A new vascular imaging technique—coronary ultrafast Doppler angiography (CUDA)—can accurately and noninvasively map the intramyocardial coronary structure and quantify fluctuations in intramural coronary blood flow.
CUDA, along with adaptive coronary Doppler processing, calculated power velocity integral (PVI), a metric similar to coronary flow, which afforded researchers a quantitative measurement of coronary flow variations and coronary flow reserve (CFR).
The study was published June 4 in the Journal of the American College of Cardiology: Cardiovascular Imaging.
“These results establish that ultrafast ultrasound combined with adaptive coronary Doppler processing is capable of visualizing the epicardial and intramural coronary vasculature, a vascular compartment currently uncharted in vivo in humans by existing clinical angiography techniques,” wrote lead author David Maresca, PhD with the Institut Langevin in Paris, and colleagues.
Researchers performed CUDA open-chest procedures in nine swine models. Flow change was determined during hyperemia after a 30-second left anterior descending (LAD) artery occlusion followed by reperfusion. This was compared to gold-standard measurements taken with a flowmeter probe.
Quantification of the coronary flow changes during hyperemia was “in good agreement with gold standard measurements,” as was the assessment of coronary flow reserve. In the animals with infarction, the novel imaging technique visualized strong hyperemia and the appearance of abnormal coronary vessel structures in the reperfused LAD territory.
Maresca and colleagues also tested the viability of CUDA use in two adult and two pediatric volunteers. They found the resulted demonstrated “it is possible to detect intramural coronary veins and arteries in a transthoracic clinical in vivo setting,” they wrote.
While authors touted the success of CUDA, they did note the new procedure did not provide an absolute calculation of the flow rate, due to the angle dependency of Doppler imaging, but could only quantify the rate using the PVI.
“These results could open new possibilities for the noninvasive characterization of intramural CFR in patients with microvascular angina,” authors wrote. “Moreover, the capability of CUDA to image both venous and arterial flows could also be useful for better understanding of the venous myocardial drainage, which remains somewhat unknown.”
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.