Measurement of coronary blood flow using X-ray angiography

Abstract

Abstract Objectives Blood flow measurement can be performed during percutaneous coronary intervention by angiographic analysis but can be susceptible to motion artefacts in long time-frame. Thus, the aim of this study is to develop a short time-frame algorithm to be applied in clinical practice for measuring coronary blood flow without being affected by breathing artefacts. Additionally, to assess its accuracy and precision in comparison to reference measurements of thermodilution and Davies’ current method that has long time-frame analysis. Methods An algorithm was created that depends on selecting single heartbeat in diastole with narrow region-of-interest by using MATLAB-software. This was tested on 17-patients whose divided into three categories; with, without and with minimal breathing. Results There was high correlation between single heartbeat algorithm and both reference measurements in patient with minimal breathing and poor correlation in patients with breathing. In minimally breathing patients, there was high correlation with thermodilution but no correlation with Davies. Thermodilution values were higher than 2 the single heartbeat algorithm (mean-difference 19.24%) but Davies had lower values (mean-difference -18.08%). Intra-observer variability for Davies and single heartbeat methods were similarly low while inter-observer variability was higher with 12.99% and 21.63% for Davies’ and single heartbeat algorithm respectively. Conclusion Single heartbeat algorithm produced comparable flow values to both reference measurements. Although both X-ray based algorithms can be applied on non or minimally breathing patients, one heartbeat algorithm was more time consuming and cannot resolve breathing artefacts issue. Additionally, thermodilution flow values were generally higher than both X-ray based analysis.