There is growing evidence that points to the importance of accurate assessments of the coronary microvasculature (the constriction of the smallest heart vessels) in tailoring heart disease therapies. This is especially relevant for women and diabetic patients who are more susceptible to microvascular dysfunction. Accurate information about a person's heart health can enable doctors to make more informed treatment decisions, such as prescribing medication, deciding on surgical intervention, or discontinuing medication. However, traditional X-rays (angiograms) used by cardiologists to image the heart's larger arteries do not adequately display these tiny blood vessels. Consequently, the current clinical practice may lead to overdiagnosis, resulting in potentially unnecessary invasive procedures such as stent insertion, which carry risks and require recovery time. Now, a new diagnostic technology uses tiny fiber optic sensors to detect the causes of heart disease, more quickly and accurately than existing methods.

Scientists at University College London (UCL, London, UK) have developed a new device named iKOr that uses an ultra-thin microcatheter integrated with fiber optic sensors, enabling doctors to examine both blood pressure and blood flow around the heart as well as identify signs of artery narrowing and thickening, common indicators of heart disease. The slimline probe is especially suitable for detecting microvasculature. The iKOr device incorporates a temperature and pressure sensor merely 0.2mm wide — twice the thickness of a human hair — which is inserted through the patient's blood vessels on an ultra-thin catheter.

The iKOr device measures the flow rate around the heart by emitting a brief pulse of light upstream of the vessels being investigated, thereby slightly warming the blood by approximately one degree. The sensor records the time taken for the downstream temperature change, allowing the device to determine whether the flow is being obstructed by the narrowing of vessels. However, before the device can gain widespread use by doctors, researchers must verify its safe and easy application in patients. Initial patient tests confirm its safety, ease of use, and functionality. These will be followed by a more extensive clinical trial to further confirm the device's safety and superior performance compared to existing tests. Researchers suggest that the iKOr device could potentially assist numerous patients experiencing cardiovascular symptoms like chest pains, whose cause remains unidentified by current techniques.

“The iKOr device is responding to a clinical need – to significantly improve how blood flow in the heart is measured,” said lead iKOr developer, Professor Adrien Desjardins from the UCL Medical Physics & Biomedical Engineering. “Our microcatheter provides concurrent pressure and flow measurements from inside coronary arteries – this is unique and makes the tiny blood vessels more measurable, compared to traditional X-rays. This will help to significantly improve diagnosis and treatment for a large group of patients; those with obstructive coronary artery disease and coronary microvascular dysfunction.” 

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