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Coronary physiology

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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
#1
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
#2
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/29769168/pressure-wire-compared-to-microcatheter-sensing-for-coronary-fractional-flow-reserve-the-perform-study
#3
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
#4
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/29764841/genetic-targeting-of-organ-specific-blood-vessels
#5
Wenjuan Pu, Lingjuan He, Ximeng Han, Xueying Tian, Yan Li, Hui Zhang, Qiaozhen Liu, Xiuzhen Huang, Libo Zhang, Qing-Dong Wang, Zhenyang Yu, Xiao Yang, Nicola Smart, Bin Zhou
<u>Rationale:</u> Organs of the body require vascular networks to supply oxygen and nutrients and maintain physiological function. The blood vessels of different organs are structurally and functionally heterogeneous in nature. To more precisely dissect their distinct in vivo function in individual organs, without potential interference from off-site targets, it is necessary to genetically target them in an organ-specific manner. <u>Objective:</u> To generate a genetic system that targets vascular endothelial cells in an organ- or tissue- specific manner and to exemplify the potential application of intersectional genetics for precise, target-specific gene manipulation in vivo...
May 15, 2018: Circulation Research
https://www.readbyqxmd.com/read/29755221/effect-of-6-months-of-meditation-on-blood-sugar-glycosylated-hemoglobin-and-insulin-levels-in-patients-of-coronary-artery-disease
#6
Shashank Shekhar Sinha, Ajay Kumar Jain, Sanjay Tyagi, S K Gupta, Aarti Sood Mahajan
Background and Objectives: Coronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide. It has been recognized that stress, diabetes, and hypertension are important in etiology and progression of CAD. This study is to evaluate the role of meditation in improving biochemical parameters such as blood glucose, glycosylated hemoglobin, and serum insulin levels in known CAD patients. Material and Methods: Sixty CAD patients are divided into two groups of which one group did meditation and other did not...
May 2018: International Journal of Yoga
https://www.readbyqxmd.com/read/29754806/machine-learning-in-cardiac-ct-basic-concepts-and-contemporary-data
#7
REVIEW
Gurpreet Singh, Subhi J Al'Aref, Marly Van Assen, Timothy Suyong Kim, Alexander van Rosendael, Kranthi K Kolli, Aeshita Dwivedi, Gabriel Maliakal, Mohit Pandey, Jing Wang, Virginie Do, Manasa Gummalla, Carlo N De Cecco, James K Min
Propelled by the synergy of the groundbreaking advancements in the ability to analyze high-dimensional datasets and the increasing availability of imaging and clinical data, machine learning (ML) is poised to transform the practice of cardiovascular medicine. Owing to the growing body of literature validating both the diagnostic performance as well as the prognostic implications of anatomic and physiologic findings, coronary computed tomography angiography (CCTA) is now a well-established non-invasive modality for the assessment of cardiovascular disease...
April 30, 2018: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29754388/consumption-of-probiotic-lactobacillus-fermentum-mtcc-5898-fermented-milk-attenuates-dyslipidemia-oxidative-stress-and-inflammation-in-male-rats-fed-on-cholesterol-enriched-diet
#8
Radha Yadav, Suhail Hakeem Khan, Sanusi Bello Mada, Sunita Meena, Rajeev Kapila, Suman Kapila
There is a growing and alarming prevalence that increased serum cholesterol is closely related to increased cardiovascular disease risk. Probiotic consumption could be a safe and natural strategy to combat. Therefore, we sought to examine the cholesterol-lowering potential of co-supplementation of probiotic bacteria Lactobacillus fermentum MTCC: 5898-fermented buffalo milk (2.5% fat) in rats fed cholesterol-enriched diet. Male Wistar rats were divided into three groups on the basis of feed, viz. group 1, fed standard diet (SD); group 2, fed cholesterol-enriched diet (CED); and group 3, fed cholesterol-enriched diet along with L...
May 13, 2018: Probiotics and Antimicrobial Proteins
https://www.readbyqxmd.com/read/29754161/motion-corrected-whole-heart-pet-mr-for-the-simultaneous-visualisation-of-coronary-artery-integrity-and-myocardial-viability-an-initial-clinical-validation
#9
Camila Munoz, Karl P Kunze, Radhouene Neji, Teresa Vitadello, Christoph Rischpler, René M Botnar, Stephan G Nekolla, Claudia Prieto
PURPOSE: Cardiac PET-MR has shown potential for the comprehensive assessment of coronary heart disease. However, image degradation due to physiological motion remains a challenge that could hinder the adoption of this technology in clinical practice. The purpose of this study was to validate a recently proposed respiratory motion-corrected PET-MR framework for the simultaneous visualisation of myocardial viability (18 F-FDG PET) and coronary artery anatomy (coronary MR angiography, CMRA) in patients with chronic total occlusion (CTO)...
May 12, 2018: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29748585/humanizing-miniature-hearts-through-4-flow-cannulation-perfusion-decellularization-and-recellularization
#10
Duong T Nguyen, Matthew O'Hara, Cecilia Graneli, Ryan Hicks, Tasso Miliotis, Ann-Christin Nyström, Sara Hansson, Pia Davidsson, Li-Ming Gan, Maria Chiara Magnone, Magnus Althage, Sepideh Heydarkhan-Hagvall
Despite improvements in pre-clinical drug testing models, predictability of clinical outcomes continues to be inadequate and costly due to poor evidence of drug metabolism. Humanized miniature organs integrating decellularized rodent organs with tissue specific cells are translational models that can provide further physiological understanding and evidence. Here, we evaluated 4-Flow cannulated rat hearts as the fundamental humanized organ model for cardiovascular drug validation. Results show clearance of cellular components in all chambers in 4-Flow hearts with efficient perfusion into both coronary arteries and cardiac veins...
May 10, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29735395/is-fractional-flow-reserve-useful-in-assessing-coronary-artery-fistula-a-case-based-discussion-and-review
#11
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/29734056/promoter-variants-of-tnf-%C3%AE-rs1800629-and-il-10-rs1800871-are-independently-associated-with-the-susceptibility-of-coronary-artery-disease-in-north-indian
#12
Reena Kumari, Sandeep Kumar, Mohammad Kaleem Ahmad, Rajeev Singh, Shashi Kant Kumar, Akshayaya Pradhan, Sharad Chandra, Sudhir Kumar
BACKGROUND: Tumor necrosis factor-alpha (TNF-α) are considered as a pro inflammatory and interleukin-10 (IL-10) anti inflammatory have been shown to predict the risk of incident of coronary artery disease (CAD). The polymorphism at promoter of TNF-α and IL-10 has been shown to increase transcriptional activity of the gene and play a important role in patho physiology of CAD. Aim of present study is to examine the impact of the TNF-α and IL-10 variant allele on various markers of the CAD and to study its relation with circulating TNF-α and IL-10 levels...
May 4, 2018: Cytokine
https://www.readbyqxmd.com/read/29732926/imaging-guided-pre-dilatation-stenting-post-dilatation-ipsp-a-protocolized-approach-highlighting-the-importance-of-intravascular-imaging-for-implantation-of-bioresorbable-scaffolds
#13
Ziad A Ali, Keyvan Karimi Galougahi, Richard Shlofmitz, Akiko Maehara, Gary S Mintz, Alexandre Abizaid, Daniel Chamié, Jonathan Hill, Patrick W Serruys, Yoshinobu Onuma, Gregg W Stone
The advent of the fully bioresorbable vascular scaffold (BVS) is the latest step in a series of advancements in the design of intracoronary stents over the past few decades. The novelty of this technology is in providing temporary vessel scaffolding and local antiproliferative therapy to prevent neointimal hyperplasia after percutaneous coronary intervention followed by gradual resorption of the scaffold to restore the native vessel anatomy and physiology-a process termed vascular reparative therapy. Areas covered: The first generation of BVS has not been able to fully match the high benchmark in safety and efficacy set by contemporary metallic drug-eluting stents...
May 7, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29730084/effectiveness-of-nurse-led-patient-centered-care-behavioral-risk-modification-on-secondary-prevention-of-coronary-heart-disease-a-systematic-review
#14
REVIEW
Chung-Yan Chiang, Kai-Chow Choi, Ka-Ming Ho, Sau-Fung Yu
BACKGROUND: Despite establishment of advocacies centered on using patient-centered care to improve disease-related behavioral changes and health outcomes, studies have seldom discussed incorporation of patient-centered care concept in the design of secondary cardiac prevention. OBJECTIVES: This review aimed to identify, appraise, and examine existing evidence on the effectiveness of nurse-led patient-centered care for secondary cardiac prevention in patients with coronary heart disease...
April 22, 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29730070/exercise-prehabilitation-in-elective-intra-cavity-surgery-a-role-within-the-eras-pathway-a-narrative-review
#15
REVIEW
Samuel T Orange, Matthew J Northgraves, Phil Marshall, Leigh A Madden, Rebecca V Vince
The Enhanced Recovery after Surgery (ERAS) model integrates several elements of perioperative care into a standardised clinical pathway for surgical patients. ERAS programmes aim to reduce the rate of complications, improve surgical recovery, and limit postoperative length of hospital stay (LOHS). One area of growing interest that is not currently included within ERAS protocols is the use of exercise prehabilitation (PREHAB) interventions. PREHAB refers to the systematic process of improving functional capacity of the patient to withstand the upcoming physiological stress of surgery...
May 3, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29724722/coronary-artery-remodeling-and-fibrosis-with-continuous-flow-left-ventricular-assist-device-support
#16
Amrut V Ambardekar, Mary C M Weiser-Evans, Marcella Li, Suneet N Purohit, Muhammad Aftab, T Brett Reece, Karen S Moulton
BACKGROUND: Coronary artery fluid dynamics may be altered because of the nonphysiological flow seen in continuous-flow left ventricular assist devices (CF-LVADs). Our aim was to study the structure and composition of coronary vessels after CF-LVAD. METHODS AND RESULTS: Coronary arteries were collected from patients with heart failure (HF) at the time of transplantation, of whom 15 were supported with a CF-LVAD before transplant (HF+LVAD group) and 9 were not (HF non-LVAD group)...
May 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29718158/management-of-left-main-disease-an-update
#17
Jean Fajadet, Davide Capodanno, Gregg W Stone
A severe narrowing of the left main coronary artery (LMCA), usually due to atherosclerosis, jeopardizes a large area of myocardium and increases the risk of major adverse cardiac events. Management strategies for LMCA disease include coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). In general, PCI offers more rapid recovery and a lower early adverse event rate, whereas CABG offers a more durable procedure. The largest of six LMCA trials comparing PCI with CABG recently reported that in patients with site-reported low or intermediate anatomical complexity PCI was non-inferior to CABG with respect to the composite of death, stroke, or myocardial infarction at 3 years...
April 30, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29716756/coronary-microvascular-dysfunction-in-patients-with-stable-coronary-artery-disease-the-ce-marc-2-coronary-physiology-sub-study
#18
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/29714043/vasomotion-as-an-oscillatory-sign-of-functional-impairment-in-the-human-internal-thoracic-artery-a-study-based-on-risk-factors-and-vessel-reactivity
#19
Diogo A Fonseca, Pedro E Antunes, Manuel J Antunes, Maria Dulce Cotrim
NEW FINDINGS: What is the central question of this study? Vasomotion has been viewed as a rhythmic oscillation of the vascular tone that is physiologically important for optimal tissue perfusion. Also, it has been primarily studied in the microcirculation. However, the precise underlying mechanisms and the physiological significance remain unknown. What is the main finding and its importance? Vasomotion is not specific of the microcirculation, as shown by our findings. In human arteries from patients undergoing cardiac surgery, an increased incidence was associated with endothelial dysfunction settings...
April 30, 2018: Experimental Physiology
https://www.readbyqxmd.com/read/29713011/pathophysiological-coronary-and-microcirculatory-flow-alterations-in-aortic-stenosis
#20
REVIEW
Michael Michail, Justin E Davies, James D Cameron, Kim H Parker, Adam J Brown
Regulation of coronary blood flow is maintained through a delicate balance of ventriculoarterial and neurohumoral mechanisms. The aortic valve is integral to the functions of these systems, and disease states that compromise aortic valve integrity have the potential to seriously disrupt coronary blood flow. Aortic stenosis (AS) is the most common cause of valvular heart disease requiring medical intervention, and the prevalence and associated socio-economic burden of AS are set to increase with population ageing...
April 30, 2018: Nature Reviews. Cardiology
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