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Adjedj J, Picard F, Mogi S, Bize A, Sambin L, Muller O, Varenne O, De Bruyne B, Ghaleh B. Accurate assessment of coronary blood flow by continuous thermodilution technique: Validation in a swine model. Catheter Cardiovasc Interv 2021; 99:836-843. [PMID: 34080778 DOI: 10.1002/ccd.29802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/26/2021] [Accepted: 05/20/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To assess the accuracy of coronary thermodilution measurements made with the RayFlow® infusion catheter. BACKGROUND Measurements of absolute coronary blood flow (ABF) and absolute microvascular resistance (Rμ ) by continuous coronary thermodilution can be obtained in humans but their accuracy using a novel dedicated infusion catheter has not yet been validated. We compared ABF values obtained at different infusion rates to coronary blood flow (CBF) values obtained using flow probes, in swine. METHODS Twelve domestic swine were instrumented with coronary flow probes placed around the left anterior descending and circumflex coronary arteries. ABF was assessed with the RayFlow® infusion catheter during continuous saline infusion at fixed rates of 5 (n = 14), 10 (n = 15), 15 (n = 19), and 20 (n = 12) ml/min. RESULTS In the 60 measurements, ABF measured using thermodilution averaged 41 ± 17 ml/min (range from 17 to 90) and CBF values obtained with the coronary flow probes averaged 37 ± 18 ml/min (range from 8 to 87). The corresponding Rμ values were 1532 ± 791 (range from 323 to 5103) and 1903 ± 1162 (range from 287 to 6000) Woods units using thermodilution and coronary flow probe assessments, respectively. ABF and Rμ values measured using thermodilution were significantly correlated with the corresponding measurements obtained using coronary flow probes (R = 0.84 [0.73-0.95] and R = 0.80 [0.69-0.88], respectively). CONCLUSIONS ABF and Rμ assessed by continuous saline infusion through a RayFlow® catheter closely correlate with measurements obtained with the gold standard coronary flow probes in a swine model.
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Affiliation(s)
- Julien Adjedj
- Arnault Tzanck Institute, Department of Cardiology, Saint Laurent du Var, France.,Paris Descartes University, Faculty of Medicine, Paris, France.,Cardiology Department, Université Paris Est Créteil, INSERM, IMRB, Créteil, France.,Cardiology Department, École Nationale Vétérinaire d'Alfort, IMRB, Maisons-Alfort, France.,Lausanne University Hospital, Department of Cardiology, Lausanne, Switzerland
| | - Fabien Picard
- Arnault Tzanck Institute, Department of Cardiology, Saint Laurent du Var, France.,Paris Descartes University, Faculty of Medicine, Paris, France
| | - Satoshi Mogi
- Arnault Tzanck Institute, Department of Cardiology, Saint Laurent du Var, France.,Paris Descartes University, Faculty of Medicine, Paris, France
| | - Alain Bize
- Cardiology Department, Université Paris Est Créteil, INSERM, IMRB, Créteil, France.,Cardiology Department, École Nationale Vétérinaire d'Alfort, IMRB, Maisons-Alfort, France
| | - Lucien Sambin
- Cardiology Department, Université Paris Est Créteil, INSERM, IMRB, Créteil, France.,Cardiology Department, École Nationale Vétérinaire d'Alfort, IMRB, Maisons-Alfort, France
| | - Olivier Muller
- Lausanne University Hospital, Department of Cardiology, Lausanne, Switzerland
| | - Olivier Varenne
- Arnault Tzanck Institute, Department of Cardiology, Saint Laurent du Var, France.,Paris Descartes University, Faculty of Medicine, Paris, France
| | - Bernard De Bruyne
- Lausanne University Hospital, Department of Cardiology, Lausanne, Switzerland.,Cardiology Department, Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium
| | - Bijan Ghaleh
- Cardiology Department, Université Paris Est Créteil, INSERM, IMRB, Créteil, France.,Cardiology Department, École Nationale Vétérinaire d'Alfort, IMRB, Maisons-Alfort, France
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Adjedj J, Picard F, Collet C, Bruneval P, Fournier S, Bize A, Sambin L, Berdeaux A, Varenne O, De Bruyne B, Ghaleh B. Intracoronary Saline-Induced Hyperemia During Coronary Thermodilution Measurements of Absolute Coronary Blood Flow: An Animal Mechanistic Study. J Am Heart Assoc 2020; 9:e015793. [PMID: 32689859 PMCID: PMC7792254 DOI: 10.1161/jaha.120.015793] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background Absolute hyperemic coronary blood flow and microvascular resistances can be measured by continuous thermodilution with a dedicated infusion catheter. We aimed to determine the mechanisms of this hyperemic response in animal. Methods and Results Twenty open chest pigs were instrumented with flow probes on coronary arteries. The following possible mechanisms of saline‐induced hyperemia were explored compared with maximal hyperemia achieve with adenosine by testing: (1) various infusion rates; (2) various infusion content and temperature; (3) NO production inhibition with L‐arginine methyl ester and endothelial denudation; (4) effects of vibrations generated by rotational atherectomy and of infusion through one end‐hole versus side‐holes. Saline infusion rates of 5, 10 and 15 mL/min did not reach maximal hyperemia as compared with adenosine. Percentage of coronary blood flow expressed in percent of the coronary blood flow after adenosine were 48±17% at baseline, 57±18% at 5 mL/min, 65±17% at 10 mL/min, 82±26% at 15 mL/min and 107±18% at 20 mL/min. Maximal hyperemia was observed during infusion of both saline at body temperature and glucose 5%, after endothelial denudation, l‐arginine methyl ester administration, and after stent implantation. The activation of a Rota burr in the first millimeters of the epicardial artery also induced maximal hyperemia. Maximal hyperemia was achieved by infusion through lateral side‐holes but not through an end‐hole catheter. Conclusions Infusion of saline at 20 mL/min through a catheter with side holes in the first millimeters of the epicardial artery induces maximal hyperemia. The data indicate that this vasodilation is related neither to the composition/temperature of the indicator nor is it endothelial mediated. It is suggested that it could be elicited by epicardial wall vibrations.
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Affiliation(s)
- Julien Adjedj
- Department of Cardiology Institut Arnault Tzanck Saint Laurent du Var France.,Department of Cardiology Lausanne University Center Hospital Lausanne Switzerland.,U955-IMRB Equipe 03 Inserm UPEC Ecole Nationale Vétérinaire d'Alfort Maisons-Alfort France.,Université Paris Est UMR_S955 UPEC Ecole Nationale Vétérinaire d'Alfort Créteil France.,Faculté de Médecine Paris Descartes Université Paris Descartes Paris France
| | - Fabien Picard
- Faculté de Médecine Paris Descartes Université Paris Descartes Paris France.,AP-HP, Hôpital Cochin Paris France
| | - Carlos Collet
- Cardiovascular Center Aalst, OLV Clinic Aalst Belgium
| | - Patrick Bruneval
- UMR 970 Inserm Paris Cardiovascular Research Center Hôpital Européen Georges Pompidou Paris France
| | - Stephane Fournier
- Department of Cardiology Lausanne University Center Hospital Lausanne Switzerland.,Cardiovascular Center Aalst, OLV Clinic Aalst Belgium
| | - Alain Bize
- U955-IMRB Equipe 03 Inserm UPEC Ecole Nationale Vétérinaire d'Alfort Maisons-Alfort France.,Université Paris Est UMR_S955 UPEC Ecole Nationale Vétérinaire d'Alfort Créteil France
| | - Lucien Sambin
- U955-IMRB Equipe 03 Inserm UPEC Ecole Nationale Vétérinaire d'Alfort Maisons-Alfort France.,Université Paris Est UMR_S955 UPEC Ecole Nationale Vétérinaire d'Alfort Créteil France
| | - Alain Berdeaux
- U955-IMRB Equipe 03 Inserm UPEC Ecole Nationale Vétérinaire d'Alfort Maisons-Alfort France.,Université Paris Est UMR_S955 UPEC Ecole Nationale Vétérinaire d'Alfort Créteil France
| | - Olivier Varenne
- Faculté de Médecine Paris Descartes Université Paris Descartes Paris France.,AP-HP, Hôpital Cochin Paris France
| | - Bernard De Bruyne
- Department of Cardiology Lausanne University Center Hospital Lausanne Switzerland.,Cardiovascular Center Aalst, OLV Clinic Aalst Belgium
| | - Bijan Ghaleh
- U955-IMRB Equipe 03 Inserm UPEC Ecole Nationale Vétérinaire d'Alfort Maisons-Alfort France.,Université Paris Est UMR_S955 UPEC Ecole Nationale Vétérinaire d'Alfort Créteil France
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Chenoune M, Tissier R, Lidouren F, Couvreur N, Bize A, Ghaleh B, Berdeaux A. F010 L’hypothermie induite par ventilation liquide totale permet d’induire une cardioprotection persistante après une ischémie myocardique prolongée chez le lapin. Arch Cardiovasc Dis 2009. [DOI: 10.1016/s1875-2136(09)72263-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tissier R, Couvreur N, Ghaleh B, Bruneval P, Lidouren F, Morin D, Zini R, Bize A, Chenoune M, Belair MF, Mandet C, Douheret M, Dubois-Rande JL, Parker JC, Cohen MV, Downey JM, Berdeaux A. Rapid cooling preserves the ischaemic myocardium against mitochondrial damage and left ventricular dysfunction. Cardiovasc Res 2009; 83:345-53. [PMID: 19196828 DOI: 10.1093/cvr/cvp046] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS We investigated whether rapid cooling instituted by total liquid ventilation (TLV) improves cardiac and mitochondrial function in rabbits submitted to ischaemia-reperfusion. METHODS AND RESULTS Rabbits were chronically instrumented with a coronary artery occluder and myocardial ultrasonic crystals for assessment of segment length-shortening. Two weeks later they were re-anaesthetized and underwent either a normothermic 30-min coronary artery occlusion (CAO) (Control group, n = 7) or a comparable CAO with cooling initiated by a 10-min hypothermic TLV and maintained by a cold blanket placed on the skin. Cooling was initiated after 5 or 15 min of CAO (Hypo-TLV and Hypo-TLV(15') groups, n = 6 and 5, respectively). A last group underwent normothermic TLV during CAO (Normo-TLV group, n = 6). Wall motion was measured in the conscious state over three days of reperfusion before infarct size evaluation and histology. Additional experiments were done for myocardial sampling in anaesthetized rabbits for mitochondrial studies. The Hypo-TLV procedure induced a rapid decrease in myocardial temperature to 32-34 degrees C. Throughout reperfusion, segment length-shortening was significantly increased in Hypo-TLV and Hypo-TLV(15') vs. Control and Normo-TLV (15.1 +/- 3.3%, 16.4 +/- 2.3%, 1.8 +/- 0.6%, and 1.1 +/- 0.8% at 72 h, respectively). Infarct sizes were also considerably attenuated in Hypo-TLV and Hypo-TLV(15') vs. Control and Normo-TLV (4 +/- 1%, 11 +/- 5%, 39 +/- 2%, and 42 +/- 5% infarction of risk zones, respectively). Mitochondrial function in myocardial samples obtained at the end of ischaemia or after 10 min of reperfusion was improved by Hypo-TLV with respect to ADP-stimulated respiration and calcium-induced opening of mitochondrial permeability transition pores (mPTP). Calcium concentration opening mPTP was, e.g., increased at the end of ischaemia in the risk zone in Hypo-TLV vs. Control (157 +/- 12 vs. 86 +/- 12 microM). Histology and electron microscopy also revealed better preservation of lungs and of cardiomyocyte ultrastructure in Hypo-TLV when compared with Control. CONCLUSION Institution of rapid cooling by TLV during ischaemia reduces infarct size as well as other sequelae of ischaemia, such as post-ischaemic contractile and mitochondrial dysfunction.
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Couvreur N, Lucats L, Tissier R, Bize A, Berdeaux A, Ghaleh B. Differential effects of postconditioning on myocardial stunning and infarction: a study in conscious dogs and anesthetized rabbits. Am J Physiol Heart Circ Physiol 2006; 291:H1345-50. [PMID: 16565317 DOI: 10.1152/ajpheart.00124.2006] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Postconditioning, i.e., brief intermittent episodes of myocardial ischemia-reperfusion performed at the onset of reperfusion, reduces infarct size after prolonged ischemia. Our goal was to determine whether postconditioning is protective against myocardial stunning. Accordingly, conscious chronically instrumented dogs (sonomicrometry, coronary balloon occluder) were subjected to a control sequence (10 min coronary artery occlusion, CAO, followed by coronary artery reperfusion, CAR) and a week apart to postconditioning with four cycles of brief CAR and CAO performed at completion of the 10 min CAO. Three postconditioning protocols were investigated, i.e., 15 s CAR/15 s CAO ( n = 5), 30 s CAR/30 s CAO ( n = 7), and 1 min CAR/1 min CAO ( n = 6). Left ventricular wall thickening was abolished during CAO and similarly reduced during subsequent stunning in control and postconditioning sequences (e.g., at 1 h CAR, 33 ± 4 vs. 34 ± 4%, 30 ± 4 vs. 30 ± 4%, and 33 ± 4 vs. 32 ± 4% for 15 s postconditioning, 30 s postconditioning, and 1 min postconditioning vs. corresponding control, respectively). We confirmed this result in anesthetized rabbits by demonstrating that shortening of left ventricular segment length was similarly depressed after 10 min CAO in control and postconditioning sequences (4 cycles of 30 s CAR/30 s CAO). In additional rabbits, the same postconditioning protocol significantly reduced infarct size after 30 min CAO and 3 h CAR (39 ± 7%, n = 6 vs. 56 ± 4%, n = 7 of the area at risk in postconditioning vs. control, respectively). Thus, contrasting to its beneficial effects on myocardial infarction, postconditioning does not protect against myocardial stunning in dogs and rabbits. Conversely, additional episodes of ischemia-reperfusion with postconditioning do not worsen myocardial stunning.
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Affiliation(s)
- Nicolas Couvreur
- Institut National de la Santé et de la Recherce Médicale, Unité 660, Créteil, France
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