen Sonck1, MD, PhD; Adriaan Wilgenhof1,9, MD; Thomas R. Keeble3, MD; Peter Damman5, MD, PhD; Paul Knaapen6, MD, PhD; Carlos Collet1, MD, PhD; Nico H.J. Pijls4, MD, PhD; Bernard De Bruyne1,2, MD, PhD

Abstract

BACKGROUND: Continuous intracoronary thermodilution with saline allows for the accurate measurement of volumetric blood flow (Q) and absolute microvascular resistance (Rμ). However, this requires repositioning of the temperature sensor by the operator to measure the entry temperature of the saline infusate, denoted as Ti.

AIMS: We evaluated whether Ti could be predicted based on known parameters without compromising the accuracy of calculated Q. This would significantly simplify the technique and render it completely operator independent.

METHODS: In a derivation cohort of 371 patients with Q measured both at rest and during hyperaemia, multivariate linear regression was used to derive an equation for the prediction of Ti. Agreement between standard Q (calculated with measured Ti) and simplified Q (calculated with predicted Ti) was assessed in a validation cohort of 120 patients that underwent repeat Q measurements. The accuracy of simplified Q was assessed in a second validation cohort of 23 patients with [15O]H2O positron emission tomography (PET)-derived Q measurements.

RESULTS: Simplified Q exhibited strong agreement with standard Q (r=0.94, confidence interval [CI]: 0.93-0.95; intraclass correlation coefficient [ICC] 0.94, CI: 0.92-0.95;...

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Volume 20 Number 19
Oct 7, 2024
Volume 20 Number 19
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