Assessing the Impact of Prolonged Averaging of Coronary Continuous Thermodilution Traces
Continuous Thermodilution is a novel method of quantifying coronary flow (Q) in mL/min. To account for variability of Q within the cardiac cycle, the trace is smoothened with a 2 s moving average filter. This can sometimes be ineffective due to significant heart rate variability, ventricular extrasy...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/14/3/285 |
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| author | Samer Fawaz Daniel Munhoz Thabo Mahendiran Emanuele Gallinoro Takuya Mizukami Sarosh A. Khan Rupert F. G. Simpson Johan Svanerud Christopher M. Cook John R. Davies Grigoris V. Karamasis Bernard De Bruyne Thomas R. Keeble |
| author_facet | Samer Fawaz Daniel Munhoz Thabo Mahendiran Emanuele Gallinoro Takuya Mizukami Sarosh A. Khan Rupert F. G. Simpson Johan Svanerud Christopher M. Cook John R. Davies Grigoris V. Karamasis Bernard De Bruyne Thomas R. Keeble |
| author_sort | Samer Fawaz |
| collection | DOAJ |
| description | Continuous Thermodilution is a novel method of quantifying coronary flow (Q) in mL/min. To account for variability of Q within the cardiac cycle, the trace is smoothened with a 2 s moving average filter. This can sometimes be ineffective due to significant heart rate variability, ventricular extrasystoles, and deep inspiration, resulting in a fluctuating temperature trace and ambiguity in the location of the “steady state”. This study aims to assess whether a longer moving average filter would smoothen any fluctuations within the continuous thermodilution traces resulting in improved interpretability and reproducibility on a test–retest basis. Patients with ANOCA underwent repeat continuous thermodilution measurements. Analysis of traces were performed at averages of 10, 15, and 20 s to determine the maximum acceptable average. The maximum acceptable average was subsequently applied as a moving average filter and the traces were re-analysed to assess the practical consequences of a longer moving average. Reproducibility was then assessed and compared to a 2 s moving average. Of the averages tested, only 10 s met the criteria for acceptance. When the data was reanalysed with a 10 s moving average filter, there was no significant improvement in reproducibility, however, it resulted in a 12% diagnostic mismatch. Applying a longer moving average filter to continuous thermodilution data does not improve reproducibility. Furthermore, it results in a loss of fidelity on the traces, and a 12% diagnostic mismatch. Overall, current practice should be maintained. |
| first_indexed | 2024-03-08T03:59:08Z |
| format | Article |
| id | doaj.art-e9ab77c26d3d44aa963e23d4179f2cc0 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-08T03:59:08Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-e9ab77c26d3d44aa963e23d4179f2cc02024-02-09T15:10:05ZengMDPI AGDiagnostics2075-44182024-01-0114328510.3390/diagnostics14030285Assessing the Impact of Prolonged Averaging of Coronary Continuous Thermodilution TracesSamer Fawaz0Daniel Munhoz1Thabo Mahendiran2Emanuele Gallinoro3Takuya Mizukami4Sarosh A. Khan5Rupert F. G. Simpson6Johan Svanerud7Christopher M. Cook8John R. Davies9Grigoris V. Karamasis10Bernard De Bruyne11Thomas R. Keeble12Essex Cardiothoracic Centre, Basildon Hospital, Nether Mayne, Basildon SS16 5NL, UKCardiovascular Center Aalst, OLV Clinic, 9300 Aalst, BelgiumCardiovascular Center Aalst, OLV Clinic, 9300 Aalst, BelgiumCardiovascular Center Aalst, OLV Clinic, 9300 Aalst, BelgiumCardiovascular Center Aalst, OLV Clinic, 9300 Aalst, BelgiumEssex Cardiothoracic Centre, Basildon Hospital, Nether Mayne, Basildon SS16 5NL, UKEssex Cardiothoracic Centre, Basildon Hospital, Nether Mayne, Basildon SS16 5NL, UKCoroventis Research AB, 756 51 Uppsala, SwedenEssex Cardiothoracic Centre, Basildon Hospital, Nether Mayne, Basildon SS16 5NL, UKEssex Cardiothoracic Centre, Basildon Hospital, Nether Mayne, Basildon SS16 5NL, UKSchool of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, 157 72 Athens, GreeceCardiovascular Center Aalst, OLV Clinic, 9300 Aalst, BelgiumEssex Cardiothoracic Centre, Basildon Hospital, Nether Mayne, Basildon SS16 5NL, UKContinuous Thermodilution is a novel method of quantifying coronary flow (Q) in mL/min. To account for variability of Q within the cardiac cycle, the trace is smoothened with a 2 s moving average filter. This can sometimes be ineffective due to significant heart rate variability, ventricular extrasystoles, and deep inspiration, resulting in a fluctuating temperature trace and ambiguity in the location of the “steady state”. This study aims to assess whether a longer moving average filter would smoothen any fluctuations within the continuous thermodilution traces resulting in improved interpretability and reproducibility on a test–retest basis. Patients with ANOCA underwent repeat continuous thermodilution measurements. Analysis of traces were performed at averages of 10, 15, and 20 s to determine the maximum acceptable average. The maximum acceptable average was subsequently applied as a moving average filter and the traces were re-analysed to assess the practical consequences of a longer moving average. Reproducibility was then assessed and compared to a 2 s moving average. Of the averages tested, only 10 s met the criteria for acceptance. When the data was reanalysed with a 10 s moving average filter, there was no significant improvement in reproducibility, however, it resulted in a 12% diagnostic mismatch. Applying a longer moving average filter to continuous thermodilution data does not improve reproducibility. Furthermore, it results in a loss of fidelity on the traces, and a 12% diagnostic mismatch. Overall, current practice should be maintained.https://www.mdpi.com/2075-4418/14/3/285coronaryCMDcontinuous thermodilutionmicrovascularCoroflow |
| spellingShingle | Samer Fawaz Daniel Munhoz Thabo Mahendiran Emanuele Gallinoro Takuya Mizukami Sarosh A. Khan Rupert F. G. Simpson Johan Svanerud Christopher M. Cook John R. Davies Grigoris V. Karamasis Bernard De Bruyne Thomas R. Keeble Assessing the Impact of Prolonged Averaging of Coronary Continuous Thermodilution Traces Diagnostics coronary CMD continuous thermodilution microvascular Coroflow |
| title | Assessing the Impact of Prolonged Averaging of Coronary Continuous Thermodilution Traces |
| title_full | Assessing the Impact of Prolonged Averaging of Coronary Continuous Thermodilution Traces |
| title_fullStr | Assessing the Impact of Prolonged Averaging of Coronary Continuous Thermodilution Traces |
| title_full_unstemmed | Assessing the Impact of Prolonged Averaging of Coronary Continuous Thermodilution Traces |
| title_short | Assessing the Impact of Prolonged Averaging of Coronary Continuous Thermodilution Traces |
| title_sort | assessing the impact of prolonged averaging of coronary continuous thermodilution traces |
| topic | coronary CMD continuous thermodilution microvascular Coroflow |
| url | https://www.mdpi.com/2075-4418/14/3/285 |
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