Comparison of Intra-coronary and Intra-aortic Pressure Recordings for Coronary Wave Intensity Analysis
Abstract Body (Do not enter title and authors here): Background: Coronary wave intensity analysis (WIA) provides a mechanistic view of coronary hemodynamics and has been increasingly used to phenotype coronary microvascular disease (CMD). Standard WIA requires simultaneous pressure and flow measurements within the same vessel, but intra-coronary pressure measurement may be limited by hardware availability. In patients with non-obstructive coronary arteries, aortic pressure may serve as a surrogate for intra-coronary pressure to enable broader feasibility of WIA. We aimed to determine whether wave profiles derived from intra-aortic and intra-coronary pressure measurements are comparable when paired with intracoronary Doppler flow in patients with non-obstructive coronary artery disease.
Methods: Patients undergoing invasive coronary physiology assessment of the left anterior descending artery were included. Intracoronary flow velocity and intra-coronary pressure were simultaneously recorded using a ComboWire (Philips Volcano) in the proximal LAD. Aortic pressure was concurrently measured via the guide catheter to allow comparison of pressure sources. In the intra-aortic pressure group, pressure and flow data were aligned using the R wave of the ECG trace. WIA was performed using conventional methods to quantify the dominant waves: forward compression wave (FCW), backward compression wave (BCW), and backward expansion wave (BEW). Agreement between wave intensity was assessed using Bland-Altman analysis and Pearson correlation.
Results: A total of 14 paired waveforms were analyzed with a total of 42 coronary waves compared. Wave intensities calculated using intra-coronary versus intra-aortic pressure showed excellent agreement across all wave types. Mean bias between methods was −0.07 x 103 W×m-2×s-1 with limits of agreement from −0.63 to +0.49. The correlation between intra-coronary and intra-aortic wave intensities was strong (r = 0.997, p < 0.001), with minimal dispersion and consistent agreement across the full range of wave intensities (Figure 1).
Conclusions: In patients with non-obstructive coronary arteries, wave intensity analysis using guide-catheter aortic pressure yields results nearly identical to those obtained with intra-coronary pressure. These findings support the use of aortic pressure as a reliable surrogate for intra-coronary pressure in WIA for the calculation of microvascular coronary hemodynamics, reducing technical barriers and enabling broader clinical and research utilization.
Carrington, Justin
( Mayo Clinic
, Rochester
, Minnesota
, United States
)
Prasad, Abhiram
( Mayo Clinic
, Rochester
, Minnesota
, United States
)
Gulati, Rajiv
( MAYO CLINIC
, Rochester
, Minnesota
, United States
)
Lerman, Amir
( Mayo Clinic
, Rochester
, Minnesota
, United States
)
Raphael, Claire
( Mayo Clinic
, Rochester
, Minnesota
, United States
)
Author Disclosures:
Justin Carrington:DO NOT have relevant financial relationships
| Abhiram Prasad:DO NOT have relevant financial relationships
| Rajiv Gulati:DO NOT have relevant financial relationships
| Amir Lerman:DO NOT have relevant financial relationships
| Claire Raphael:No Answer