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J Am Coll Cardiol, 2003; 41:403-408, doi:10.1016/S0735-1097(02)02817-6 © 2003 by the American College of Cardiology Foundation |
* Department of Cardiology, Hippokration Hospital, Athens Medical School, Athens, Greece
Manuscript received June 21, 2002; revised manuscript received September 18, 2002, accepted October 31, 2002.
* Reprint requests and correspondence: Dr. Christodoulos Stefanadis, 9 Tepeleniou Str., 15452 Paleo Psychico, Athens, Greece.
cstefan{at}cc.uoa.gr
OBJECTIVES: This study investigated whether temperature measurements are influenced by blood flow.
BACKGROUND: Previous ex vivo studies showed marked thermal heterogeneity in atheromatic plaques. In stable lesions, however, trivial in vivo temperature variations are recorded, perhaps due to the "cooling effect" of blood flow.
METHODS: Eighteen patients with effort angina were studied. Coronary flow velocity was continuously recorded; over another guidewire, temperature measurements were performed at the proximal vessel wall and at the lesion before, during, and after complete interruption of blood flow by inflation of a balloon. The 
Tp was assigned as the difference between the proximal vessel wall temperature and the maximal temperature during and after balloon inflation. The Tl was assigned as the difference between the atherosclerotic plaque and the proximal vessel wall.
RESULTS: The procedure was not complicated. During and after complete interruption of flow, Tp was 0.012 ± 0.01°C and –0.006 ± –0.01°C (p < 0.001), respectively. The Tl was 0.08 ± 0.04°C at baseline and went to 0.18 ± 0.05°C (60.5 ± 14.1% increase) during and 0.08 ± 0.04°C after flow interruption (p < 0.001). The Tl was greater than Tp during and after impairment of flow (p < 0.001). A correlation between the baseline average peak velocity and Tl during flow interruption was found (R = 0.57, p = 0.01). In seven patients thermal heterogeneity was not detected at baseline, and during balloon inflation Tl increased by 76.0 ± 8.4%.
CONCLUSIONS: Thermal heterogeneity is underestimated in atherosclerotic plaques in patients with effort angina. Potential in vivo underestimation of heat production locally in human atherosclerotic is due to the "cooling effect" of coronary blood flow.
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