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https://www.readbyqxmd.com/read/29055128/a-generalized-outflow-boundary-condition-impedance-model-for-non-invasive-prediction-of-ischemia-in-diseased-coronary-arteries
#1
Iyad A Fayssal, Fadl Moukalled, Samir Alam, Hussain Isma'eel
This paper reports on a new boundary condition formulation to model the total coronary myocardial flow and impedance characteristics of the myocardial vascular bed for any specific patient when considered for non-invasive diagnosis of fractional flow reserve (FFR). The developed boundary condition model inherits an implicit representation of the downstream truncated vascular bed and is based on integrating patient-specific physiologic parameters that can be non-invasively extracted for each patient to account for blood flow demand to the myocardium at rest and hyperemic conditions...
October 21, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29054592/the-impact-of-tissue-doppler-index-e-e-ratio-on-instantaneous-wave-free-ratio
#2
Hiroyuki Arashi, Junichi Yamaguchi, Tonre Ri, Hisao Otsuki, Masashi Nakao, Kazuho Kamishima, Kentaro Jujo, Yuichiro Minami, Hiroshi Ogawa, Nobuhisa Hagiwara
BACKGROUND: The instantaneous wave-free ratio (iFR) is a vasodilator-free, invasive pressure wire index of the functional severity of coronary stenosis and is calculated under resting conditions. In a recent study, iFR was found to be more closely linked to coronary flow reserve (CFR) than fractional flow reserve (FFR). E/e' is a surrogate marker of left ventricular (LV) filling pressure and LV diastolic dysfunction. Coronary resting flow was found to be increased in patients with elevated E/e', and higher coronary resting flow was associated with lower CFR...
October 17, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29050684/comparison-of-accuracy-of-one-use-methods-for-calculating-fractional-flow-reserve-by-intravascular-optical-coherence-tomography-to-that-determined-by-the-pressure-wire-method
#3
Sun-Joo Jang, Jung-Min Ahn, Boyoung Kim, Ji-Min Gu, Hyung Jin Sung, Seung-Jung Park, Wang-Yuhl Oh
Although the identification of the hemodynamic significance of coronary lesions becomes important for revascularization strategy, the potential role of 3-dimensional high-resolution intracoronary optical coherence tomography (OCT) for predicting functional significance of coronary lesions remains unclear. We assessed the diagnostic performance of 2 computational approaches for deriving fractional flow reserve (FFR) from intravascular OCT images. We developed 2 methods to derive FFR-OCT by AFD (FFR-OCTAFD) and FFR-OCT by CFD (FFR-OCTCFD)...
September 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29050683/correlation-of-fractional-flow-reserve-with-ischemic-burden-measured-by-cardiovascular-magnetic-resonance-perfusion-imaging
#4
Shazia T Hussain, Matthias Paul, Geraint Morton, Andreas Schuster, Amedeo Chiribiri, Divaka Perera, Eike Nagel
Cardiovascular magnetic resonance (CMR) perfusion imaging and fractional flow reserve (FFR) assess myocardial ischemia. FFR measures the pressure loss across a stenosis determining hemodynamic significance but does not assess the area subtended by the stenotic vessel. CMR perfusion imaging measures the extent of myocardial blood flow reduction (=ischemic burden). Both techniques allow for continuous rather than categorical evaluation, but their relationship is poorly understood. This study investigates the relationship between the FFR value and the extent of myocardial ischemia...
September 4, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29050558/similarity-and-difference-of-resting-distal%C3%A2-to-aortic-coronary-pressure-and%C3%A2-instantaneous-wave-free-ratio
#5
Joo Myung Lee, Jonghanne Park, Doyeon Hwang, Chee Hae Kim, Ki Hong Choi, Tae-Min Rhee, Yaliang Tong, Jin Joo Park, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Bon-Kwon Koo
BACKGROUND: Instantaneous wave-free ratio (iFR) has been used in clinical practice to identify functionally significant stenosis and to guide treatment strategy. However, there are limited clinical data regarding another resting pressure-derived index, resting distal to aortic coronary pressure (Pd/Pa), and similarities and differences between resting Pd/Pa and iFR. OBJECTIVES: The authors investigated the changes in resting Pd/Pa and iFR according to anatomic and hemodynamic stenosis severity and their prognostic implications...
October 24, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29050557/agreement-of-the-resting-distal-to%C3%A2-aortic%C3%A2-coronary-pressure-with-the%C3%A2-instantaneous-wave-free-ratio
#6
Yuhei Kobayashi, Nils P Johnson, Frederik M Zimmermann, Nils Witt, Colin Berry, Allen Jeremias, Bon-Kwon Koo, Giovanni Esposito, Gilles Rioufol, Seung-Jung Park, Takeshi Nishi, Dong-Hyun Choi, Keith G Oldroyd, Emanuele Barbato, Nico H J Pijls, Bernard De Bruyne, William F Fearon
BACKGROUND: Recently, 2 randomized controlled trials showed that the instantaneous wave-free ratio (iFR), a resting coronary physiological index, is noninferior to fractional flow reserve for guiding revascularization. The resting distal to aortic coronary pressure (Pd/Pa) measured at rest is another adenosine-free index widely available in the cardiac catheterization laboratory; however, little is known about the agreement of Pd/Pa using iFR as a reference standard. OBJECTIVES: The goal of this study was to investigate the agreement of Pd/Pa with iFR...
October 24, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29049831/improving-myocardial-fractional-flow-reserve-in-coronary-atherosclerosis-via-cx37-gene-silence-a-preclinical-validation-study-in-pigs
#7
Suxia Guo, Ying Yang, Zhenyu Yang, Huayan You, Yunke Shi, Zhao Hu, Zhaohui Meng, Jianming Xiao
OBJECTIVES: The purpose of this study was to evaluate the effect of CX37 gene silence on myocardial fractional flow reserve (FFR). METHODS: A total of 90 male pigs were randomly divided into saline, mock and 3 different doses (5, 10 and 20 µl) of CX37 viral suspension groups that could induce coronary plaque formation with high-fat diet. After performing myocardial FFR by intravascular ultrasound, different doses of CX37 viral suspension, saline and mock small interfering RNA (siRNA) were transfected into the related coronary...
July 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29046003/-ffr-guided-revascularisation-pros-and-cons
#8
Hannes Reuter, Stephan Baldus
An invasive measurement of the fractional flow reserve (FFR) allows the valuation of the individual risk for ischemic events in patients with coronary artery disease. Therefore, FFR has become a valuable tool to guide coronary revascularisations. The cut-off value ≤ 0.80 has been validated in many different subsets of patients. However, FFR values describe a risk continuum with an inverse correlation between FFR value and the risk of events. So FFR should always be interpreted regarding the patient's clinical context, especially in patients with a high risk for rapid disease progression...
October 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29042397/influence-of-contrast-media-dose-and-osmolality-on-the-diagnostic-performance-of-contrast-fractional-flow-reserve
#9
Takeshi Nishi, Nils P Johnson, Bernard De Bruyne, Colin Berry, K Lance Gould, Allen Jeremias, Keith G Oldroyd, Yuhei Kobayashi, Dong-Hyun Choi, Nico H J Pijls, William F Fearon
BACKGROUND: Contrast fractional flow reserve (cFFR) is a method for assessing functional significance of coronary stenoses, which is more accurate than resting indices and does not require adenosine. However, contrast media volume and osmolality may affect the degree of hyperemia and therefore diagnostic performance. METHODS AND RESULTS: cFFR, instantaneous wave-free ratio, distal pressure/aortic pressure at rest, and FFR were measured in 763 patients from 12 centers...
October 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29041720/robust-and-efficient-multi-frequency-temporal-phase-unwrapping-optimal-fringe-frequency-and-pattern-sequence-selection
#10
Minliang Zhang, Qian Chen, Tianyang Tao, Shijie Feng, Yan Hu, Hui Li, Chao Zuo
Temporal phase unwrapping (TPU) is an essential algorithm in fringe projection profilometry (FPP), especially when measuring complex objects with discontinuities and isolated surfaces. Among others, the multi-frequency TPU has been proven to be the most reliable algorithm in the presence of noise. For a practical FPP system, in order to achieve an accurate, efficient, and reliable measurement, one needs to make wise choices about three key experimental parameters: the highest fringe frequency, the phase-shifting steps, and the fringe pattern sequence...
August 21, 2017: Optics Express
https://www.readbyqxmd.com/read/29038225/role-of-proximal-optimization-technique-guided-by-intravascular-ultrasound-on-stent-expansion-stent-symmetry-index-and-side-branch-hemodynamics-in-patients-with-coronary-bifurcation-lesions
#11
Diaa Hakim, Arka Chatterjee, Olusuen Alli, Joshua Turner, Assad Sattar, Nicolas Foin, Massoud A Leesar
BACKGROUND: Bench models of coronary bifurcation lesions demonstrated that the proximal optimization technique (POT) expanded the stent and opened the side branch (SB). We investigated the role of POT guided by intravascular ultrasound on the main vessel (MV) stent expansion and SB fractional flow reserve (FFR) in patients with coronary bifurcation lesion. METHODS AND RESULTS: In 40 patients with coronary bifurcation lesion, 120 intravascular ultrasound examinations of the MV were performed at baseline, after MV stenting, and POT followed by 95 FFR measurements of the SB...
October 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29037762/evaluation-of-lesion-flow-coefficient-for-the-detection-of-coronary-artery-disease-in-patient-groups-from-two-academic-medical-centers
#12
Srikara V Peelukhana, Rupak K Banerjee, Tim P van de Hoef, Kranthi K Kolli, Mohamed Effat, Tarek Helmy, Massoud Leesar, Hanan Kerr, Jan J Piek, Paul Succop, Lloyd Back, Imran Arif
BACKGROUND: In this study, lesion flow coefficient (LFC: ratio of % area stenosis [%AS] to the square root of the ratio of the pressure drop across the stenosis to the dynamic pressure in the throat region), that combines both the anatomical (%AS) and functional measurements (pressure and flow), was assessed for application in a clinical setting. METHODS AND RESULTS: Pressure, flow, and anatomical values were obtained from patients in 251 vessels from two different centers...
September 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29020260/clinical-implications-of-three-vessel-fractional-flow-reserve-measurement-in-patients-with-coronary-artery-disease
#13
Joo Myung Lee, Bon-Kwon Koo, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Doyeon Hwang, Jonghanne Park, Kyung-Jin Kim, Jinlong Zhang, Xinyang Hu, JianAn Wang, Chul Ahn, Fei Ye, Shaoliang Chen, Junqing Yang, Jiyan Chen, Nobuhiro Tanaka, Hiroyoshi Yokoi, Hitoshi Matsuo, Hiroaki Takashima, Yasutsugu Shiono, Takashi Akasaka
Aims: There are limited data on the clinical implications of total physiologic atherosclerotic burden assessed by invasive physiologic studies in patients with coronary artery disease. We investigated the prognostic implications of total physiologic atherosclerotic burden assessed by total sum of fractional flow reserve (FFR) in three vessels (3V-FFR). Methods and results: A total of 1136 patients underwent FFR measurement in three vessels (3V FFR-FRIENDS study, NCT01621438)...
August 19, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28990941/influence-of-coronary-calcification-patterns-on-hemodynamic-outcome-of-coronary-stenoses-and-remodeling
#14
Ahmet Demirkıran, Ozan Çakır, Adem Atıcı, Emre Aslanger, Cansu Akdeniz, Berrin Umman, Sabahattin Umman, Zehra Bugra, Murat Sezer
OBJECTIVE: The histological characteristics of plaque may affect the hemodynamic outcome of a given coronary stenosis. In particular, the potential effect of volumetric calcium content and the topographical distribution in the lesion segment on physiological outcome has not yet been investigated. The aim of this study was to identify any potential correlation between patterns of calcification and the fractional flow reserve (FFR) and the coronary remodeling index (RMI). METHODS: A total of 26 stable angina pectoris and 34 acute coronary syndrome patients without persistent ST-segment elevation constituted the study population...
October 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28980386/fractional-flow-reserve-versus-angiography-guided-percutaneous-coronary-intervention-an-updated-systematic-review
#15
Tariq Enezate, Jad Omran, Ashraf S Al-Dadah, Martin Alpert, Christopher J White, Mazen Abu-Fadel, Herbert Aronow, Mauricio Cohen, Frank Aguirre, Mitul Patel, Ehtisham Mahmud
OBJECTIVES: To compare outcomes of fractional flow reserve (FFR) to angiography (ANGIO) guided percutaneous coronary intervention (PCI). BACKGROUND: The results of a recent randomized controlled trial reported unfavorable effects of routine measurement of FFR, thereby questioning its validity in improving clinical outcomes. METHODS: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were queried from January, 2000 through December, 2016 and studies comparing FFR and ANGIO guided PCI were included...
October 5, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28937495/noninvasive-computed-tomography-derived-fractional-flow-reserve-based-on-structural-and-fluid-analysis-reproducibility-of-on-site-determination-by-unexperienced-observers
#16
Keiken Ri, Kanako K Kumamaru, Shinichiro Fujimoto, Yuko Kawaguchi, Tomotaka Dohi, Sou Yamada, Kazuhisa Takamura, Yosuke Kogure, Norikazu Yamada, Etsuro Kato, Ryusuke Irie, Tomohiro Takamura, Michimasa Suzuki, Masaaki Hori, Shigeki Aoki, Hiroyuki Daida
OBJECTIVE: The aim of this study was to evaluate the reproducibility of computed tomography (CT)-derived fractional flow reserve (FFR) determined on site by inexperienced observers using a postprocessing software based on structural and fluid analysis. METHODS: Using 21 coronary vessels in 7 patients who underwent 320-row coronary CT angiography and catheter-FFR, 2 independent inexperienced observers (A: a student radiation technologist; B: a nonmedical staff) determined the CT-FFR using a postprocessing software...
September 20, 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28926310/coronary-ct-angiography-derived-fractional-flow-reserve
#17
Christian Tesche, Carlo N De Cecco, Moritz H Albrecht, Taylor M Duguay, Richard R Bayer, Sheldon E Litwin, Daniel H Steinberg, U Joseph Schoepf
Invasive coronary angiography (ICA) with measurement of fractional flow reserve (FFR) by means of a pressure wire technique is the established reference standard for the functional assessment of coronary artery disease (CAD) ( 1 , 2 ). Coronary computed tomographic (CT) angiography has emerged as a noninvasive method for direct assessment of CAD and plaque characterization with high diagnostic accuracy compared with ICA ( 3 , 4 ). However, the solely anatomic assessment provided with both coronary CT angiography and ICA has poor discriminatory power for ischemia-inducing lesions...
October 2017: Radiology
https://www.readbyqxmd.com/read/28920099/fast-virtual-fractional-flow-reserve-based%C3%A2-upon-steady-state-computational-fluid-dynamics-analysis-results-from-the-virtu-fast-study
#18
Paul D Morris, Daniel Alejandro Silva Soto, Jeroen F A Feher, Dan Rafiroiu, Angela Lungu, Susheel Varma, Patricia V Lawford, D Rodney Hose, Julian P Gunn
Fractional flow reserve (FFR)-guided percutaneous intervention is superior to standard assessment but remains underused. The authors have developed a novel "pseudotransient" analysis protocol for computing virtual fractional flow reserve (vFFR) based upon angiographic images and steady-state computational fluid dynamics. This protocol generates vFFR results in 189 s (cf >24 h for transient analysis) using a desktop PC, with <1% error relative to that of full-transient computational fluid dynamics analysis...
August 2017: JACC. Basic to Translational Science
https://www.readbyqxmd.com/read/28916602/validation-study-of-image-based-fractional-flow-reserve-during-coronary-angiography
#19
Mariano Pellicano, Ifat Lavi, Bernard De Bruyne, Hana Vaknin-Assa, Abid Assali, Orna Valtzer, Yonit Lotringer, Giora Weisz, Yaron Almagor, Panagiotis Xaplanteris, Ajay J Kirtane, Pablo Codner, Martin B Leon, Ran Kornowski
BACKGROUND: Fractional flow reserve (FFR), an index of the hemodynamic severity of coronary stenoses, is derived from invasive measurements and requires a pressure-monitoring guidewire and hyperemic stimulus. Angiography-derived FFR measurements (FFRangio) may have several advantages. The aim of this study is to assess the diagnostic performance and interobserver reproducibility of FFRangio in patients with stable coronary artery disease. METHODS AND RESULTS: FFRangio is a computational method based on rapid flow analysis for the assessment of FFR...
September 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28902523/functional-assessment-of-lesion-severity-without-using-the-pressure-wire-coronary-imaging-and-blood-flow-simulation
#20
Michail I Papafaklis, Michail C Mavrogiannis, Panagiotis K Siogkas, Lampros S Lakkas, Christos S Katsouras, Dimitrios I Fotiadis, Lampros K Michalis
Hemodynamic indices derived from measurements with the pressure wire (primarily fractional flow reserve [FFR]) have been established as a reliable tool for assessing coronary stenoses and improving clinical decision making. However, the use of the pressure wire constitutes a hurdle for the universal adoption of physiology-guided patient management. Technological advancements have enabled the large-scale application of blood flow simulation (computational fluid dynamics [CFD]) to medical imaging, thereby enabling the virtual assessment of coronary physiology...
November 2017: Expert Review of Cardiovascular Therapy
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