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https://www.readbyqxmd.com/read/29673505/influence-of-microcirculatory-dysfunction-on-angiography-based-functional-assessment-of-coronary-stenoses
#1
Hernán Mejía-Rentería, Joo Myung Lee, Francesco Lauri, Nina W van der Hoeven, Guus A de Waard, Fernando Macaya, María José Pérez-Vizcayno, Nieves Gonzalo, Pilar Jiménez-Quevedo, Luis Nombela-Franco, Pablo Salinas, Iván Núñez-Gil, María Del Trigo, Sonoka Goto, Hyun Jong Lee, Catherine Liontou, Antonio Fernández-Ortiz, Carlos Macaya, Niels van Royen, Bon-Kwon Koo, Javier Escaned
OBJECTIVES: The authors sought to evaluate the influence of coronary microcirculatory dysfunction (CMD) on the diagnostic performance of the quantitative flow ratio (QFR). BACKGROUND: Functional angiographic assessment of coronary stenoses based on fluid dynamics, such as QFR, constitutes an attractive alternative to fractional flow reserve (FFR). However, it is unknown whether CMD affects the reliability of angiography-based functional indices. METHODS: FFR and the index of microcirculatory resistance (IMR) were measured in 300 vessels (248 patients) as part of a multicenter international registry...
April 23, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29657049/prognostic-implication-of-thermodilution-coronary-flow-reserve-in-patients-with-indeterminate-pressure-bounded-coronary-flow-reserve
#2
Joo Myung Lee, Tae-Min Rhee, Doyeon Hwang, Jonghanne Park, Chee Hae Kim, Ki Hong Choi, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Bon-Kwon Koo
BACKGROUND: Recently, the concept of pressure-bounded coronary flow reserve (PB-CFR) has been introduced. However, using pressure-only data, a substantial proportion of patients could not be classified into high or low PB-CFR and remained as indeterminate PB-CFR. The current study evaluated the prognostic implication of thermodilution-based CFR (thermo-CFR) in patients with indeterminate PB-CFR. METHODS: Among 199 patients (211 lesions) with indeterminate PB-CFR, 170 patients (179 lesions) with deferral of revascularization were analyzed for the current study...
June 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29651685/cardiogoniometry-compared-to-fractional-flow-reserve-at-identifying-physiologically-significant-coronary-stenosis-the-cardioflow-study
#3
Oliver I Brown, Andrew L Clark, Raj Chelliah, Benjamin J Davison, Adam N Mather, Michael S Cunnington, Joseph John, Albert Alahmar, Richard Oliver, Konstantinos Aznaouridis, Angela Hoye
Cardiogoniometry (CGM) is method of 3-dimensional electrocardiographic assessment which has been shown to identify patients with angiographically defined, stable coronary artery disease (CAD). However, angiographic evidence of CAD, does not always correlate to physiologically significant disease. The aim of our study was to assess the ability of CGM to detect physiologically significant coronary stenosis defined by fractional flow reserve (FFR). In a tertiary cardiology centre, elective patients with single vessel CAD were enrolled into a prospective double blinded observational study...
April 12, 2018: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/29643278/absolute-myocardial-blood-flow-after-elective-percutaneous-coronary-intervention-evaluated-on-phase-contrast-cine-cardiovascular-magnetic-resonance-imaging
#4
Rikuta Hamaya, Akinori Sugano, Yoshihisa Kanaji, Tadashi Fukuda, Yoshinori Kanno, Taishi Yonetsu, Eisuke Usui, Masahiro Hoshino, Masahiro Hada, Hiroaki Ohya, Yohei Sumino, Haruhito Yuki, Tadashi Murai, Tetsumin Lee, Tsunekazu Kakuta
BACKGROUND: Few studies have documented changes in myocardial blood flow (MBF) after percutaneous coronary intervention (PCI). Phase-contrast cine cardiovascular MRI (PC-CCMR) of the coronary sinus (CS) is a promising approach to quantify MBF. The aim of this study was to quantify CS flow (CSF) on PC-CCMR as a measure of volumetric MBF before and after elective PCI.Methods and Results:We prospectively studied 34 patients with stable angina undergoing elective PCI for a single de novo lesion...
April 12, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29627899/influence-of-visual-functional-mismatch-on-coronary-flow-profiles-after-percutaneous-coronary-intervention-a-propensity-score-matched-analysis
#5
Masahiro Hoshino, Taishi Yonetsu, Tadashi Murai, Yoshihisa Kanaji, Eisuke Usui, Masahiro Hada, Rikuta Hamaya, Yoshinori Kanno, Tetsumin Lee, Tsunekazu Kakuta
The aims of this study are to clarify whether discrepancies between angiographic and fractional flow reserve (FFR) measurements (visual-functional mismatch) influence coronary flow profiles after percutaneous coronary intervention. While current guidelines FFR-guided revascularization, clinical practice most commonly relies on angiographic evaluation, which may under- or over-estimate the functional relevance of the lesion. Our retrospective analysis involved 274 vessels from 264 patients with stable angina pectoris who underwent FFR, index of microvascular resistance, and coronary flow reserve (CFR) measurements before and after PCI...
April 7, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29622448/long-term-prognostic-value-of-invasive-and-non-invasive-measures-early-after-heart-transplantation
#6
Yukari Kobayashi, Yuhei Kobayashi, Hyoung-Mo Yang, Sara Bouajila, Helen Luikart, Takeshi Nishi, Dong-Hyun Choi, Ingela Schnittger, Hannah A Valantine, Kiran K Khush, Alan C Y Yeung, Francois Haddad, William F Fearon
BACKGROUND: Invasively assessed coronary microvascular resistance early after heart transplantation predicts worse long-term outcome; however, little is known about the relationship between microvascular resistance, left ventricular function and outcomes in this setting. METHODS: A total of 100 cardiac transplant recipients had fractional flow reserve (FFR) and the index of microcirculatory resistance (IMR) measured in the left anterior descending artery and echocardiographic assessment of left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) at 1 year after heart transplantation...
June 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29616627/lumen-boundaries-extracted-from-coronary-computed-tomography-angiography-on-computed-fractional-flow-reserve-ffrct-validation-with-optical-coherence-tomography
#7
Kenzo Uzu, Hiromasa Otake, Gilwoo Choi, Takayoshi Toba, Hyun Jin Kim, Arjun Rou, Michiel Schaap, Leo Grady, Masahito Kawata, Toshiro Shinke, Charles Anthony Taylor, Ken-Ichi Hirata
AIMS: To evaluate the accuracy of minimal lumen area (MLA) by coronary computed tomography angiography (cCTA) and its impact on fractional flow reserve (FFRCT). METHODS AND RESULTS: Fifty-seven patients (118 lesions, 72 vessels) who underwent cCTA and optical coherence tomography (OCT) were enrolled. OCT and cCTA were co-registered and MLAs were measured with both modalities. FFROCT was calculated using OCT-updated models with cCTA-based lumen geometry replaced by OCT-derived geometry...
April 3, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29614585/-coronary-microvascular-resistance-and-its-relevant-factors-in-patients-with-moderate-coronary-stenosis-and-chest-pain
#8
D F He, M Y Liu, L J Zhang, C J Guo, Y P Chi, L Zhao, X J Zhang
Objective: To evaluate the impact of cardiovascular risk factors on index of microvascular resistance (IMR) and coronary flow reserve (CFR) and to explore the characteristics of IMR and CFR and the relationship between IMR and angiographic features in patients with intermediate coronary stenosis and chest pain. Methods: Fractional flow reserve (FFR), CFR, and IMR were measured in patients who underwent invasive coronary angiography with 40%-70% stenosis by visual assessment. All patients with FFR>0.75 were enrolled and grouped with the cut-off points of IMR≥25 and CFR≤2...
April 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29605246/influence-of-local-myocardial-damage-on-index-of-microcirculatory-resistance-and-fractional-flow-reserve-in-target-and-nontarget-vascular-territories-in-a-porcine-microvascular-injury-model
#9
Joo Myung Lee, Hyun Kuk Kim, Kyung Seob Lim, Jun-Kyu Park, Ki Hong Choi, Jonghanne Park, Doyeon Hwang, Tae-Min Rhee, Jeong Hoon Yang, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Joo-Yong Hahn, Bon-Kwon Koo, Myung Ho Jeong
OBJECTIVES: The aim of this study was to investigate the influence of microvascular damage in one vessel territory on invasively measured physiological parameters in the other vessel, using a porcine microvascular damage model. BACKGROUND: Although fractional flow reserve (FFR)-guided decision-making for the nonculprit stenosis in patients with acute myocardial infarction has been reported to be better than angiography-guided revascularization, there have been debates regarding the influence of microvascular dysfunction on measured FFR in nonculprit vessels...
March 22, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29598929/relationship-of-the-duke-jeopardy-score-combined-with-minimal-lumen-diameter-as-assessed-by-computed-tomography-angiography-to-the-hemodynamic-relevance-of-coronary-artery-stenosis
#10
Mengmeng Yu, Yonghong Zhao, Wenbin Li, Zhigang Lu, Meng Wei, Wenxiao Zhou, Jiayin Zhang
OBJECTIVES: To study the diagnostic performance of the ratio between the Duke jeopardy score (DJS) and the minimal lumen diameter (MLD) (DJS/MLDCT ratio) as assessed by coronary computed tomographic angiography (CTA) for differentiating functionally significant from non-significant coronary artery stenoses, with reference to invasive fractional flow reserve (FFR). METHODS: Patients who underwent both coronary CTA and FFR measurement during invasive coronary angiography (ICA) within 2 weeks were retrospectively included in the study...
March 2, 2018: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29589976/the-transluminal-attenuation-gradient-in-coronary-ct-angiography-for-the-detection-of-hemodynamically-significant-disease-can-all-arteries-be-treated-equally
#11
Fujimoto Shinichiro, Andreas A Giannopoulos, Kumamaru K Kanako, Rie Matsumori, Etsuro Kato, Yuko Kawaguchi, Kazuhisa Takamura, Katsumi Miyauchi, Frank J Rybicki, Hiroyuki Daida, Dimitris Mitsouras
OBJECTIVE: Results of the use of the Transluminal Attenuation Gradient(TAG) at coronary CT angiography (CCTA) to predict haemodynamically significant disease vary widely. This study tested whether diagnostic performance of TAG to predict FFR<0.8 is improved when applied separately to subsets of coronary arteries that carry similar physiologic flow. METHODS: Twenty-eight patients with 64×0.5 mm CCTA and invasive FFR in ≥1 major coronary artery were retrospectively evaluated...
March 28, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29588737/performing-and-interpreting-fractional-flow-reserve-measurements-in-clinical-practice-an-expert-consensus-document
#12
Stephan Achenbach, Tanja Rudolph, Johannes Rieber, Holger Eggebrecht, Gert Richardt, Thomas Schmitz, Nikos Werner, Florian Boenner, Helge Möllmann
Fractional flow reserve (FFR) measurements can determine the haemodynamic relevance of coronary artery stenoses. Current guidelines recommend their use in lesions in the absence of non-invasive proof of ischaemia. The prognostic impact of FFR has been evaluated in randomised trials, and it has been shown that revascularisation can be safely deferred if FFR is >0.80, while revascularisation of stenoses with FFR values ≤0.80 results in significantly lower event rates compared to medical treatment. Left main stenoses, aorto-ostial lesions, as well as patients with left ventricular hypertrophy and severely-impaired ejection fraction, have been excluded from large, randomised trials...
September 2017: Interventional Cardiology
https://www.readbyqxmd.com/read/29569332/the-impact-of-coronary-chronic-total-occlusion-percutaneous-coronary-intervention-upon-donor-vessel-fractional-flow-reserve-and-instantaneous-wave-free-ratio-implications-for-physiology-guided-pci-in-patients-with-cto
#13
Shah R Mohdnazri, Grigoris V Karamasis, Firas Al-Janabi, Christopher M Cook, James Hampton-Till, Jufen Zhang, Rasha Al-Lamee, Jason N Dungu, Swamy Gedela, Kare H Tang, Paul A Kelly, Justin E Davies, John R Davies, Thomas R Keeble
OBJECTIVE: To investigate the immediate and short term impact of right coronary artery (RCA) chronic total coronary occlusion (CTO) percutaneous coronary intervention (PCI) upon collateral donor vessel fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR). BACKGROUND: CTO PCI influences collateral donor vessel physiology, making the indication and/or timing of donor vessel revascularization difficult to determine. METHODS: In patients with RCA CTO, FFR, iFR, and collateral function index (FFRcoll ) were measured in LAD and LCx pre-CTO PCI, immediately post and at 4 month follow-up...
March 22, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29569282/fractional-flow-reserve-ct-assessment-of-coronary-stenosis
#14
Edmund K Kerut, Michael Turner
Coronary computed tomography angiography (CCTA) has been an established noninvasive method for detection of coronary artery disease (CAD). Although CCTA has had a high sensitivity and negative predictive value for CAD detection, specificity for obstructive CAD has been relatively low, partly due to coronary calcium, imaging artifacts, and other factors leading to an overestimation of stenosis severity. A relatively new noninvasive method of calculation of fractional flow reserve (FFR) using CCTA (FFRCT ) data has been developed...
March 22, 2018: Echocardiography
https://www.readbyqxmd.com/read/29566702/a-new-cfd-based-non-invasive-method-for-functional-diagnosis-of-coronary-stenosis
#15
Xinzhou Xie, Minwen Zheng, Didi Wen, Yabing Li, Songyun Xie
BACKGROUND: Accurate functional diagnosis of coronary stenosis is vital for decision making in coronary revascularization. With recent advances in computational fluid dynamics (CFD), fractional flow reserve (FFR) can be derived non-invasively from coronary computed tomography angiography images (FFRCT ) for functional measurement of stenosis. However, the accuracy of FFRCT is limited due to the approximate modeling approach of maximal hyperemia conditions. To overcome this problem, a new CFD based non-invasive method is proposed...
March 22, 2018: Biomedical Engineering Online
https://www.readbyqxmd.com/read/29555835/evaluation-of-coronary-artery-stenosis-by-quantitative-flow-ratio-during-invasive-coronary-angiography-the-wifi-ii-study-wire-free-functional-imaging-ii
#16
Jelmer Westra, Shengxian Tu, Simon Winther, Louise Nissen, Mai-Britt Vestergaard, Birgitte Krogsgaard Andersen, Emil Nielsen Holck, Camilla Fox Maule, Jane Kirk Johansen, Lene Nyhus Andreasen, Jo Krogsgaard Simonsen, Yimin Zhang, Steen Dalby Kristensen, Michael Maeng, Anne Kaltoft, Christian Juhl Terkelsen, Lars Romer Krusell, Lars Jakobsen, Johan H C Reiber, Jens Flensted Lassen, Morten Bøttcher, Hans Erik Bøtker, Evald Høj Christiansen, Niels Ramsing Holm
BACKGROUND: Quantitative flow ratio (QFR) is a novel diagnostic modality for functional testing of coronary artery stenosis without the use of pressure wires and induction of hyperemia. QFR is based on computation of standard invasive coronary angiographic imaging. The purpose of WIFI II (Wire-Free Functional Imaging II) was to evaluate the feasibility and diagnostic performance of QFR in unselected consecutive patients. METHODS AND RESULTS: WIFI II was a predefined substudy to the Dan-NICAD study (Danish Study of Non-Invasive Diagnostic Testing in Coronary Artery Disease), referring 362 consecutive patients with suspected coronary artery disease on coronary computed tomographic angiography for diagnostic invasive coronary angiography...
March 2018: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29553991/intracoronary-versus-intravenous-adenosine-to-assess-fractional-flow-reserve-a-systematic-review-and-meta-analysis
#17
Sebastiano Gili, Umberto Barbero, Daniele Errigo, Giuseppe De Luca, Giuseppe Biondi-Zoccai, Antonio Maria Leone, Mario Iannaccone, Antonio Montefusco, Pierluigi Omedé, Claudio Moretti, Maurizio D'Amico, Fiorenzo Gaita, Fabrizio D'Ascenzo
AIMS: Intravenous infusion of adenosine is the reference method to measure fractional flow reserve (FFR). Intracoronary boluses are often used because of time and convenience, but their effectiveness has yet to be assessed. METHODS: We conducted a systematic review and meta-analysis of prospective studies directly comparing intravenous and intracoronary adenosine administration for FFR measurement. FFR values and prevalence of functionally critical lesions obtained with the different methods of adenosine administration were compared...
March 16, 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29550308/virtual-coronary-intervention-a-treatment-planning-tool-based-upon-the-angiogram
#18
Rebecca C Gosling, Paul D Morris, Daniel A Silva Soto, Patricia V Lawford, D Rodney Hose, Julian P Gunn
OBJECTIVES: This study sought to assess the ability of a novel virtual coronary intervention (VCI) tool based on invasive angiography to predict the patient's physiological response to stenting. BACKGROUND: Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) is associated with improved clinical and economic outcomes compared with angiographic guidance alone. Virtual (v)FFR can be calculated based upon a 3-dimensional (3D) reconstruction of the coronary anatomy from the angiogram, using computational fluid dynamics (CFD) modeling...
March 9, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29543186/online-angiography-image-based-ffr-assessment-during-coronary-catheterization-a-single-center-study
#19
Ran Kornowski, Hana Vaknin-Assa, Abid Assali, Gabriel Greenberg, Orna Valtzer, Ifat Lavi
OBJECTIVES: To assess the diagnostic performance of angiography-derived fractional flow reserve (FFRangio) measurements in patients with stable coronary artery disease when used online in the catheterization laboratory during routine coronary angiography. BACKGROUND: FFR, an index of the hemodynamic severity of coronary stenosis, is derived from invasive measurements using a pressure-monitoring guidewire and hyperemic stimulus. While FFR is the gold standard, it remains under-utilized...
March 15, 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29501432/impact-of-right-atrial-pressure-on-fractional-flow-reserve-calculation-in-the-presence-of-a-chronic-total-occlusion
#20
Grigoris V Karamasis, Andreas S Kalogeropoulos, Shah H Mohdnazri, Firas Al-Janabi, Rohan Jagathesan, Gerald J Clesham, Kare H Tang, Paul A Kelly, John R Davies, Thomas R Keeble
BACKGROUND: The aim of this study was to assess the impact of right atrial pressure (Pra) on non-CTO vessels FFR measurements in patients with a chronic total occlusion. METHODS: Consecutive patients who underwent PCI for a CTO of the right coronary artery (RCA) were included. Prior to RCA recanalization, FFR and FFRmyo were measured in non-CTO vessels. FFR was calculated using the Pd/Pa equation during maximum hyperaemia and also accounting for right atrial pressure (Pd-Pra/Pa-Pra)...
February 7, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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