Quantification of coronary microvascular resistance using angiographic images for volumetric blood flow measurement: in vivo validation.
Quantification of coronary microvascular resistance using angiographic images for volumetric blood flow measurement: in vivo validation.
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DOI：
10.1152/ajpheart.01123.2010
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发表时间：
2011-06
期刊：
影响因子：
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通讯作者：
Zhang Zhang-Zhang;Shigeho Takarada;S. Molloi
中科院分区：
文献类型：
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作者：
Zhang Zhang-Zhang;Shigeho Takarada;S. Molloi
结构性冠状动脉微循环异常是临床上重要的预后决定因素。然而，微血管阻力（MR）的评估需要速度导丝。测量血流量的首过分布分析技术先前已得到验证。本研究的目的是使用首过分布分析对MR测量技术进行体内验证。在12只麻醉猪的冠状动脉左前降支（LAD）近段上安装了一个渡越时间超声流量探头。将微球注射到LAD中以创建微血管功能障碍的模型。用腺苷（400 μg·kg（-1）·min（-1））造成最大充血。在LAD动脉床中绘制感兴趣区域，以使用血管造影图像生成时间-密度曲线。使用时间-密度曲线并假设在注射期间血液被造影剂暂时替代，进行体积血流测量（Q（a））。连续记录来自流量探头的血流量（Q（p））、冠状动脉压（P（a））和右心房压（P（v））。分别使用Q（p）和Q（a）计算基于流量探头的归一化MR（NMR（p））和基于血管造影的归一化MR（NMR（a））。在258次测量中，Q（a）与金标准Q（p）呈强相关（Q（a）= 0.90 Q（p）+6.6ml/min，r（2）= 0.91，P < 0.0001）。NMR（a）与NMR（p）呈线性相关（NMR（a）= 0.90 NMR（p）+ 0.02 mmHg·ml（-1）·min（-1），r（2）= 0.91，P < 0.0001）。此外，Bland-Altman分析显示NMR（a）和NMR（p）之间的密切一致性。总之，使用猪模型验证了基于血管造影图像数据的NMR量化技术。这项研究提供了一种方法来测量核磁共振，而不使用速度线，这可能是用于评估冠状动脉造影过程中的微血管条件。
Structural coronary microcirculation abnormalities are important prognostic determinants in clinical settings. However, an assessment of microvascular resistance (MR) requires a velocity wire. A first-pass distribution analysis technique to measure volumetric blood flow has been previously validated. The aim of this study was the in vivo validation of the MR measurement technique using first-pass distribution analysis. Twelve anesthetized swine were instrumented with a transit-time ultrasound flow probe on the proximal segment of the left anterior descending coronary artery (LAD). Microspheres were injected into the LAD to create a model of microvascular dysfunction. Adenosine (400 μg·kg(-1)·min(-1)) was used to produce maximum hyperemia. A region of interest in the LAD arterial bed was drawn to generate time-density curves using angiographic images. Volumetric blood flow measurements (Q(a)) were made using a time-density curve and the assumption that blood was momentarily replaced with contrast agent during the injection. Blood flow from the flow probe (Q(p)), coronary pressure (P(a)), and right atrium pressure (P(v)) were continuously recorded. Flow probe-based normalized MR (NMR(p)) and angiography-based normalized MR (NMR(a)) were calculated using Q(p) and Q(a), respectively. In 258 measurements, Q(a) showed a strong correlation with the gold standard Q(p) (Q(a) = 0.90 Q(p) + 6.6 ml/min, r(2) = 0.91, P < 0.0001). NMR(a) correlated linearly with NMR(p) (NMR(a) = 0.90 NMR(p) + 0.02 mmHg·ml(-1)·min(-1), r(2) = 0.91, P < 0.0001). Additionally, the Bland-Altman analysis showed a close agreement between NMR(a) and NMR(p). In conclusion, a technique based on angiographic image data for quantifying NMR was validated using a swine model. This study provides a method to measure NMR without using a velocity wire, which can potentially be used to evaluate microvascular conditions during coronary arteriography.