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https://www.readbyqxmd.com/read/28937495/noninvasive-computed-tomography-derived-fractional-flow-reserve-based-on-structural-and-fluid-analysis-reproducibility-of-on-site-determination-by-unexperienced-observers
#1
Keiken Ri, Kanako K Kumamaru, Shinichiro Fujimoto, Yuko Kawaguchi, Tomotaka Dohi, Sou Yamada, Kazuhisa Takamura, Yosuke Kogure, Norikazu Yamada, Etsuro Kato, Ryusuke Irie, Tomohiro Takamura, Michimasa Suzuki, Masaaki Hori, Shigeki Aoki, Hiroyuki Daida
OBJECTIVE: The aim of this study was to evaluate the reproducibility of computed tomography (CT)-derived fractional flow reserve (FFR) determined on site by inexperienced observers using a postprocessing software based on structural and fluid analysis. METHODS: Using 21 coronary vessels in 7 patients who underwent 320-row coronary CT angiography and catheter-FFR, 2 independent inexperienced observers (A: a student radiation technologist; B: a nonmedical staff) determined the CT-FFR using a postprocessing software...
September 20, 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28932342/complex-coronary-hemodynamics-simple-analog-modelling-as-an-educational-tool
#2
Gaurav R Parikh, Elvis Peter, Nikolaos Kakouros
OBJECTIVE: Invasive coronary angiography remains the cornerstone for evaluation of coronary stenoses despite there being a poor correlation between luminal loss assessment by coronary luminography and myocardial ischemia. This is especially true for coronary lesions deemed moderate by visual assessment. Coronary pressure-derived fractional flow reserve (FFR) has emerged as the gold standard for the evaluation of hemodynamic significance of coronary artery stenosis, which is cost effective and leads to improved patient outcomes...
2017: Open Medical Informatics Journal
https://www.readbyqxmd.com/read/28927636/feasibility-of-coronary-fractional-flow-reserve-with-dual-anti-platelet-therapy-in-low-risk-coronary-lesions-without-systemic-anticoagulation-results-of-the-smart-ffr-study
#3
Fernando Boccalandro, Mandeep Dhindsa, Prem Subramaniyam, Mary Mok
BACKGROUND: Fractional flow reserve (FFR) is used to assess the functional significance of coronary artery stenoses. The optimal anti-thrombotic regimen for FFR has not been studied. PURPOSE: The goal of this study was to determine whether FFR could be safely performed in Type A coronary lesions, using only upstream dual anti-platelet therapy (DAT) with aspirin and clopidogrel, compared with DAT plus anticoagulation in low risk coronary lesions. METHODS/MATERIALS: Two hundred patients undergoing FFR for Type A intermediate coronary lesions were blindly randomized into two groups of 100 patients each...
August 18, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28926310/coronary-ct-angiography-derived-fractional-flow-reserve
#4
Christian Tesche, Carlo N De Cecco, Moritz H Albrecht, Taylor M Duguay, Richard R Bayer, Sheldon E Litwin, Daniel H Steinberg, U Joseph Schoepf
Invasive coronary angiography (ICA) with measurement of fractional flow reserve (FFR) by means of a pressure wire technique is the established reference standard for the functional assessment of coronary artery disease (CAD) ( 1 , 2 ). Coronary computed tomographic (CT) angiography has emerged as a noninvasive method for direct assessment of CAD and plaque characterization with high diagnostic accuracy compared with ICA ( 3 , 4 ). However, the solely anatomic assessment provided with both coronary CT angiography and ICA has poor discriminatory power for ischemia-inducing lesions...
October 2017: Radiology
https://www.readbyqxmd.com/read/28920099/fast-virtual-fractional-flow-reserve-based%C3%A2-upon-steady-state-computational-fluid-dynamics-analysis-results-from-the-virtu-fast-study
#5
Paul D Morris, Daniel Alejandro Silva Soto, Jeroen F A Feher, Dan Rafiroiu, Angela Lungu, Susheel Varma, Patricia V Lawford, D Rodney Hose, Julian P Gunn
Fractional flow reserve (FFR)-guided percutaneous intervention is superior to standard assessment but remains underused. The authors have developed a novel "pseudotransient" analysis protocol for computing virtual fractional flow reserve (vFFR) based upon angiographic images and steady-state computational fluid dynamics. This protocol generates vFFR results in 189 s (cf >24 h for transient analysis) using a desktop PC, with <1% error relative to that of full-transient computational fluid dynamics analysis...
August 2017: JACC. Basic to Translational Science
https://www.readbyqxmd.com/read/28918837/diagnostic-value-of-noninvasive-computed-tomography-perfusion-imaging-and-coronary-computed-tomography-angiography-for-assessing-hemodynamically-significant-native-coronary-artery-lesions
#6
REVIEW
Pooja Sethi, Hemang B Panchal, Sreenivas P Veeranki, Zia Ur Rahman, Hadii Mamudu, Timir K Paul
BACKGROUND: The objective of this study is to determine the diagnostic performance of computed tomography perfusion (CTP) with and without computed tomography angiography (CTA) in assessment of hemodynamically significant coronary artery lesions in comparison to invasive fractional flow reserve (FFR). MATERIALS AND METHODS: PubMed and Cochrane Center Register of Controlled Trials from January 2010 searched through December 2014. Nine original studies were selected evaluating the diagnostic performance of CTP with and without CTA to invasive coronary angiography in evaluation of hemodynamic significance of coronary lesions (n = 951)...
September 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28917659/sonification-of-scalp-recorded-frequency-following-responses-ffrs-offers-improved-response-detection-over-conventional-statistical-metrics
#7
Gavin M Bidelman
BACKGROUND: The human frequency-following response (FFR) is a neurophonic potential used to examine the brain's encoding of complex sounds (e.g., speech) and monitor neuroplastic changes in auditory processing. Given the FFR's low amplitude (order of nanovolts), current conventions in literature recommend collecting several thousand trials to obtain a robust evoked response with adequate signal-to-noise ratio. NEW METHOD: By exploiting the spectrotemporal fidelity of the response, we examined whether auditory playbacks (i...
September 13, 2017: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/28916602/validation-study-of-image-based-fractional-flow-reserve-during-coronary-angiography
#8
Mariano Pellicano, Ifat Lavi, Bernard De Bruyne, Hana Vaknin-Assa, Abid Assali, Orna Valtzer, Yonit Lotringer, Giora Weisz, Yaron Almagor, Panagiotis Xaplanteris, Ajay J Kirtane, Pablo Codner, Martin B Leon, Ran Kornowski
BACKGROUND: Fractional flow reserve (FFR), an index of the hemodynamic severity of coronary stenoses, is derived from invasive measurements and requires a pressure-monitoring guidewire and hyperemic stimulus. Angiography-derived FFR measurements (FFRangio) may have several advantages. The aim of this study is to assess the diagnostic performance and interobserver reproducibility of FFRangio in patients with stable coronary artery disease. METHODS AND RESULTS: FFRangio is a computational method based on rapid flow analysis for the assessment of FFR...
September 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28902523/functional-assessment-of-lesion-severity-without-using-the-pressure-wire-coronary-imaging-and-blood-flow-simulation
#9
Michail I Papafaklis, Michail C Mavrogiannis, Panagiotis K Siogkas, Lampros S Lakkas, Christos S Katsouras, Dimitrios I Fotiadis, Lampros K Michalis
Hemodynamic indices derived from measurements with the pressure wire (primarily fractional flow reserve [FFR]) have been established as a reliable tool for assessing coronary stenoses and improving clinical decision making. However, the use of the pressure wire constitutes a hurdle for the universal adoption of physiology-guided patient management. Technological advancements have enabled the large-scale application of blood flow simulation (computational fluid dynamics [CFD]) to medical imaging, thereby enabling the virtual assessment of coronary physiology...
September 19, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28890684/neural-correlates-of-early-sound-encoding-and-their-relationship-to-speech-in-noise-perception
#10
Emily B J Coffey, Alexander M P Chepesiuk, Sibylle C Herholz, Sylvain Baillet, Robert J Zatorre
Speech-in-noise (SIN) perception is a complex cognitive skill that affects social, vocational, and educational activities. Poor SIN ability particularly affects young and elderly populations, yet varies considerably even among healthy young adults with normal hearing. Although SIN skills are known to be influenced by top-down processes that can selectively enhance lower-level sound representations, the complementary role of feed-forward mechanisms and their relationship to musical training is poorly understood...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28888873/comparison-of-regadenoson-and-nitroprusside-to-adenosine-for-measurement-of-fractional-flow-reserve-a-systematic-review-and-meta-analysis
#11
Justin Z Lee, Nirmal Singh, Iwan Nyotowidjojo, Carol Howe, See-Wei Low, Thach Nguyen, Duane Pinto, Gautam Kumar, Kwan S Lee
BACKGROUND: FFR is useful in defining the physiological significance of intermediate coronary stenosis and requires induction of maximal hyperemia and measurement of pressure proximal and distal to the stenosis. Hyperemia normally is induced by either IV or IC adenosine, a medication associated with short-term side effects. IV regadenoson and IC nitroprusside have been suggested as viable alternatives. This meta-analysis aims to identify all studies comparing use of intravenous (IV) regadenoson or intracoronary (IC) nitroprusside with IV adenosine to determine differences related to the agent utilized for assessment of fractional flow reserve (FFR)...
July 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28882237/the-evolving-future-of-instantaneous%C3%A2-wave-free-ratio-and-fractional-flow%C3%A2-reserve
#12
REVIEW
Matthias Götberg, Christopher M Cook, Sayan Sen, Sukhjinder Nijjer, Javier Escaned, Justin E Davies
In this review, the authors reflect upon the role of coronary physiology in the modern management of coronary artery disease. They critically appraise the scientific background of the instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR), from early experimental studies to validation studies against indexes of ischemia, to clinical trials assessing outcome. At this important juncture for the field, the authors make predictions for the future of physiological stenosis assessment, outlining developments for both iFR and FFR in new clinical domains beyond the confines of stable angina...
September 12, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28866449/fractional-flow-reserve-in-below-the-knee-arteries-with-critical-limb-ischemia-and-validation-against-gold-standard-morphologic-functional-measures-and-long-term-clinical-outcomes
#13
Zoltán Ruzsa, Szilárd Róna, Gábor G Tóth, Péter Sótonyi, Olivier F Bertrand, Balázs Nemes, Béla Merkely, Kálmán Hüttl
INTRODUCTION: The aim of this study was to assess the applicability of fractional flow reserve measurement (FFR) in below-the-knee (BTK) arteries and to evaluate its correlation with non-invasive functional parameters before and after angioplasty. METHODS: We enrolled 39 patients with severe BTK arterial lesions. Inclusion criteria were critical limb ischemia (Rutherford 4-6) and angiographically proven arterial stenosis of the distal lower limb (percent diameter stenosis ≥70%)...
July 18, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28864324/intracoronary-optical-coherence-tomography-derived-virtual-fractional-flow-reserve-for-the-assessment-of-coronary-artery-disease
#14
Fumiyasu Seike, Teruyoshi Uetani, Kazuhisa Nishimura, Hiroshi Kawakami, Haruhiko Higashi, Jun Aono, Takayuki Nagai, Katsuji Inoue, Jun Suzuki, Hideo Kawakami, Takafumi Okura, Kazunori Yasuda, Jitsuo Higaki, Shuntaro Ikeda
Fractional flow reserve (FFR) is widely used for the assessment of myocardial ischemia. Optical coherence tomography (OCT) provides accurate visualization of coronary artery morphology. The aim of this study was to investigate the relation between FFR and OCT-derived FFR. We retrospectively analyzed 31 lesions (25 left anterior descending arteries, 2 left circumflex arteries, and 4 right coronary arteries) in 31 patients with moderate-to-severe coronary stenosis, who underwent OCT and FFR measurements simultaneously...
August 8, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28862970/clinical-outcomes-of-deferred-lesions-with-angiographically-insignificant-stenosis-but-low-fractional-flow-reserve
#15
Joo Myung Lee, Bon-Kwon Koo, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Xinyang Hu, Fei Ye, Shaoliang Chen, Junqing Yang, Jiyan Chen, Nobuhiro Tanaka, Hiroyoshi Yokoi, Hitoshi Matsuo, Hiroaki Takashima, Yasutsugu Shiono, Doyeon Hwang, Jonghanne Park, Kyung-Jin Kim, Takashi Akasaka, Jianan Wang
BACKGROUND: Data are limited regarding outcomes of deferred lesions in patients with angiographically insignificant stenosis but low fractional flow reserve (FFR). We investigated the natural history of angiographically insignificant stenosis with low FFR among patients who underwent routine 3-vessel FFR measurement. METHODS AND RESULTS: From December 2011 to March 2014, 1136 patients with 3298 vessels underwent routine 3-vessel FFR measurement (3V FFR-FRIENDS study, ClinicalTrials...
August 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28855886/advanced-imaging-of-intracranial-atherosclerosis-lessons-from-interventional-cardiology
#16
Davor Pavlin-Premrl, Rahul Sharma, Bruce C V Campbell, J Mocco, Nicholas L Opie, Thomas J Oxley
Intracranial atherosclerosis is a major cause of ischemic stroke. Patients with a high degree of stenosis have a significant rate of stroke despite medical therapy. Two randomized trials of stenting have failed to show benefit. Improving periprocedural complication rates and patient selection may improve stenting outcomes. Fractional flow reserve (FFR), intravascular ultrasound (IVUS), and optical coherence tomography (OCT) are intravascular imaging techniques employed to improve patient selection and stent placement in interventional cardiology...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28853190/diagnostic-accuracy-of-instantaneous-wave-free-ratio-in-clinical-practice
#17
Wern Yew Ding, Satheesh Nair, Clare Appleby
AIMS: To evaluate the correlation between iFR and FFR in real-world clinical practice. METHODS AND RESULTS: Retrospective, single-centre study of 229 consecutive pressure-wire studies (np  = 158). Real-time iFR and FFR measurements were performed for angiographically borderline stenoses. Functionally significant stenoses were defined as iFR <0.86 or FFR ≤0.80. An iFR between 0.86 and 0.93 was considered within the grey zone (Hybrid approach). Median iFR and FFR (IQR) were 0...
August 29, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28851731/exploring-coronary-circulatory-response-to-stenosis-and-its-association-with-invasive-physiologic-indices-using-absolute-myocardial-blood-flow-and-coronary-pressure
#18
Joo Myung Lee, Doyeon Hwang, Jonghanne Park, Jinlong Zhang, Yaliang Tong, Chee Hae Kim, Ji-In Bang, Minseok Suh, Jin Chul Paeng, Gi Jeong Cheon, Bon-Kwon Koo
Background -Although invasive physiologic assessment for coronary stenosis has become a standard practice to guide treatment strategy, coronary circulatory response and changes in invasive physiologic indices, according to different anatomical and hemodynamic lesion severity, have not been fully demonstrated in patients with coronary artery disease. Methods -One hundred fifteen patients with left anterior descending artery stenosis who underwent both (13)N-ammonia positron emission tomography (PET) and invasive physiologic measurement were analyzed...
August 29, 2017: Circulation
https://www.readbyqxmd.com/read/28846545/physiologic-evaluation-of-coronary-lesions-using-instantaneous-wave-free-ratio-ifr-in-patients-with-severe-aortic-stenosis-undergoing-trans-catheter-aortic-valve-implantation
#19
Roberto Scarsini, Gabriele Pesarini, Carlo Zivelonghi, Anna Piccoli, Valeria Ferrero, Mattia Lunardi, Leonardo Gottin, Claudia Zanetti, Giuseppe Faggian, Flavio Ribichini
AIMS: We sought to assess eventual changes in iFR measurements in patients with aortic stenosis (AS) before and after TAVI in coronary lesions with different degree of angiographic severity. METHODS AND RESULTS: The functional relevance of 145 coronary lesions was assessed by on-line iFR and FFR measurement in 66 patients with severe AS before and after TAVI, during the same procedure. The iFR-FFR classification agreement was calculated for pre- and post-TAVI measurements...
August 29, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28845857/-fractional-flow-reserve-a-practical-guide-for-interventional-cardiologists-and-the-cardiologist-s-point-of-view
#20
Serafina Valente, Alessio Mattesini, Roberta Rossini, Sergio Berti, Carlotta Sorini Dini, Alessandro Politi, Luca Golino, Francesco Romeo, Giuseppe Musumeci, Gian Franco Gensini, Carlo Di Mario
Fractional flow reserve (FFR) is considered the gold standard for functional assessment of coronary stenosis in stable coronary artery disease. The use of FFR enables an ischemia-guided revascularization with improvement of clinical outcomes in a cost-effective fashion. Both clinical and interventional cardiologists should be aware of the advantages and potential pitfalls of this technique. We focus on FFR with the aim to provide the clinical cardiologist with information on indications and technical aspects to confirm a correct execution of FFR in different coronary anatomical settings...
September 2017: Giornale Italiano di Cardiologia
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