A combination of thermal methods to assess coronary pressure and flow dynamics with a pressure-sensing guide wire

• Published in: Medical engineering & physics 2013-03, Vol.35 (3), p.298-309
• Main Authors: van der Horst, Arjen, van’t Veer, Marcel, van der Sligte, Robin A.M, Rutten, Marcel C.M, Pijls, Nico H.J, van de Vosse, Frans N
• Format: Article
• Language: English
• Subjects: Blood Pressure; Calibration; Cardiology - instrumentation; Coronary Circulation - physiology; Coronary circulatory disease; Coronary Disease - physiopathology; Diastole; Equipment Design; Flow dynamics; Hemodynamics; Hot Temperature; Humans; Pressure wire; Radiology; Reproducibility of Results; Stress, Mechanical; Temperature; Thermal anemometry; Thermodilution; Thermodilution - methods
• ISSN: 1350-4533; 1873-4030
• DOI: 10.1016/j.medengphy.2012.05.002

Abstract Measurement of coronary pressure and absolute flow dynamics have shown great potential in discerning different types of coronary circulatory disease. In the present study, the feasibility of assessing pressure and flow dynamics with a combination of two thermal methods, developed in combination with a pressure-sensor-tipped guide wire, was evaluated in an in vitro coronary model. A continuous infusion thermodilution method was employed to determine the average flow, whereas a thermal anemometric method was utilized to assess the pressure and flow dynamics, simultaneously. In the latter method, the electrical power supplied to an element, kept at constant temperature above ambient temperature, was used as a measure for the shear rate. It was found that, using a single calibration function, the method was able to assess coronary pressure and flow dynamics for different flow amplitudes, heart rates, and different pressure wires. However, due to the fact that the thermal anemometric method cannot detect local shear rate reversal, the method was unable to reliably measure flow dynamics close to zero. Nevertheless, the combined methodology was able to reliably assess diastolic hemodynamics. The diastolic peak flow and average diastolic resistance could be determined with a small relative error of (8 ± 7)% and (7 ± 5)%, respectively.