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https://www.readbyqxmd.com/read/28318875/feasibility-of-pet-for-the-management-of-coronary-artery-disease-comparison-between-cfr-and-ffr
#1
REVIEW
Osamu Manabe, Masanao Naya, Nagara Tamaki
Myocardial perfusion imaging using positron emission tomography (PET) allows both qualitative and quantitative measurement. The quantitative myocardial blood flow and coronary flow reserve (CFR) are reliable indices for evaluating functional severity, influenced by both epicardial stenosis and microvascular disease. Fractional flow reserve (FFR) also reflects physiological stenosis, which measures the pressure differences across a coronary artery stenosis during maximum hyperemia. Discordance between CFR and FFR has been noticed in estimating the functional significance of coronary stenosis...
March 16, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28318655/coronary-artery-stenoses-more-often-overestimated-in-older-patients-angiographic-stenosis-overestimation-in-elderly
#2
Nanette M Borren, Jan Paul Ottervanger, Martijn A Reinders, Elvin Kedhi
BACKGROUND: Angiographic overestimation of coronary artery stenosis severity may result in unnecessary revascularization and is possibly more prevalent with increasing age. AIM: To identify whether age is an independent clinical predictor for angiographic overestimation of a coronary artery stenosis. METHODS: Fractional flow reserve (FFR) of 335 coronary lesions was performed in 260 consecutive patients with stable coronary artery disease (CAD)...
February 28, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28317458/use-of-the-instantaneous-wave-free-ratio-or-fractional-flow-reserve-in-pci
#3
Justin E Davies, Sayan Sen, Hakim-Moulay Dehbi, Rasha Al-Lamee, Ricardo Petraco, Sukhjinder S Nijjer, Ravinay Bhindi, Sam J Lehman, Darren Walters, James Sapontis, Luc Janssens, Christiaan J Vrints, Ahmed Khashaba, Mika Laine, Eric Van Belle, Florian Krackhardt, Waldemar Bojara, Olaf Going, Tobias Härle, Ciro Indolfi, Giampaolo Niccoli, Flavo Ribichini, Nobuhiro Tanaka, Hiroyoshi Yokoi, Hiroaki Takashima, Yuetsu Kikuta, Andrejs Erglis, Hugo Vinhas, Pedro Canas Silva, Sérgio B Baptista, Ali Alghamdi, Farrel Hellig, Bon-Kwon Koo, Chang-Wook Nam, Eun-Seok Shin, Joon-Hyung Doh, Salvatore Brugaletta, Eduardo Alegria-Barrero, Martijin Meuwissen, Jan J Piek, Niels van Royen, Murat Sezer, Carlo Di Mario, Robert T Gerber, Iqbal S Malik, Andrew S P Sharp, Suneel Talwar, Kare Tang, Habib Samady, John Altman, Arnold H Seto, Jasvindar Singh, Allen Jeremias, Hitoshi Matsuo, Rajesh K Kharbanda, Manesh R Patel, Patrick Serruys, Javier Escaned
Background Coronary revascularization guided by fractional flow reserve (FFR) is associated with better patient outcomes after the procedure than revascularization guided by angiography alone. It is unknown whether the instantaneous wave-free ratio (iFR), an alternative measure that does not require the administration of adenosine, will offer benefits similar to those of FFR. Methods We randomly assigned 2492 patients with coronary artery disease, in a 1:1 ratio, to undergo either iFR-guided or FFR-guided coronary revascularization...
March 18, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28317438/instantaneous-wave-free-ratio-versus-fractional-flow-reserve-to-guide-pci
#4
Matthias Götberg, Evald H Christiansen, Ingibjörg J Gudmundsdottir, Lennart Sandhall, Mikael Danielewicz, Lars Jakobsen, Sven-Erik Olsson, Patrik Öhagen, Hans Olsson, Elmir Omerovic, Fredrik Calais, Pontus Lindroos, Michael Maeng, Tim Tödt, Dimitrios Venetsanos, Stefan K James, Amra Kåregren, Margareta Nilsson, Jörg Carlsson, Dario Hauer, Jens Jensen, Ann-Charlotte Karlsson, Georgios Panayi, David Erlinge, Ole Fröbert
Background The instantaneous wave-free ratio (iFR) is an index used to assess the severity of coronary-artery stenosis. The index has been tested against fractional flow reserve (FFR) in small trials, and the two measures have been found to have similar diagnostic accuracy. However, studies of clinical outcomes associated with the use of iFR are lacking. We aimed to evaluate whether iFR is noninferior to FFR with respect to the rate of subsequent major adverse cardiac events. Methods We conducted a multicenter, randomized, controlled, open-label clinical trial using the Swedish Coronary Angiography and Angioplasty Registry for enrollment...
March 18, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28317428/fractional-flow-reserve-guided-multivessel-angioplasty-in-myocardial-infarction
#5
Pieter C Smits, Mohamed Abdel-Wahab, Franz-Josef Neumann, Bianca M Boxma-de Klerk, Ketil Lunde, Carl E Schotborgh, Zsolt Piroth, David Horak, Adrian Wlodarczak, Paul J Ong, Rainer Hambrecht, Oskar Angerås, Gert Richardt, Elmir Omerovic
Background In patients with ST-segment elevation myocardial infarction (STEMI), the use of percutaneous coronary intervention (PCI) to restore blood flow in an infarct-related coronary artery improves outcomes. The use of PCI in non-infarct-related coronary arteries remains controversial. Methods We randomly assigned 885 patients with STEMI and multivessel disease who had undergone primary PCI of an infarct-related coronary artery in a 1:2 ratio to undergo complete revascularization of non-infarct-related coronary arteries guided by fractional flow reserve (FFR) (295 patients) or to undergo no revascularization of non-infarct-related coronary arteries (590 patients)...
March 18, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28303683/factors-associated-with-deferred-lesion-failure-following-fractional-flow-reserve-assessment-in-patients-with-diabetes-mellitus
#6
Mark W Kennedy, Enrico Fabris, Renicus S Hermanides, Emel Kaplan, Nanette Borren, Balazs Berta, Petra C Koopmans, Jan Paul Ottervanger, Harry Suryapranata, Elvin Kedhi
OBJECTIVE: To explore the predictors of deferred lesion failure (DLF) in patients with diabetes mellitus (DM) and lesions with a fractional flow reserve (FFR) >0.80 and to examine whether a predictive relationship between negative FFR values (>0.80-1.00) and DLF exists. BACKGROUND: DM is associated with rapidly progressive atherosclerosis and predictors of DLF in FFR negative lesions in this high-risk group are unknown. METHODS: All DM patients who underwent FFR-assessment between 1/01/2010 and 31/12/2013 were included, and followed until 1/7/2015...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28303473/incremental-role-of-resting-myocardial-computed-tomography-perfusion-for-predicting-physiologically-significant-coronary-artery-disease-a-machine-learning-approach
#7
Donghee Han, Ji Hyun Lee, Asim Rizvi, Heidi Gransar, Lohendran Baskaran, Joshua Schulman-Marcus, Bríain Ó Hartaigh, Fay Y Lin, James K Min
BACKGROUND: Evaluation of resting myocardial computed tomography perfusion (CTP) by coronary CT angiography (CCTA) might serve as a useful addition for determining coronary artery disease. We aimed to evaluate the incremental benefit of resting CTP over coronary stenosis for predicting ischemia using a computational algorithm trained by machine learning methods. METHODS: 252 patients underwent CCTA and invasive fractional flow reserve (FFR). CT stenosis was classified as 0%, 1-30%, 31-49%, 50-70%, and >70% maximal stenosis...
March 16, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28296167/what-can-intracoronary-pressure-measurements-tell-us-about-flow-reserve-pressure-bounded-coronary-flow-reserve-and-example-application-to-the-randomized-defer-trial
#8
Frederik M Zimmermann, Nico H J Pijls, Bernard De Bruyne, G Jan-Willem Bech, Pepijn van Schaardenburgh, Richard L Kirkeeide, K Lance Gould, Nils P Johnson
OBJECTIVE: We propose a novel technique called pressure-bounded coronary flow reserve (pb-CFR) and demonstrate its application to the randomized DEFER trial. BACKGROUND: Intracoronary flow reserve assessment remains underutilized relative to pressure measurements partly due to less robust tools. METHODS: While rest and hyperemic intracoronary pressure measurements cannot quantify CFR exactly, they do provide upper and lower bounds. We validated pb-CFR invasively against traditional CFR, then applied it to high fractional flow reserve (FFR ≥ 0...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28291726/change-in-angiogram-derived-management-strategy-of-patients-with-chest-pain-when-some-ffr-data-are-available-how-consistent-is-the-effect
#9
Vinayak Nagaraja, Mamas Mamas, Michael Mahmoudi, Campbell Rogers, Nick Curzen
BACKGROUND: The assessment of patients presenting with angina using invasive angiography alone is imperfect. By contrast, fractional flow reserve (FFR) allows for assessment of lesion-specific ischemia, which is predictive of clinical outcome. A series of studies has demonstrated that the availability of FFR data at the time of diagnostic angiography leads to significant differences in the management of those patients. HYPOTHESIS: The objective of this paper is to describe assess the consistency in the difference in management resulting from an FFR-directed versus and angiogram-directed strategy in appropriate observational and randomized trials...
February 27, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28281728/comparison-between-fractional-flow-reserve-and-visual-assessment-for-moderate-coronary-artery-stenosis
#10
Bilge Duran Karaduman, Murat Akçay, Hüseyin Ayhan, Hacı Ahmet Kasapkara, Murat Can Güney, Tahir Durmaz, Telat Keleş, Nihal Akar Bayram, Emine Bilen, Engin Bozkurt
BACKGROUND: 'Fractional flow reserve (FFR)' is an interventional diagnostic method based on intracoronary pressure measurement used for the assessment of the severity of coronary artery stenoses. Our study aimed to compare visual measurements made by multiple observers with fractional flow reserve measurement in the assessment of angiographically moderate coronary artery stenosis. METHODS: The angiographic images of moderate coronary artery lesions 359 patients enrolled in the study that had interpreted independently by three interventional cardiologists assigned as observers (O1, O2, O3)...
March 10, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28281238/practical-considerations-of-fractional-flow-reserve-utilization-to-guide-revascularization
#11
REVIEW
Tara Shah, Joshua D Geleris, Joshua Schulman-Marcus, Dmitriy N Feldman, Rajesh V Swaminathan
Invasive angiography has long been the gold standard for the diagnosis of obstructive coronary artery disease (CAD). However, the relationship between angiographic measures of stenosis and coronary blood flow is complex, and there is frequent discordance between the visual assessment of a stenotic lesion and its effect on myocardial perfusion. Fractional flow reserve is a rapidly emerging invasive means of assessing the physiologic significance of an epicardial stenosis. This review provides a pragmatic understanding of the physiologic principles that guide fractional flow reserve (FFR), sheds light on its nuances, and explores the most landmark investigations...
February 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28279401/dense-calcium-and-lesion-specific-ischemia-a-comparison-of-ccta-with-fractional-flow-reserve
#12
Lohendran Baskaran, Bríain Ó Hartaigh, Joshua Schulman-Marcus, Heidi Gransar, Fay Lin, James K Min
BACKGROUND AND AIMS: Studies evaluating the relationship between dense coronary calcium (DC) and myocardial ischemia have had incongruent results. We sought to clarify whether DC, as detected by computed coronary tomographic angiography (CCTA), is an independent predictor of ischemia as measured by invasive fractional flow reserve (FFR). METHODS: In total, 249 (399 lesions) stable patients undergoing CCTA and invasive FFR were enrolled for this post-hoc analysis...
February 24, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28265791/a-systematic-review-of-imaging-anatomy-in-predicting-functional-significance-of-coronary-stenoses-determined-by-fractional-flow-reserve
#13
Miao Chu, Neng Dai, Junqing Yang, Jelmer Westra, Shengxian Tu
Fractional flow reserve (FFR) is the current gold standard to assess the physiological significance of coronary stenoses. With the development of coronary imaging techniques, several anatomic parameters have been investigated in vivo and their associations with FFR have been studied. The aim of this review is to summarize the accuracy of anatomic parameters derived by the present coronary imaging techniques including invasive coronary angiography, coronary computed tomography angiography, intravascular ultrasound and optical coherence tomography, in predicting a significant FFR...
March 6, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28259798/basic-neural-processing-of-sound-in-adults-is-influenced-by-bilingual-experience
#14
Erika Skoe, Emily Burakiewicz, Michael Figueiredo, Margaret Hardin
The central auditory nervous system (CANS) undergoes language-dependent tuning to enhance linguistically relevant features of sound. However, less is known about how dual-language exposure affects the CANS. Recent reports indicate that Spanish-English bilingual children and adolescents have larger neural responses to the fundamental frequency (F0) of vowels, as measured by the frequency-following response (FFR), a phase-locked response to sound. Given the cross-language significance of F0, this led us to hypothesize that enhanced neural responses to the F0 are not unique to Spanish-English bilingual children and adolescents but are instead a common feature of a CANS with significant early dual language experience...
March 1, 2017: Neuroscience
https://www.readbyqxmd.com/read/28259668/anatomic-myocardial-volume-index-by%C3%A2-ct%C3%A2-versus-physiological-index-by-ffr%C3%A2-angiography-between-the-main-vessel-and%C3%A2-side-branch
#15
EDITORIAL
Yukio Ozaki
No abstract text is available yet for this article.
February 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28259665/identification-of-coronary-artery-side-branch-supplying-myocardial-mass-that-may-benefit-from-revascularization
#16
Hyung Yoon Kim, Joon-Hyung Doh, Hong-Seok Lim, Chang-Wook Nam, Eun-Seok Shin, Bon-Kwon Koo, Joo Myung Lee, Taek Kyu Park, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Seung Hyuk Choi, Hyeon-Cheol Gwon, Sang-Hoon Lee, Sung Mok Kim, Yeonhyeon Choe, Jin-Ho Choi
OBJECTIVES: The authors sought to identify whether a coronary side branch (SB) is supplying a myocardial mass that may benefit from revascularization. BACKGROUND: The amount of subtending myocardium and physiological stenosis is frequently different between the main vessel (MV) and SB. METHODS: In this multicenter registry, 482 patients who underwent coronary computed tomography angiography and fractional flow reserve (FFR) measurement were enrolled...
February 25, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28254512/electrocorticographic-delineation-of-human-auditory-cortical-fields-based-on-effects-of-propofol-anesthesia
#17
Kirill V Nourski, Matthew I Banks, Mitchell Steinschneider, Ariane E Rhone, Hiroto Kawasaki, Rashmi N Mueller, Michael M Todd, Matthew A Howard
The functional organization of human auditory cortex remains incompletely characterized. While the posteromedial two thirds of Heschl's gyrus (HG) is generally considered to be part of core auditory cortex, additional subdivisions of HG remain speculative. To further delineate the hierarchical organization of human auditory cortex, we investigated regional heterogeneity in the modulation of auditory cortical responses under varying depths of anesthesia induced by propofol. Non-invasive studies have shown that propofol differentially affects auditory cortical activity, with a greater impact on non-core areas...
February 27, 2017: NeuroImage
https://www.readbyqxmd.com/read/28237533/differential-sensitivity-to-changes-in-pitch-acceleration-in-the-auditory-brainstem-and-cortex
#18
Ananthanarayan Krishnan, Chandan H Suresh, Jackson T Gandour
The cortical pitch-specific response (CPR) is differentially sensitive to pitch contours varying in rate of acceleration-time-variant Mandarin Tone2 (T2) versus constant, linear rising ramp (Linear)-as a function of language experience (Krishnan, Gandour, & Suresh, 2014). CPR and brainstem frequency following response (FFR) data were recorded concurrently from native Mandarin listeners using the same stimuli. Results showed that T2 elicited larger responses than Linear at both cortical and brainstem levels (CPR: Na-Pb, Pb-Nb; FFR)...
February 23, 2017: Brain and Language
https://www.readbyqxmd.com/read/28220273/numerical-and-experimental-investigations-of-the-flow-pressure-relation-in-multiple-sequential-stenoses-coronary-artery
#19
S Li, Cheng Chin, Vikas Thondapu, Eric K W Poon, Jason P Monty, Yingguang Li, Andrew S H Ooi, Shengxian Tu, Peter Barlis
Virtual fractional flow reserve (vFFR) has been evaluated as an adjunct to invasive fractional flow reserve (FFR) in the light of its operational and economic benefits. The accuracy of vFFR and the complexity of hyperemic flow simulation are still not clearly understood. This study investigates the flow-pressure relation in an idealised multiple sequential stenoses coronary artery model via numerical and experimental approaches. Pressure drop is linearly correlated with flow rate irrespective of the number of stenosis...
February 20, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28214966/anomalous-coronary-arteries-and-myocardial-bridges-risk-stratification-in-children-using-novel-cardiac-catheterization-techniques
#20
Hitesh Agrawal, Silvana Molossi, Mahboob Alam, S Kristen Sexson-Tejtel, Carlos M Mery, E Dean McKenzie, Charles D Fraser, Athar M Qureshi
The evaluation of the vast majority of children with anomalous aortic origin of a coronary artery (AAOCA) and/or myocardial bridges is performed with non-invasive testing. However, a subset of these patients may benefit from invasive testing for risk stratification. All patients included in the Coronary Anomalies Program (CAP) at Texas Children's Hospital who underwent cardiac catheterization were included. Techniques included selective coronary angiograms (SCA), intravascular ultrasound (IVUS), and fractional flow reserve (FFR) measurements with provocative testing using adenosine and/or dobutamine infusions...
February 18, 2017: Pediatric Cardiology
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