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https://www.readbyqxmd.com/read/28331135/applicability-of-3-dimensional-quantitative-coronary-angiography-derived-computed-fractional-flow-reserve-for-intermediate-coronary-stenosis
#1
Kyoichiro Yazaki, Masato Otsuka, Shohei Kataoka, Mitsuru Kahata, Asako Kumagai, Koji Inoue, Hiroshi Koganei, Kenji Enta, Yasuhiro Ishii
BACKGROUND: Quantitative flow ratio (QFR) is a newly developed image-based index for estimating fractional flow reserve (FFR).Methods and Results:We analyzed 151 coronary arteries with intermediate stenosis in 142 patients undergoing wire-based FFR measurement using dedicated software. Predefined contrast flow QFR, which was derived from 3-dimensional quantitative coronary angiography (3-D QCA) withThrombolysis in Myocardial Infarction (TIMI) frame counts, was compared with FFR as a reference...
March 22, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28318875/feasibility-of-pet-for-the-management-of-coronary-artery-disease-comparison-between-cfr-and-ffr
#2
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
#3
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
#4
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
#5
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/28296167/what-can-intracoronary-pressure-measurements-tell-us-about-flow-reserve-pressure-bounded-coronary-flow-reserve-and-example-application-to-the-randomized-defer-trial
#6
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/28281728/comparison-between-fractional-flow-reserve-and-visual-assessment-for-moderate-coronary-artery-stenosis
#7
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
#8
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
#9
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/28259798/basic-neural-processing-of-sound-in-adults-is-influenced-by-bilingual-experience
#10
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/28259665/identification-of-coronary-artery-side-branch-supplying-myocardial-mass-that-may-benefit-from-revascularization
#11
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/28214966/anomalous-coronary-arteries-and-myocardial-bridges-risk-stratification-in-children-using-novel-cardiac-catheterization-techniques
#12
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
https://www.readbyqxmd.com/read/28202246/analysis-of-myocardial-perfusion-parameters-in-an-ex-vivo-porcine-heart-model-using-third-generation-dual-source-ct
#13
Gert Jan Pelgrim, Taylor M Duguay, J Marco A Stijnen, Akos Varga-Szemes, Sjoerd Van Tuijl, U Joseph Schoepf, Matthijs Oudkerk, Rozemarijn Vliegenthart
PURPOSE: To evaluate the relationship between fractional flow reserve (FFR)-determined coronary artery stenosis severity and myocardial perfusion parameters derived from dynamic myocardial CT perfusion imaging (CTP) in an ex-vivo porcine heart model. METHODS: Six porcine hearts were perfused according to Langendorff. Circulatory parameters such as arterial blood flow (ABF) (L/min), mean arterial pressure (MAP) (mmHg) and heart rate (bpm) were monitored. Using an inflatable cuff and monitored via a pressure wire, coronary artery stenoses of different FFR grades were created (no stenosis, FFR = 0...
February 3, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28196527/assessment-of-increasing-intravenous-adenosine-dose-in-fractional-flow-reserve
#14
David Sparv, Matthias Götberg, Jan Harnek, Tobias Persson, Bjarne Madsen Hardig, David Erlinge
BACKGROUND: Effects of increased adenosine dose in the assessment of fractional flow reserve (FFR) were studied in relation to FFR results, hemodynamic effects and patient discomfort. FFR require maximal hyperemia mediated by adenosine. Standard dose is 140 μg/kg/min administrated intravenously. Higher doses are commonly used in clinical practice, but an extensive comparison between standard intravenous dose and a high dose (220 μg/kg/min) has previously not been performed. METHODS: Seventy-five patients undergoing FFR received standard dose adenosine, followed by high dose adenosine...
February 14, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28185890/recording-the-human-brainstem-frequency-following-response-in-the-free-field
#15
Nuno Gama, Isabelle Peretz, Alexandre Lehmann
BACKGROUND: The human auditory brainstem frequency-following response (FFR) is an objective measure used to investigate the brainstem's encoding ability of sounds. Traditionally, FFRs are recorded under close-field conditions (earphones), but free-field stimulations (loudspeaker) have yet to be attempted, which would increase the applications of FFRs by making this technique accessible to those who cannot wear inserted transducers. Here we test the feasibility and reliability of measuring speech ABRs across free and close-field...
February 7, 2017: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/28168977/diffuse-coronary-artery-disease-among-other-atherosclerotic-plaque-characteristics-by-coronary-computed-tomography-angiography-for-predicting-coronary-vessel-specific-ischemia-by-fractional-flow-reserve
#16
Asim Rizvi, Bríain Ó Hartaigh, Ibrahim Danad, Donghee Han, Ji Hyun Lee, Heidi Gransar, Jackie Szymonifka, Fay Y Lin, James K Min
BACKGROUND AND AIMS: Coronary computed tomography angiography (CCTA) permits effective identification of diffuse CAD and atherosclerotic plaque characteristics (APCs). We sought to examine the usefulness of diffuse CAD beyond luminal narrowing and APCs by CCTA to detect vessel-specific ischemia. METHODS: 407 vessels (n = 252 patients) from the DeFACTO diagnostic accuracy study were retrospectively analyzed for percent plaque diffuseness (PD). Percent plaque diffuseness (PD) was obtained on per-vessel level by summation of all contiguous lesion lengths and divided by total vessel length, and was logarithmically transformed (log percent PD)...
March 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28161129/navvus-ffr-to-reduce-contrast-cost-and-radiation-contract-insights-from-a-single-centre-clinical-and-economical-evaluation-with-the-rxi-rapid-exchange-ffr-device
#17
Kaneshka Masdjedi, Nicolas M Van Mieghem, Roberto Diletti, Robert-Jan van Geuns, Peter de Jaegere, Evelyn Regar, Felix Zijlstra, Ron T van Domburg, Joost Daemen
OBJECTIVES: To assess whether the RXi Navvus system compared to the use of standard Fractional Flow Reserve (FFR) wires reduces total contrast volume, radiation and overall study cost in a real world patient population referred for coronary angiography or percutaneous coronary intervention. BACKGROUND: FFR is the mainstay of functional hemodynamic assessment of coronary artery lesions. The RXi Navvus system (ACIST Medical Systems, Eden Prairie, MN) is a monorail microcatheter with FFR-measurement capability through optical pressure sensor technology...
April 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28154267/contrast-induced-hyperemia-as-an-alternative-to-drug-induced-hyperemia-in-the-evaluation-of-the-fractional-flow-reserve-in-coronary-lesions
#18
Nobuo Shiode, Tomokazu Okimoto, Hiromichi Tamekiyo, Tomoharu Kawase, Kenichi Yamane, Yuzo Kagawa, Yuto Fujii, Yusuke Ueda, Naoya Hironobe, Yasuko Kato, Yasuhiko Hayashi
Objective Measuring the fractional flow reserve (FFR) requires the induction of coronary hyperemia, usually with adenosine, adenosine triphosphate (ATP), or papaverine. However, adenosine can induce rhythmic complications, and intracoronary boluses of papaverine that prolong the QT interval can cause ventricular tachycardia. Injection of contrast media, which is routinely performed to validate the FFR guidewire placement, also induces hyperemia and may be an alternative method of measuring the FFR. We evaluated the diagnostic accuracy of the FFR after contrast hyperemia (FFRcont) compared to FFR evaluated after intracoronary papaverine (FFRpp)...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28134124/the-impact-of-microvascular-resistance-on-the-discordance-between-anatomical-and-functional-evaluations-of-intermediate-coronary-disease
#19
Kyoung-Woo Seo, Hong-Seok Lim, Myeong-Ho Yoon, Seung-Jea Tahk, So-Yeon Choi, Byoung-Joo Choi, Hyoung-Mo Yang, Joon-Han Shin, Gyo-Seung Hwang, Jin-Sun Park, XiongJie Jin
AIMS: In intermediate coronary artery disease, discordance between anatomical and functional assessments persists and the diagnostic accuracy of an anatomical evaluation is not satisfactory for determining functional significance. We evaluated the impact of microvascular resistance on 'anatomical-functional discordance'. METHODS AND RESULTS: In 97 intermediate coronary lesions of 83 patients, minimum lumen area (MLA), fractional flow reserve (FFR), ∆(Pd/Pa-FFR), and hyperaemic microvascular resistance index (hMVRI) were measured using intravascular ultrasound and intracoronary dual pressure and Doppler sensor-tipped guidewire...
January 31, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28123019/cortical-correlates-of-the-auditory-frequency-following-and-onset-responses-eeg-and-fmri-evidence
#20
Emily B J Coffey, Gabriella Musacchia, Robert J Zatorre
The frequency-following response (FFR) is a measure of the brain's periodic sound encoding. It is of increasing importance for studying the human auditory nervous system due to numerous associations with auditory cognition and dysfunction. Although the FFR is widely interpreted as originating from brainstem nuclei, a recent study using MEG suggested that there is also a right-lateralized contribution from the auditory cortex at the fundamental frequency (Coffey et al., 2016b). Our objectives in the present work were to validate and better localize this result using a completely different neuroimaging modality and to document the relationships between the FFR, the onset response, and cortical activity...
January 25, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
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