CORONARY FLOW RESERVE MEASUREMENTS WITH A NEW JUDKINS-STYLE DOPPLER ANGIOGRAPHIC CATHETER

The authors assessed whether measurements obtained by Judkins-style Do ppler catheters are comparable to those achieved with the intracoronar y Doppler technique in 42 patients with normal coronary arteries on an giography (19 syndrome X and 23 heart transplant patients). Resting co ronary flow velocity and response to a hyperemic intracoronary dose of papaverine was measured with a Judkins-style, 8F Doppler-tipped cathe ter positioned in the left coronary ostium and a 3.6F intracoronary Do ppler catheter positioned in the proximal left anterior descending art ery. Mean coronary flow velocity at rest was significantly higher with the Judkins Doppler (10.1 +/- 4.6 vs 6.3 +/- 4.5 cm/sec, p<0.01). The mean coronary flow velocity at peak hyperemia was also significantly higher with the Judkins Doppler (33.7 +/- 14.1 vs 19.7 +/- 11.5 cm/sec , p<0.01). Coronary flow reserve was 3.57 +/- 1.3 with the Judkins Dop pler and 3.47 +/- 1.2 with the intracoronary Doppler (r=0.85). A secon d study was performed in 14 heart transplant patients with the intraco ronary Doppler positioned in the left main coronary artery. The restin g and hyperemic now velocities were again higher with the Judkins Dopp ler but the differences were not statistically significant. There was again a strong correlation between the Doppler catheters for coronary flow reserve measurements. The Judkins-style Doppler technique appears to be a quick, safe, and accurate alternative to the intracoronary Do ppler technique.