Repeatability and Correlation of Coronary Physiology Indices Measured With Bolus and Continuous Thermodilution.

IF 7.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Circulation: Cardiovascular Interventions Pub Date : 2025-04-01 Epub Date: 2025-04-15 DOI:10.1161/CIRCINTERVENTIONS.124.014919

Christopher C Y Wong, Luke P Dawson, Pascal Theriault-Lauzier, Annette Skoda, Helen Luikart, Jennifer A Tremmel, Kiran K Khush, William F Fearon

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引用次数: 0

Abstract

Background: Previous studies have shown weak agreement between coronary physiology indices derived from continuous and bolus thermodilution, and suggested greater variability with bolus thermodilution measurements. This study aimed to evaluate the repeatability and correlation of continuous and bolus thermodilution-derived physiology indices in cardiac transplant recipients.

Methods: Paired fractional flow reserve (FFR), coronary flow reserve (CFR), index of microcirculatory resistance (IMR), absolute hyperemic resistance (R_Hyp), and microvascular resistance reserve (MRR) using continuous and bolus thermodilution were performed in consecutive cardiac transplant recipients.

Results: In 20 patients, IMR was more repeatable than CFR and MRR derived from either continuous thermodilution (intraclass correlation coefficient, 0.95 versus 0.70 and 0.59; P=0.004 and P=0.002, respectively) or bolus thermodilution (intraclass correlation coefficient, 0.95 versus 0.20 and 0.33; P<0.001 and P=0.002, respectively), and similarly repeatable compared with R_Hyp (intraclass correlation coefficient, 0.95 versus 0.87; P=0.188). FFR by continuous thermodilution correlated with standard FFR measurements (R=0.89, P<0.001) but were significantly lower in value (0.87±0.05 versus 0.89±0.05; P=0.004). CFR and MRR measurements using continuous thermodilution did not correlate with measurements using bolus thermodilution (R=0.33, P=0.170; R=0.34, P=0.155, respectively) and were significantly lower in value (2.9±1.0 versus 3.7±0.8, P=0.003; 3.4±1.1 versus 4.8±1.3, P<0.001, respectively). IMR and R_Hyp did not correlate (R=0.28, P=0.226).

Conclusions: In cardiac transplant recipients, IMR had superior repeatability compared with CFR and MRR derived from either bolus or continuous thermodilution, and was equally repeatable compared with R_Hyp. FFR, CFR, and MRR values obtained from continuous thermodilution were systematically lower compared with their counterparts obtained from bolus thermodilution.

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冠脉生理指标的重复性及相关性研究。

背景：先前的研究表明，连续热稀释和大剂量热稀释得出的冠状动脉生理指标之间的一致性较弱，并且表明大剂量热稀释测量结果具有更大的可变性。本研究旨在评价心脏移植受者连续和大剂量热调节生理指标的可重复性和相关性。方法：连续和大剂量热稀释对连续心脏移植受者进行血流储备（FFR）、冠状动脉血流储备（CFR）、微循环阻力指数（IMR）、绝对充血阻力（RHyp）和微血管阻力储备（MRR）的配对测定。结果：在20例患者中，IMR的可重复性优于连续热稀释法得出的CFR和MRR(组内相关系数分别为0.95、0.70和0.59；P=0.004和P=0.002)或大剂量热调节(类内相关系数分别为0.95、0.20和0.33；PP=0.002)，与RHyp相比重复性相似(类内相关系数0.95比0.87；P = 0.188)。连续热变FFR与标准FFR测量值相关（R=0.89， PP=0.004）。使用连续热稀释的CFR和MRR测量值与使用大量热稀释的测量值不相关(R=0.33， P=0.170；R=0.34， P=0.155)，且值显著低于(2.9±1.0 vs 3.7±0.8，P=0.003；3.4±1.1比4.8±1.3，PHyp无相关性（R=0.28， P=0.226）。结论：在心脏移植受者中，IMR与CFR和MRR相比具有更高的可重复性，与RHyp相比具有同样的可重复性。连续热化得到的FFR、CFR和MRR值与单次热化得到的值相比有系统地降低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Circulation: Cardiovascular Interventions CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

10.30

自引率

1.80%

发文量

221

审稿时长

6-12 weeks

期刊介绍： Circulation: Cardiovascular Interventions, an American Heart Association journal, focuses on interventional techniques pertaining to coronary artery disease, structural heart disease, and vascular disease, with priority placed on original research and on randomized trials and large registry studies. In addition, pharmacological, diagnostic, and pathophysiological aspects of interventional cardiology are given special attention in this online-only journal.