The distribution function of the hydrogen clearance time constant provides a continuous and quantitative method to estimate heterogeneous myocardial blood flow distribution in a preclinical model.
May aid preclinical quantification of post-stenotic myocardial perfusion heterogeneity; leaves open human validation before any clinical use.
A continuous and quantitative analysis of the uneven distribution of coronary blood flow was accomplished in anesthetized open-chest dogs using the distribution function of the hydrogen (H2) clearance time constant. The distribution function was derived by analysing the H2 washout curves in the coronary sinus which were obtained by the H2 clearance method, using platinum electrodes placed in the coronary sinus. Twelve to seventeen platinum electrodes were employed to obtain simultaneous measurements of the regional myocardial flow before and after stenosis of the left anterior descending coronary artery. Theoretically, the H2 washout curves in the coronary sinus could be interpreted as a function with multi-exponential characteristics, represented by an equation similar to the Laplace transform of the distribution function of the H2 clearance time constant. Therefore, we assumed that such an equation would represent the uneven distribution of coronary blood. We obtained the distribution function by using an approximation method to solve the integral equation and we employed digital computation to increase the resolution. Before stenosis of the left anterior descending coronary artery, the log distribution function curves with respect to the H2 clearance time constant were roughly symmetrical in terms of the maximum peak in the time constant. After stenosis of the left anterior descending coronary artery, the log distribution function had two peaks and the range of distribution was much larger than that before coronary stenosis. Our findings may prove to be valuable as a technique to estimate continuously and quantitatively the heterogeneous distribution of myocardial blood flow.
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Ashikawa et al. (1982) studied this question.
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