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https://www.readbyqxmd.com/read/28544741/diagnostic-accuracy-of-a-hybrid-approach-of-instantaneous-wave-free-ratio-and-fractional-flow-reserve-using-high-dose-intracoronary-adenosine-to-characterize-intermediate-coronary-lesions-results-of-the-pals-practical-assessment-of-lesion-severity-prospective
#1
Fernando Rivero, Javier Cuesta, Teresa Bastante, Amparo Benedicto, Marcos García-Guimaraes, Manuel Fuentes-Ferrer, Teresa Alvarado, Fernando Alfonso
OBJECTIVES: We sought to investigate the diagnostic accuracy of instantaneous wave-free ratio (iFR) and high-dose intracoronary adenosine fractional flow reserve (IC-FFR) compared with classical intravenous adenosine fractional flow reserve (IV-FFR) to assess coronary stenosis severity. The usefulness of two hybrid strategies combining iFR and high-dose IC-FFR was also evaluated. BACKGROUND: Physiological assessment of intermediate coronary stenoses to guide revascularization is currently recommended...
May 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28540210/integration-of-non-invasive-functional-assessments-with-anatomical-risk-stratification-in-complex-coronary-artery-disease-the-non-invasive-functional-syntax-score
#2
REVIEW
Carlos Collet, Yoshinobu Onuma, Yosuke Miyazaki, Marie-Angèle Morel, Patrick W Serruys
Since the early days of coronary angiography, the extension and severity of coronary artery disease (CAD) have been used for risk stratification. The SYNTAX score objectively characterizes CAD in patients with multivessel disease. Furthermore, recalculating the SYNTAX score by the incorporation of the functional component coronary stenosis (i.e., FFR) increases the discrimination for the risk of adverse events. The calculation of the SYNTAX score derived from non-invasive modalities such as coronary computed tomography angiography (CTA) has emerged as a mean to obtain the SYNTAX score before invasive cardiac catheterization...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28540209/myocardial-blood-flow-quantification-for-evaluation-of-coronary-artery-disease-by-computed-tomography
#3
REVIEW
Filippo Cademartiri, Sara Seitun, Alberto Clemente, Ludovico La Grutta, Patrizia Toia, Giuseppe Runza, Massimo Midiri, Erica Maffei
During the last decade coronary computed tomography angiography (CTA) has become the preeminent non-invasive imaging modality to detect coronary artery disease (CAD) with high accuracy. However, CTA has a limited value in assessing the hemodynamic significance of a given stenosis due to a modest specificity and positive predictive value. In recent years, different CT techniques for detecting myocardial ischemia have emerged, such as CT-derived fractional flow reserve (FFR-CT), transluminal attenuation gradient (TAG), and myocardial CT perfusion (CTP) imaging...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28540075/fractional-flow-reserve-to-guide-surgical-coronary-revascularization
#4
REVIEW
Tara Shah, Joshua D Geleris, Ming Zhong, Rajesh V Swaminathan, Luke K Kim, Dmitriy N Feldman
Coronary angiography has traditionally been used as the final diagnostic tool in the evaluation of coronary artery disease (CAD). However, conventional angiography identifies anatomically obstructive coronary disease, but it is limited in its ability to identify hemodynamically significant lesions. The emergence of fractional flow reserve (FFR) technology, in conjunction with angiography, offers a functional, as well as anatomic, assessment of epicardial coronary obstructions. Several pivotal studies have demonstrated that FFR-guided coronary revascularization is a safe and effective in patients with single and multivessel CAD...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28539573/identification-of-the-state-of-maximal-hyperemia-in-the-assessment-of-coronary-fractional-flow-reserve-using-non-invasive-electrical-velocimetry
#5
Takahide Murasawa, Masao Takahashi, Masahiro Myojo, Arihiro Kiyosue, Atsushi Oguri, Jiro Ando, Issei Komuro
Previous research revealed that, in patients with coronary pressure-derived fractional flow reserve (FFR) in the 'grey zone' (0.75-0.85), repeated FFR assessments sometimes yield conflicting results. One of the causes of the fluctuations in FFR values around the grey zone may be imprecise identification of the point where maximal hyperemia is achieved. Identification of the state of maximal hyperemia during assessment of FFR can be challenging. This study aimed to determine whether non-invasive electrical velocimetry (EV) can be used to identify the state of maximal hyperemia...
May 23, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28538960/diagnostic-accuracy-of-computed-tomography-derived-fractional-flow-reserve-a-systematic-review
#6
Christopher M Cook, Ricardo Petraco, Matthew J Shun-Shin, Yousif Ahmad, Sukhjinder Nijjer, Rasha Al-Lamee, Yuetsu Kikuta, Yasutsugu Shiono, Jamil Mayet, Darrel P Francis, Sayan Sen, Justin E Davies
Importance: Computed tomography-derived fractional flow reserve (FFR-CT) is a novel, noninvasive test for myocardial ischemia. Clinicians using FFR-CT must be able to interpret individual FFR-CT results to determine subsequent patient care. Objective: To provide clinicians a means of interpreting individual FFR-CT results with respect to the range of invasive FFRs that this interpretation might likely represent. Evidence Review: We performed a systematic review in accordance with guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses...
May 24, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28536897/validation-of-myocardial-perfusion-quantification-by-dynamic-ct-in-an-ex-vivo-porcine-heart-model
#7
Gert Jan Pelgrim, Marco Das, Sjoerd van Tuijl, Marly van Assen, Frits W Prinzen, Marco Stijnen, Matthijs Oudkerk, Joachim E Wildberger, Rozemarijn Vliegenthart
To test the accuracy of quantification of myocardial perfusion imaging (MPI) using computed tomography (CT) in ex-vivo porcine models. Five isolated porcine hearts were perfused according to Langendorff. Hearts were perfused using retrograde flow through the aorta and blood flow, blood pressure and heart rate were monitored throughout the experiment. An inflatable cuff was placed around the circumflex (Cx) artery to create stenosis grades which were monitored using a pressure wire, analysing perfusion at several fractional flow reserve values of 1...
May 23, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28522372/effective-antimicrobial-activity-of-a-peptide-mutant-cbf-14-2-against-penicillin-resistant-bacteria-based-on-its-unnatural-amino-acids
#8
Wei Kang, Hanhan Liu, Lingman Ma, Mengxiao Wang, Shanshan Wei, Pengbo Sun, Meiling Jiang, Min Guo, Changlin Zhou, Jie Dou
Broad spectrum activities, a unique mode of actions and rare resistant variants make antimicrobial peptide (AMP) a potential alternative to antibiotics. However, AMPs still have limitations in clinical development due to their physiological stability, toxicity and manufacturing costs. Cbf-14, derived from cathelicidin-BF has been proven to be effective against drug-resistant bacteria. Herein, a series of Cbf-14 mutants were designed to overcome these limitations. Design strategies included substitutions of lysine (Lys) or leucine (Leu) with similar residues such as ornithine (Orn) and norleucine (Ile), which are unnatural amino acids, to generate AMPs with enhanced therapeutic potential...
May 15, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28521932/discordance-between-fractional-flow-reserve-and-coronary-flow-reserve-insights-from-intracoronary-imaging-and-physiological%C3%A2-assessment
#9
Sung Gyun Ahn, Jon Suh, Olivia Y Hung, Hee Su Lee, Yasir H Bouchi, Wenjie Zeng, Rounak Gandhi, Parham Eshtehardi, Bill D Gogas, Habib Samady
OBJECTIVES: The aim of this study was to investigate the epicardial and microvascular substrates associated with discordances between fractional flow reserve (FFR) and coronary flow reserve (CFR) values. BACKGROUND: Discordances between FFR and CFR remain poorly characterized. METHODS: FFR, hyperemic stenosis resistance (HSR), and intravascular ultrasound were performed as indexes of epicardial function and CFR and hyperemic microvascular resistance (HMR) as measures of microvascular function in 94 patients with moderate coronary stenosis...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28514756/elevated-crp-levels-predict-poor-outcome-and-tumor-recurrence-in-patients-with-thymic-epithelial-tumors-a-pro-and-retrospective-analysis
#10
Stefan Janik, Christine Bekos, Philipp Hacker, Thomas Raunegger, Bahil Ghanim, Elisa Einwallner, Lucian Beer, Walter Klepetko, Leonhard Müllauer, Hendrik J Ankersmit, Bernhard Moser
OBJECTIVE: Scarce information exists on the pathogenesis of thymic epithelial tumors (TETs), comprising thymomas, thymic carcinomas (TCs) and neuroendocrine tumors. C-reactive protein (CRP) increases during certain malignancies. We aimed to investigate the clinical relevance of CRP in patients with TETs. RESULTS: Pretreatment CRP serum concentrations were significantly elevated in patients with TETs, particularly TCs and metastatic TETs. After complete tumor resection CRP serum concentrations were decreased (p = 0...
April 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28514327/postoperative-assessment-of-myocardial-function-and-microcirculation-in-patients-with-acute-coronary-syndrome-by-myocardial-contrast-echocardiography
#11
Li Jiang, Hong Yao, Zhao-Guang Liang
BACKGROUND Postoperative myocardial function and microcirculation of acute coronary syndrome (ACS) was assessed by myocardial contrast echocardiography (MCE). MATERIAL AND METHODS Eighty-nine ACS patients treated with percutaneous coronary intervention (PCI) were detected by MCE and two-dimensional ultrasonography before and a month later after PCI respectively. Their myocardial perfusion was evaluated by myocardial contrast score (MSC) and contrast score index (CSI); cross-sectional area of microvessel (A), average myocardial microvascular impairment (β), and myocardial blood flow (MBF) were analyzed by cardiac ultrasound quantitative analysis (CUSQ), and fractional flow reserve (FFR) change was observed...
May 17, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28506646/virtual-resting-pd-pa-from-coronary-angiography-and-blood-flow-modelling-diagnostic-performance-against-fractional-flow-reserve
#12
Michail I Papafaklis, Takashi Muramatsu, Yuki Ishibashi, Christos V Bourantas, Dimitrios I Fotiadis, Emmanouil S Brilakis, Héctor M Garcia-Garcia, Javier Escaned, Patrick W Serruys, Lampros K Michalis
BACKGROUND: Fractional flow reserve (FFR) has been established as a useful diagnostic tool. The distal coronary pressure to aortic pressure (Pd/Pa) ratio at rest is a simpler physiologic index but also requires the use of the pressure wire, whereas recently proposed virtual functional indices derived from coronary imaging require complex blood flow modelling and/or are time-consuming. Our aim was to test the diagnostic performance of virtual resting Pd/Pa using routine angiographic images and a simple flow model...
May 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28504223/belgium-coronary-and-structural-heart-interventions-from-2010-to-2015
#13
Walter Desmet, Adel Aminian, Joëlle Kefer, Joseph Dens, Johan Bosmans, Marc Claeys, Christophe Dubois, Olivier Gach, Luc Janssens, Erwin Schroeder, Paul Vermeersch, Marc Carlier, Edouard Benit, Claude Hanet
In a ranking of the gross domestic product per capita in 2015, Belgium ranked 19th in the world according to the International Monetary Fun1d and the World Bank. It has a Human Development Index of 0.890, in which it is preceded by only 20 other countries in the world. This is, at least in part, due to a well-developed social security system on which all citizens can rely. Over the last 5-10 years, however, this system has come under increasing pressure. This has resulted in insufficient, incomplete and late reimbursement of all technologies that were introduced over the last ten years in the cathlab: intracoronary imaging techniques are not reimbursed at all, and FFR only to a vastly insufficient degree...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28489064/an-interference-mitigation-scheme-of-device-to-device-communications-for-sensor-networks-underlying-lte-a
#14
Jeehyeong Kim, Nzabanita Abdoul Karim, Sunghyun Cho
Device-to-Device (D2D) communication technology has become a key factor in wireless sensor networks to form autonomous communication links among sensor nodes. Many research results for D2D have been presented to resolve different technical issues of D2D. Nevertheless, the previous works have not resolved the shortage of data rate and limited coverage of wireless sensor networks. Due to bandwidth shortages and limited communication coverage, 3rd Generation Partnership Project (3GPP) has introduced a new Device-to-Device (D2D) communication technique underlying cellular networks, which can improve spectral efficiencies by enabling the direct communication of devices in proximity without passing through enhanced-NodeB (eNB)...
May 10, 2017: Sensors
https://www.readbyqxmd.com/read/28483203/correlation-between-angiographic-and-physiologic-evaluation-of-coronary-artery-narrowings-in-patients-with-aortic-valve-stenosis
#15
Giuseppe Di Gioia, Roberto Scarsini, Teresa Strisciuglio, Chiara De Biase, Carlo Zivelonghi, Danilo Franco, Bernard De Bruyne, Flavio Ribichini, Emanuele Barbato
We aimed to assess the correlation between angiographic and physiologic evaluation of coronary lesions in aortic stenosis (AS) patients presenting with intermediate coronary stenoses at the angiography. From 2002 to 2010, we included 163 patients from 2 centers with both AS and coronary artery disease (CAD), matched by age and gender with 163 contemporary patients with CAD alone. With both quantitative coronary angiography and fractional flow reserve (FFR), we assessed 259 coronary stenoses in the AS + CAD group, and 256 in the CAD alone group...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28479466/perioperative-and-late-outcomes-after-endovascular-treatment-for-isolated-iliac-artery-aneurysms
#16
Claudio Bianchini Massoni, Antonio Freyrie, Mauro Gargiulo, Tiziano Tecchio, Chiara Mascoli, Enrico Gallitto, Gianluca Faggioli, Rodolfo Pini, Matteo Azzarone, Paolo Perini, Andrea Stella
AIM: The aim of the study was to report early and follow-up outcomes of the endovascular treatment with iliac endografts for isolated iliac artery aneurysms (IIAA). METHODS: Records of patients who underwent elective endovascular repair for isolated iliac artery aneurysms (both primary and para-anastomotic) from 2005 to 2015 in two Italian centres were retrospectively examined. Demographics data, preoperative patient comorbidities, iliac aneurysm characteristics, contralateral iliac axis involvement, patency of hypogastric arteries and inferior mesenteric artery (IMA) and data of endovascular treatment were obtained for analysis...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28475383/fractional-flow-reserve-in-2017-current-data-and-everyday-practice
#17
J J Coughlan, Colin MacDonnell, Samer Arnous, Thomas J Kiernan
Fractional Flow Reserve (FFR) is an objective physiological index utilized in coronary angiography. It expresses the blood flow in the presence of a coronary artery stenosis as a fraction of the normal blood flow and gives information regarding the functional significance of the lesion. FFR guided percutaneous coronary intervention (PCI) has been shown to be superior to angiography guided PCI in several trials and registries. In addition, it appears that the use of FFR may also be preferable from an economic perspective...
May 5, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28456699/cutoff-value-and-long-term-prediction-of%C3%A2-clinical-events-by-ffr-measured-immediately-after-implantation-of-a-drug-eluting-stent-in-patients-with-coronary-artery-disease-1-to-3-year-results-from-the-dkcrush-vii-registry-study
#18
Sui-Ji Li, Zhen Ge, Jing Kan, Jun-Jie Zhang, Fei Ye, Tak W Kwan, Teguh Santoso, Song Yang, Imad Sheiban, Xue-Song Qian, Nai-Liang Tian, Tanveer S Rab, Ling Tao, Shao-Liang Chen
OBJECTIVES: This study aimed to investigate the cutoff of post-drug-eluting stent (DES) fractional flow reserve (FFR) for prediction of 1- to 3-year target vessel failure (TVF). BACKGROUND: FFR immediately after a DES implantation correlates with clinical events. However, the cutoff of post-DES FFR for predicting long-term clinical events remains understudied. METHODS: Between May 2012 and September 2013, a total of 1,476 patients who had FFR <0...
April 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28454829/design-and-rationale-of-the-compare-acute-trial-fractional-flow-reserve-guided-primary-multivessel-percutaneous-coronary-intervention-to-improve-guideline-indexed-actual-standard-of-care-for-treatment-of-st-elevation-myocardial-infarction-in-patients-with-multivessel
#19
Pieter C Smits, Amira Assaf, Gert Richardt, Elmir Omerovic, Mohamed Abdel-Wahab, Franz-Joseph Neumann
What the best strategy is for nonculprit lesions in ST-elevation myocardial infarction (STEMI) patients presenting with multivessel disease remains a clinical dilemma. Based on recent clinical studies suggesting that complete revascularization in the acute phase is beneficial, the European Society of Cardiology and American College of Cardiology/American Heart Association guidelines have been recently changed from class 3 discouragement to a class 2B recommendation concerning the treatment of the nonculprit lesions in the acute index procedure...
April 2017: American Heart Journal
https://www.readbyqxmd.com/read/28454806/assessing-micro-vascular-resistances-via-imr-to-predict-outcome-in-stemi-patients-with-multivessel-disease-undergoing-primary-pci-amicro-rationale-and-design-of-a-prospective-multicenter-clinical-trial
#20
Massimo Fineschi, Edoardo Verna, Giuseppe Mezzapelle, Davide Bartolini, Giovanni Turiano, Antonio Manari, Katia Lucarelli, Lucia Uguccioni, Alessandra Repetto, Giuseppe Tarantini
BACKGROUND: In STEMI patients treated with primary percutaneous coronary angioplasty (PPCI) the evaluation of coronary microcirculatory resistance index (IMR) predict the extent of microvascular damage and left ventricular (LV) remodeling. However, the impact of IMR on the clinical outcome after PPCI in patients with multivessel disease (MVD) remains unsettled. AIM: We designed a prospective multicenter controlled clinical trial to evaluate the prognostic value of IMR in terms of clinical outcome and left ventricular remodeling in STEMI patients with MVD undergoing PPCI...
May 2017: American Heart Journal
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