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Distinction of non-ischemia inducing versus ischemia inducing coronary stenosis by fluorescent cardiac imaging

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Abstract

Intraoperative fluorescent cardiac imaging (FCI) can quantitatively assess myocardial perfusion abnormalities produced by graded flow-limiting coronary stenosis (FLS), but there are no data to distinguish FLS from non flow-limiting stenosis (NFLS) to determine their functional significance. The aim of the study was to evaluate whether non-ischemia inducing NFLS can be quantified and differentiated from FLS by FCI technology. Data are compared to gold standard fluorescent microspheres (FM). 11 domestic pigs of either sex underwent sternotomy. Left anterior descending coronary artery blood-flow was recorded by transit-time flow measurements. After baseline and Adenosine-induced hyperemia, two stenosis of low severity (50 and 90 % NFLS) were produced, followed by FLS (50 %) and total vessel occlusion. Time-dependent fluorescence intensity curves were recorded by FCI. Slope of fluorescence intensity (SFI) and background-subtracted peak fluorescence (BSFI) intensity were calculated and data compared to myocardial blood flow measurements using FM. All NFLS and FLS reduced myocardial perfusion as quantified by FCI showing decreased normalized BSFI and SFI (P < 0.001). Box-plot analysis showed significant difference between NFLS (50 and 90 %) and FLS (50 %) assessed by BSFI (P < 0.001) and SFI (P < 0.001). In each animal, a linear correlation between FM-derived myocardial blood flow and FCI-derived BSFI (r = 0.936, P < 0.001) or SFI (r = 0.942, P < 0.001) was observed during baseline, hyperemia, graded NFLS, and FLS. Both, BSFI (r = 0.789, P < 0.001) and SFI (r = 0.802, P < 0.001) significantly correlated with transit-time flow measurements. FCI quantitative technology is capable of distinguishing between non-ischemia inducing NFLS and ischemia inducing FLS showing a good correlation compared to fluorescent microspheres.

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Acknowledgments

We want to acknowledge Christiane Pahrmann for her support in the animal laboratory and Günter Daum, PhD for his support in editing the manuscript.

Funding sources

The present study was supported by the Institut für Lasertechnologien in der Medizin und Messtechnik, University Ulm, and the University Heart Center Hamburg, Germany.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, University Heart Center Hamburg, Martinistr.52, 20246, Hamburg, Germany

    Sabine Wipper, Beate Reiter, Fabian Hahnel, Tilo Kölbel, Hermann Reichenspurner & Christian Detter

  2. Institut für Lasertechnologien in der Medizin und Messtechnik, University Ulm, Ulm, Germany

    Detlef Russ

  3. Department of Medical Biometry and Epidemiology, University Hospital Eppendorf, Hamburg, Germany

    Jan-Felix Kersten

Authors
  1. Sabine Wipper
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  2. Beate Reiter
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  3. Detlef Russ
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  6. Tilo Kölbel
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  8. Christian Detter
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Correspondence to Christian Detter.

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Wipper, S., Reiter, B., Russ, D. et al. Distinction of non-ischemia inducing versus ischemia inducing coronary stenosis by fluorescent cardiac imaging. Int J Cardiovasc Imaging 32, 363–371 (2016). https://doi.org/10.1007/s10554-015-0767-y

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  • DOI: https://doi.org/10.1007/s10554-015-0767-y

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