Figure 2.

Cardiac Catheterization Laboratory Interventional Diagnostic Procedure Protocol

Proposed step-by-step approach to guidewire-based assessment of coronary vascular function using thermodilution or Doppler and then vasoreactivity testing using acetylcholine (Ach). This simple approach focuses on thermodilution, which is straightforward to include during daily practice. Note that some operators may prefer to perform vasoreactivity testing first without the guidewire, allowing Ach challenge prior to any short-acting nitrate administration. HMR = hyperemia microvascular resistance; IC = intracardiac; LVEDP = left ventricular end-diastolic pressure; LV gram = left ventriculogram; NHPR = nonhyperemic pressure ratio; seg = segment; TT = transit time (for bolus of normal saline); other abbreviations as in Figure 1.