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European Heart Journal 2004 25(3):219-223; doi:10.1016/j.ehj.2003.11.009
Copyright © 2004 by the European Society of Cardiology.
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Clinical research

Validation of coronary flow reserve measurements by thermodilution in clinical practice

Emanuele Barbatoa, Wilbert Aarnoudseb, Wim R. Aengevaerenc, Gerald Wernerd, Volker Klausse, Waldemar Bojaraf, Istvan Herzfeldg, Keith G. Oldroydh, Nico H.J. Pijlsb and Bernard De Bruynea,* for the ‘week 25 study’ group

a Cardiovascular Center, OLV Ziekenhuis, Aalst, Belgium
b Catharina Ziekenhuis, Eindhoven, The Netherlands
c University Medical Center, Nijmegen, The Netherlands
d Klinik fur Innere Medizin III, Friedrich-Schiller-Universitat, Jena, Germany
e Departement of Cardiology, Medizinische Klinik Innenstadt, University of Munich, Munich, Germany
f Departement of Cardiology and Angiology, Bergmannsheil Bochum University Hospital, Bochum, Germany
g Department of Cardiology, Söder Hospital, Stockholm, Sweden
h Department of Cardiology, Western Infirmary, Glasgow, UK

* Correspondence to: Bernard De Bruyne, MD, PhD, Cardiovascular Center OLV Ziekenhuis, Moorselbaan 164, B-9300 Aalst (BE), Belgium. Tel: +32 53 72 44 47; Fax: +32 53 72 45 50
E-mail address: bernard.de.bruyne{at}olvz-aalst.be

Received 24 July 2003; revised 31 October 2003; accepted 6 November 2003

Abstract

Background Coronary flow reserve (CFR) and fractional flow reserve (FFR) provide complementary information on the coronary circulation. Using a pressure wire, it is possible to calculate CFR by thermodilution (CFRthermo), so that FFR and CFR can be measured with a single guide wire. The present multicentric study was performed to compare the feasibility of CFRthermoobtained with an improved algorithm and a standardized injection technique and its agreement with Doppler-derived CFR (CFRDoppler).

Methods and results In 86 patients with coronary artery disease recruited during 1 week in eight centres FFR, CFRthermoand CFRDopplerwere measured. FFR could be obtained in all patients (100%). An optimal CFRDopplercould be obtained in 69% of the patients. CFRthermocould be obtained in 97% of the patients. A significant correlation was found between CFRDopplerand CFRthermo(r=0.79, P<0.0001) but CFRthermotended to be higher than CFRDoppler.

Conclusions In a setting close to ‘real world’ practice, this multicentric study confirms the feasibility and reliability of thermodilution-derived CFR. In addition, the safety and the swiftness of assessing FFR and CFR with one single guide wire makes the latter a unique clinical tool for the evaluation of the coronary circulation.

Key Words: Coronary flow reserve • Coronary artery disease • Fractional flow reserve • Ischaemia • Thermodilution


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