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https://www.readbyqxmd.com/read/29790719/less-is-more-as-less-as-reasonably-achievable-stenting-alaras-strategy-in-the-femoropopliteal-area
#1
Koen Deloose, Joren Callaert
BACKGROUND: Although evidence supports that the performance of drug coated balloons seems to be lesion complexity independent, it is quite clear that in long lesions, severe calcified lesions and chronic total occlusions, the bail out stent ratio is very high and that the "leaving nothing behind" strategy remains a dream in a lot of our daily cases. On the other side of the spectrum, "full metal jackets" of nitinol stents are creating even more problems. Stent fractures, intimal hyperplasia and reintervention difficulties complicate the recurrent vascular disease treatment...
May 23, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29790478/validation-of-a-novel-non-hyperaemic-index-of-coronary-artery-stenosis-severity-the-resting-full-cycle-ratio-validate-rfr-study
#2
Johan Svanerud, Jung-Min Ahn, Allen Jeremias, Marcel van 't Veer, Ankita Gore, Akiko Maehara, Aaron Crowley, Nico H J Pijls, Bernard De Bruyne, Nils P Johnson, Barry Hennigan, Stuart Watkins, Colin Berry, Keith G Oldroyd, Seung-Jung Park, Ziad A Ali
AIMS: Randomised controlled trials have reported instantaneous wave-free ratio (iFR) to be non-inferior to fractional flow reserve (FFR) for major adverse cardiovascular events at one year; however, iFR is limited by sensitive landmarking of the pressure waveform, and the assumption that maximal flow and minimal resistance occur during a fixed period of diastole. We sought to validate the resting full-cycle ratio (RFR), a novel non-hyperaemic index of coronary stenosis severity based on unbiased identification of the lowest distal coronary pressure to aortic pressure ratio (Pd/Pa), independent of the ECG, landmark identification, and timing within the cardiac cycle...
May 23, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29789302/fractional-flow-reserve-and-instantaneous-wave-free-ratio-as-predictors-of-the-placebo-controlled-response-to-percutaneous-coronary-intervention-in-stable-single-vessel-coronary-artery-disease-physiology-stratified-analysis-of-orbita
#3
Rasha Al-Lamee, James P Howard, Matthew J Shun-Shin, David Thompson, Hakim-Moulay Dehbi, Sayan Sen, Sukhjinder Nijjer, Ricardo Petraco, John Davies, Thomas Keeble, Kare Tang, Iqbal S Malik, Christopher Cook, Yousif Ahmad, Andrew S P Sharp, Robert Gerber, Christopher Baker, Raffi Kaprielian, Suneel Talwar, Ravi Assomull, Graham Cole, Niall G Keenan, Gajen Kanaganayagam, Joban Sehmi, Roland Wensel, Frank E Harrell, Jamil Mayet, Simon A Thom, Justin E Davies, Darrel P Francis
BACKGROUND : There are no data on how fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are associated with the placebo-controlled efficacy of percutaneous coronary intervention (PCI) in stable single-vessel coronary artery disease. METHODS : We report the association between prerandomization invasive physiology within ORBITA (Objective Randomised Blinded Investigation With Optimal Medical Therapy of Angioplasty in Stable Angina), a placebo-controlled trial of patients who have stable angina with angiographically severe single-vessel coronary disease clinically eligible for PCI...
May 22, 2018: Circulation
https://www.readbyqxmd.com/read/29785878/five-year-outcomes-with-pci-guided-by-fractional-flow-reserve
#4
Panagiotis Xaplanteris, Stephane Fournier, Nico H J Pijls, William F Fearon, Emanuele Barbato, Pim A L Tonino, Thomas Engstrøm, Stefan Kääb, Jan-Henk Dambrink, Gilles Rioufol, Gabor G Toth, Zsolt Piroth, Nils Witt, Ole Fröbert, Petr Kala, Axel Linke, Nicola Jagic, Martin Mates, Kreton Mavromatis, Habib Samady, Anand Irimpen, Keith Oldroyd, Gianluca Campo, Martina Rothenbühler, Peter Jüni, Bernard De Bruyne
Background We hypothesized that fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) would be superior to medical therapy as initial treatment in patients with stable coronary artery disease. Methods Among 1220 patients with angiographically significant stenoses, those in whom at least one stenosis was hemodynamically significant (FFR, ≤0.80) were randomly assigned to FFR-guided PCI plus medical therapy or to medical therapy alone. Patients in whom all stenoses had an FFR of more than 0...
May 22, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29784630/what-are-the-causes-of-a-suboptimal-ffr-after-coronary-stent-deployment-insights-from-a-consecutive-series-using-oct-imaging
#5
Mathias Wolfrum, Giovanni Luigi De Maria, Stefano Benenati, Jeremy Langrish, Andrew J Lucking, Keith M Channon, Rajesh K Kharbanda, Adrian P Banning
AIMS: Fractional flow reserve (FFR) can be used to detect a suboptimal result after percutaneous coronary intervention (PCI). A lower post procedure FFR (< 0.90) has been shown to be associated with adverse clinical outcomes at follow-up. This pilot study aimed to understand the mechanisms resulting in a suboptimal FFR and whether Optical Coherence Tomography (OCT) guided optimisation could improve final FFR. METHODS AND RESULTS: Thirty five patients undergoing complex PCI were prospectively enrolled...
May 21, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29784622/non-invasive-fractional-flow-reserve-in-vessels-without-severe-obstructive-stenosis-is-associated-with-coronary-plaque-burden
#6
Mhairi K Doris, Yuka Otaki, Yoav Arnson, Balaji Tamarappoo, Markus Goeller, Heidi Gransar, Frances Wang, Sean Hayes, John Friedman, Louise Thomson, Piotr Slomka, Damini Dey, Daniel Berman
AIMS: Non-invasive fractional flow reserve derived from coronary CT angiography (FFRCT ) has been shown to be predictive of lesion-specific ischemia as assessed by invasive fractional flow reserve (FFR). However, in practice, clinicians are often faced with an abnormal distal FFRCT in the absence of a discrete obstructive lesion. Using quantitative plaque analysis, we sought to determine the relationship between an abnormal whole vessel FFRCT (V-FFRCT ) and quantitative measures of whole vessel atherosclerosis in coronary arteries without obstructive stenosis...
May 7, 2018: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29779179/clinical-outcomes-of-complete-revascularization-using-either-angiography-guided-or-fractional-flow-reserve-guided-drug-eluting-stent-implantation-in-non-culprit-vessels-in-st-elevation-myocardial-infarction-patients-insights-from-a-study-based-on-a-systematic
#7
REVIEW
Alexandre Hideo-Kajita, Hector M Garcia-Garcia, Kayode O Kuku, Solomon S Beyene, Viana Azizi, Yael F Meirovich, Gebremedhin D Melaku, Aaphtaab Dheendsa, Echo J Brathwaite, Sameer Desale, Mohammad Soud, Kazuhiro Dan, Yuichi Ozaki, Ron Waksman, Michael Lipinski
Current guidelines recommend that percutaneous coronary intervention (PCI) should be restricted to the culprit vessel in ST elevation myocardial infarction (STEMI) patients with multi-vessel disease (MVD) and without cardiogenic shock. However, newer data suggests that performing complete revascularization (CR) in MVD patients may lead to better outcomes compared to intervention in the culprit vessel only. The aim of this meta-analysis is to examine the available data to determine if CR (using either angio- or fractional flow reserve guidance-FFR) following primary PCI in STEMI patients without cardiogenic shock impacts clinical outcomes...
May 19, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29774108/prognostic-and-diagnostic-impact-of-fibrinogen-neutrophil-to-lymphocyte-ratio-and-platelet-to-lymphocyte-ratio-on-thymic-epithelial-tumors-outcome
#8
Stefan Janik, Thomas Raunegger, Philipp Hacker, Bahil Ghanim, Elisa Einwallner, Leonhard Müllauer, Ana-Iris Schiefer, Julia Moser, Walter Klepetko, Hendrik Jan Ankersmit, Bernhard Moser
Background: Peripheral blood-derived inflammation-based markers, such as Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Fibrinogen have been identified as prognostic markers in various solid malignancies. Here we aimed to investigate the prognostic and diagnostic impact of NLR, PLR, and Fibrinogen in patients with thymic epithelial tumors (TETs). Results: Pretreatment Fibrinogen serum concentrations, NLRs and PLRs were highest in patients with TCs and advanced tumor stages...
April 24, 2018: Oncotarget
https://www.readbyqxmd.com/read/29769168/pressure-wire-compared-to-microcatheter-sensing-for-coronary-fractional-flow-reserve-the-perform-study
#9
Ziad A Ali, Yasir Parviz, Matthew Brinkman, Mitsuaki Matsumura, Björn Redfors, David A Brogno, Maria D Corral, Khady N Fall, Gary S Mintz, Gregg W Stone, Akiko Maehara, Allen Jeremias, Ajay J Kirtane
AIMS: Among technologies used to assess FFR, a monorail, sensor-tipped micro pressure catheter (PC) may be advantageous for delivery and re-assessment. We sought to determine whether the larger cross-sectional area of the PC influences FFR measurements compared to the pressure wire. METHODS AND RESULTS: PERFORM was a single-center, prospective study designed to determine the precision and accuracy of the PC compared with the pressure wire (PW) for measurement of FFR...
May 15, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29769166/coronary-lesion-progression-as-assessed-by-fractional-flow-reserve-ffr-and-angiography
#10
Panagiotis Xaplanteris, Argyris Ntalianis, Bernard De Bruyne, Teresa Strisciuglio, Mariano Pellicano, Giovanni Ciccarelli, Anastasios Milkas, Emanuele Barbato
AIMS: To explore the evolution of coronary lesions that had repeated physiologic evaluation by FFR as an endpoint, describe the clinical significance of longitudinal FFR change (ΔFFR = FFR follow-up - FFR baseline), its correlation with angiographic indices and identify predictors of FFR follow-up. METHODS AND RESULTS: A retrospective, single-center analysis of 414 stenoses (331 patients) with consecutive FFR measurements at least six months apart was performed [median time interval: 24 (17, 37) months]...
May 15, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29764918/a-feed-forward-relay-integrates-the-regulatory-activities-of-bicoid-and-orthodenticle-via-sequential-binding-to-suboptimal-sites
#11
Rhea R Datta, Jia Ling, Jesse Kurland, Xiaotong Ren, Zhe Xu, Gozde Yucel, Jackie Moore, Leila Shokri, Isabel Baker, Timothy Bishop, Paolo Struffi, Rimma Levina, Martha L Bulyk, Robert J Johnston, Stephen Small
The K50 (lysine at amino acid position 50) homeodomain (HD) protein Orthodenticle (Otd) is critical for anterior patterning and brain and eye development in most metazoans. In Drosophila melanogaster , another K50HD protein, Bicoid (Bcd), has evolved to replace Otd's ancestral function in embryo patterning. Bcd is distributed as a long-range maternal gradient and activates transcription of a large number of target genes, including otd Otd and Bcd bind similar DNA sequences in vitro, but how their transcriptional activities are integrated to pattern anterior regions of the embryo is unknown...
May 15, 2018: Genes & Development
https://www.readbyqxmd.com/read/29764252/response-properties-of-the-human-frequency-following-response-ffr-to-speech-and-non-speech-sounds-level-dependence-adaptation-and-phase-locking-limits
#12
Gavin Bidelman, Louise Powers
OBJECTIVE: The frequency-following response (FFR) is a neurophonic potential used to assess auditory neural encoding at subcortical stages. Despite the FFR's empirical and clinical utility, basic response properties of this evoked potential remain undefined. DESIGN: We measured FFRs to speech and nonspeech (pure tone, chirp sweeps) stimuli to quantify three key properties of this potential: level-dependence (I/O functions), adaptation and the upper limit of neural phase-locking...
May 15, 2018: International Journal of Audiology
https://www.readbyqxmd.com/read/29754669/comparison-of-fractional-flow-reserve-and-intravascular-ultrasound-guided-intervention-strategy-for-clinical-outcomes-in-patients-with-intermediate-stenosis-flavour-rationale-and-design-of-a-randomized-clinical-trial
#13
Jeehoon Kang, Bon-Kwon Koo, Xinyang Hu, Joo Myung Lee, Joo-Yong Hahn, Hyoung-Mo Yang, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Bong-Ki Lee, Chul Ahn, JianAn Wang, Seung-Jae Tahk
BACKGROUND: Coronary angiography has limitations in defining the ischemia-causing stenotic lesion, especially in cases with intermediate coronary stenosis. Fractional flow reserve (FFR) is a current standard method to define the presence of ischemia, and intravascular ultrasound (IVUS) is the most commonly used invasive imaging tool that can provide the lesion geometry and can provide the information on plaque vulnerability. The primary aim of this study is to compare the safety and efficacy of FFR-guided and IVUS-guided percutaneous coronary intervention (PCI) strategies in patients with intermediate coronary stenosis...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29748874/correction-to-acc-aats-aha-ase-asnc-scai-scct-sts-2017-appropriate-use-criteria-for-coronary-revascularization-in-patients-with-stable-ischemic-heart-disease
#14
Manesh R Patel, John H Calhoon, Gregory J Dehmer, James Aaron Grantham, Thomas M Maddox, David J Maron, Peter K Smith
To more clearly reflect the relationship between iFR (instantaneous wave-free ratio) and FFR (fractional flow reserve), this Correction document highlights the following changes to the original document published in the Journal of Nuclear Cardiology; the version available at JACC [1] has been updated to reflect the changes, with JACC's Correction document available at [2].
May 10, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29735395/is-fractional-flow-reserve-useful-in-assessing-coronary-artery-fistula-a-case-based-discussion-and-review
#15
Samual Hayman, Aashish Goela, Shahar Lavi
We present two cases where fractional flow reserve (FFR) was utilised to guide management of coronary artery fistula (CAF), an approach advocated in recent case studies. CAF is a coronary anomaly that may present with a variety of syndromes though is frequently asymptomatic. When to exclude the fistula (surgically or percutaneously) is not always clear. A way to quantify if the fistula is physiologically meaningful would be advantageous. Our findings suggest FFR may only be assessing the concomitant epicardial coronary artery disease (CAD) rather than the degree of coronary steal and its routine use in this setting is not supported...
April 19, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29729354/gender-bias-in-the-sensory-representation-of-infant-cry
#16
S Devaraju Dhatri, G Nike Gnanateja, Ajith Kumar U, Sandeep Maruthy
The auditory neural pathway in females appears to be more sensitive to the cry of an infant [1,2]. Cortical responses in females have shown a distinct advantage compared to males in the auditory processing of infant cry. Such gender-bias in the cortical responses might emanate either at higher levels of processing such as cognitive and emotional processing or at the lower level representation of stimulus features. We assessed for a difference if any between the two genders in the sensory representation of an infant's cry...
May 2, 2018: Neuroscience Letters
https://www.readbyqxmd.com/read/29716756/coronary-microvascular-dysfunction-in-patients-with-stable-coronary-artery-disease-the-ce-marc-2-coronary-physiology-sub-study
#17
David Corcoran, Robin Young, David Adlam, Alex McConnachie, Kenneth Mangion, David Ripley, David Cairns, Julia Brown, Chiara Bucciarelli-Ducci, Andreas Baumbach, Rajesh Kharbanda, Keith G Oldroyd, Gerry P McCann, John P Greenwood, Colin Berry
BACKGROUND: In patients with angina undergoing invasive management, no obstructive coronary artery disease (NOCAD) is a common finding, and angina may persist following percutaneous coronary intervention (PCI). Coronary microvascular dysfunction may be relevant. We aimed to assess the proportion of patients presenting with suspected CAD who had coronary microvascular dysfunction. METHODS: Clinical Evaluation of Magnetic Resonance Imaging in Coronary Heart Disease 2 (CE-MARC 2) was a prospective multicenter randomised controlled trial of functional imaging versus guideline-based management in patients with suspected CAD...
April 19, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29713819/evaluation-of-the-risk-factors-for-ventricular-arrhythmias-secondary-to-qt-prolongation-induced-by-papaverine-injection-during-coronary-flow-reserve-studies-using-a-4-fr-angio-catheter
#18
Yoshitaka Okabe, Kanichi Otowa, Yasuhito Mitamura, Hisayoshi Murai, Soichiro Usui, Shuichi Kaneko, Masayuki Takamura
Estimation of the fractional flow reserve (FFR) is considered to be an established method by which to assess stable coronary artery stenosis. Induction of maximal coronary hyperemia is important during the FFR procedure. Papaverine has been reported to increase the risk of ventricular arrhythmia (VA). The purpose of the present study was to discover predictors of papaverine-induced VAs developing during FFR measurement. A total of 213 clinically stable patients were included in the study. FFRs were determined after intracoronary papaverine administration (12 mg into the left and 8 mg into the right coronary arteries)...
April 30, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29707808/pooled-diagnostic-accuracy-of-resting-distal-to-aortic-coronary-pressure-referenced-to-fractional-flow-reserve-the-importance-of-resting-coronary-physiology
#19
Rohit Maini, John Moscona, Gursukhman Sidhu, Paul Katigbak, Camilo Fernandez, Anand Irimpen, Owen Mogabgab, Charisse Ward, Rohan Samson, Thierry LeJemtel
INTRODUCTION: Both resting and hyperemic physiologic methods to guide coronary revascularization improve cardiovascular outcomes compared with angiographic guidance alone. Fractional flow reserve (FFR) remains underutilized due to concerns regarding hyperemia, prompting study of resting distal to aortic coronary pressure (Pd/Pa). Pd/Pa is a vasodilator-free resting index unlike FFR. While Pd/Pa is similar to another resting index, instantaneous wave-free ratio (iFR), it is a whole-cycle measurement not limited to the wave-free diastolic period...
April 29, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29703779/impact-of-revascularization-on-absolute-myocardial-blood-flow-as-assessed-by-serial-15-o-h-2-o-positron-emission-tomography-imaging-a-comparison-with-fractional-flow-reserve
#20
Roel S Driessen, Ibrahim Danad, Wijnand J Stuijfzand, Stefan P Schumacher, Juhani Knuuti, Maija Mäki, Adriaan A Lammertsma, Albert C van Rossum, Niels van Royen, Pieter G Raijmakers, Paul Knaapen
BACKGROUND: The main goal of coronary revascularization is to restore myocardial perfusion in case of ischemia, causing coronary artery disease. Yet, little is known on the effect of revascularization on absolute myocardial blood flow (MBF). Therefore, the present prospective study assesses the impact of coronary revascularization on absolute MBF as measured by [15 O]H2 O positron emission tomography and fractional flow reserve (FFR) in patients with stable coronary artery disease. METHODS AND RESULTS: Fifty-three patients (87% men, mean age 58...
May 2018: Circulation. Cardiovascular Imaging
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