Continuous vs Bolus Thermodilution to Assess Microvascular Resistance Reserve
Authors' conclusion
Compared with bolus thermodilution, continuous thermodilution yields lower values of CFR and MRR accompanied by an almost 3-fold reduction of the variability in the measured results.
Study context
- Population
- Patients with chest pain and nonobstructive CAD; measurements in the left anterior descending coronary artery102 with duplicate measurements
- Participants
- 175 patients
- Comparison
- Continuous vs bolus thermodilution for coronary flow reserve (CFR) and microvascular resistance reserve (MRR)
- Primary endpoint
- Agreement of CFR and MRR derived by continuous vs bolus thermodilution
Methodological detailstest-retest reliability substudy
- Test-retest reliability substudy
Primary result
As reported in the abstract
Mean difference
0.80
P < 0.001
CFR; limits of agreement −2.32 to 3.92
Mean difference
1.2
P < 0.001
MRR; limits of agreement −2.71 to 5.08
Bolus
- CFRbolus (mean ± SD)
- 3.47 ± 1.42
- MRRbolus (mean ± SD)
- 4.40 ± 1.99
- CFRbolus repeatability coefficient
- 2.79
- MRRbolus repeatability coefficient
- 3.05
Bolus
CFRbolus (mean ± SD)3.47 ± 1.42
MRRbolus (mean ± SD)4.40 ± 1.99
CFRbolus repeatability coefficient2.79
MRRbolus repeatability coefficient3.05
- Correlation between methods, CFR (significant but weak)
- r = 0.28 [95% CI: 0.14-0.41]; P < 0.001
- Correlation between methods, MRR (significant but weak)
- r = 0.26 [95% CI: 0.16-0.39]; P < 0.001
Further findings
| Outcome | Continuous | Bolus |
|---|---|---|
| Test-retest repeatability coefficient | ||
| CFR | 0.89 | 2.79 |
| MRR | 1.01 | 3.05 |
- Test-retest repeatability coefficient: n = 102 with duplicate measurements
Correlation between methods
- CFR, r
- 0.28 (95% CI: 0.14-0.41)
- MRR, r
- 0.26 (95% CI: 0.16-0.39)
- Significant but weak correlation
- P < 0.001 for both
Test-retest repeatability coefficient
- Higher precision with continuous thermodilution
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Continuous vs Bolus Thermodilution to Assess Microvascular Resistance Reserve. JACC Cardiovasc Interv. Published 27 November 2023. doi:10.
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