Functional Evaluation of Coronary Stenosis: is Quantitative Flow Ratio a Step Forward?

Aşkın, Lütfü; Tanrıverdi, Okan; Gül, Enes Elvin

doi:10.33678/cor.2022.032

Cited by 1 publication

(1 citation statement)

References 37 publications

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“…In contemporary practice, several methodologies for the invasive evaluation of CMD exist [4], namely, Doppler [5,6], Bolus Thermodilution [7,8], Continuous Thermodilution [9,10], and angiogram-derived [11][12][13]. The various benefits, pitfalls, and differences between them have been the subject matter of several notable publications [14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Assessing the Impact of Prolonged Averaging of Coronary Continuous Thermodilution Traces

Fawaz,

Munhoz,

Mahendiran

et al. 2024

Diagnostics

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Continuous Thermodilution is a novel method of quantifying coronary flow (Q) in mL/min. To account for variability of Q within the cardiac cycle, the trace is smoothened with a 2 s moving average filter. This can sometimes be ineffective due to significant heart rate variability, ventricular extrasystoles, and deep inspiration, resulting in a fluctuating temperature trace and ambiguity in the location of the “steady state”. This study aims to assess whether a longer moving average filter would smoothen any fluctuations within the continuous thermodilution traces resulting in improved interpretability and reproducibility on a test–retest basis. Patients with ANOCA underwent repeat continuous thermodilution measurements. Analysis of traces were performed at averages of 10, 15, and 20 s to determine the maximum acceptable average. The maximum acceptable average was subsequently applied as a moving average filter and the traces were re-analysed to assess the practical consequences of a longer moving average. Reproducibility was then assessed and compared to a 2 s moving average. Of the averages tested, only 10 s met the criteria for acceptance. When the data was reanalysed with a 10 s moving average filter, there was no significant improvement in reproducibility, however, it resulted in a 12% diagnostic mismatch. Applying a longer moving average filter to continuous thermodilution data does not improve reproducibility. Furthermore, it results in a loss of fidelity on the traces, and a 12% diagnostic mismatch. Overall, current practice should be maintained.

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