Coronary physiology assessment in the catheterization laboratory

Figure 1 Microvascular function measured by intracoronary Doppler. A shows an intracoronary Doppler tracing at baseline condition, with an APV of 22 cm/s; B shows Doppler at the same position during maximal hyperemia, induced with an adenosine intracoronary bolus of 200 μg, with an APV of 53 cm/s. CFR is therefore 2.4, indicating a normal endothelium-independent microvascular function; in C and D, increasing doses of intracoronary acetylcholine have been administered; the APV is compared with the baseline tracing to determine the degree of microvascular vasodilation induced by acetylcholine, which in this case is normal, suggesting a normal endothelium-dependent microvascular function. CFR: Coronary flow reserve; APV: Average peak velocity.