Interv Akut Kardiol. 2008;7(2):54-58

Digital densitography - a method of objective and detailed angiographic evaluation of perfusion of the myocardium

Miloš Steinhart¹, Aleš Herman³, Leo Steinhart³, Pavel Šmoranc², Ivo Varvařovský³

¹ Department of Physics, University of Pardubice, Pardubice

² Radiologická klinika FN a LF UK Hradec Králové

³ Kardio-Troll, pracoviště invazivní kardiologie, Krajská nemocnice, Pardubice

Aims: Given the continuing interest in the evaluation of myocardial perfusion and microvasculature, the authors present their original method of quantitative evaluation of myocardial perfusion and of the status of microvascular bed of the myocardium from a selective coronarographic investigation. So far, no angiographic method of evaluation has been objective enough and capable of providing the necessary details. We decided to solve the problem of objectivity and detailed quantitative evaluation of myocardial microcirculation by employing the principle of indicator dilution. In our method, the angiographic contrast medium serves as an indicator. The method is becoming a rather simple part of routine coronarography.

Methods: The presented method treats digitized data from normal vasographic investigations. It quantifies the rate of the washout of the myocardial blush on the descending limb of the indicator dilution curves obtained from the area supplied by the artery under study. Moreover, the region of interest can be divided into an eligible number of active data regions. This property provides important additional information on the size of the supplied area and its homogeneity. The method can be applied at any time during and after the investigation using any common PC.

Conclusions from the use to date: This paper deals selectively with methodological aspects. Clinical experience will be presented separately. The proposed method of gaining and evaluation of the washout curves, which are in principle indicator dilution curves without the absolute calibration, has been tested for more than two years in more than 200 patients with objective, reproducible, logical, and explainable results. Applicability of the proposed method in invasive and interventional cardiology as well as its suitability for studying the influence of drugs on microcirculation is clearly illustrated. Digital densitography is a method suitable for evaluation of myocardial perfusion and status of microvascular bed of the myocardium, however, it may have much broader potential utility in cardiology and other branches of medicine.

Klíčová slova: ischaemia, coronary circulation, haemodynamics, microcirculation, regional bloodflow, reperfusion, digital densitography

Zveřejněno: 1. červen 2008  Zobrazit citaci