A new method for measuring total coronary blood flow using the lithium dilution method.

BACKGROUND: The aim in this study is to evaluate a new method of measuring total coronary blood flow (TCBF) in (1) an in vitro model and in (2) an animal model by the lithium dilution method. METHODS: (1) Ringer's solution was circulated in a closed circuit with the main flow as a systemic circulation, and the side flow as a coronary circulation by a roller pump. Two peaks originating from the main and side flow were recorded by the lithium dilution method. The flow was calculated using the Fick principle based on the ratio of the areas under the curve. The validity of this method was evaluated by Bland Altman analysis. (2) Four beagles were anesthetized and subjected to insertion of two pulmonary artery catheters. The position of the catheters was confirmed as being in the pulmonary artery and in the right atrium. Lithium chloride solution was injected into the pulmonary artery and the change in lithium concentration at the right atrium was recorded. TCBF was estimated by the method used in the in vitro study. RESULTS: (1) The calculated flow correlated well with the actual flow (r2 = 0.86). (2) The estimated TCBF at baseline, with low-dose nitroglycerin, and with high-dose nitroglycerin was 206 +/- 43.0 mL/min, 304 +/- 50.3 mL/min, and 348 +/- 50.1 mL/min, respectively (mean +/- SE). TCBF was significantly increased by nitroglycerin infusion. CONCLUSION: A new method of measuring TCBF using the lithium dilution method was reliable and useful both in vitro and in an animal model. This may be clinically useful method for measuring TCBF.