Local Continuity of Myocardial Blood Flow Studied by Monochromatic Synchrotron Radiation–Excited X-ray Fluorescence Spectrometry

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Abstract
We have developed a monochromatic synchrotron radiation–excited system for two-dimensional mapping of x-ray fluorescence evoked from heavy element–loaded microspheres, which can evaluate myocardial blood flow in small contiguous regions with a small methodological error: 10.8±2.4% of the average of difference of the dual flow for 7- to 10-mg myocardial tissue (4 dogs). The fractal D value obtained from the slope of the log relative dispersion–log mass plot was 1.21±0.08 for a voxel size of 7 to 1260 mg (5 dogs) and that for a voxel size of 2.5 to 40 mg (1.12±0.06) was smaller than that for a voxel size of 40 to 1280 mg (1.25±0.14, P <.05, ANOVA, 4 dogs). The distance–correlation coefficient relation for paired myocardial regions was attenuated (correlation analysis), and the correlation coefficients between the original grouping and the two aggregates of the adjacent regions were dissociated (extended correlation analysis) under reduction of coronary perfusion pressure (6 dogs). Suppression of myocardial contraction with lidocaine (3 dogs) and vasodilation with adenosine partly improved the distance–correlation coefficient relation under reduced coronary perfusion pressure. Thus, an x-ray fluorescence system designed for precise flow measurement shows that the fractal nature of local flow distribution can be extended into regions smaller than previously reported, that in these regions the flow becomes more homogeneous, and that the self similarity and continuity of local flow are attenuated by the reduction of coronary perfusion pressure and improved by contractile suppression and coronary vasodilation.