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https://www.readbyqxmd.com/read/28882237/the-evolving-future-of-instantaneous%C3%A2-wave-free-ratio-and-fractional-flow%C3%A2-reserve
#1
REVIEW
Matthias Götberg, Christopher M Cook, Sayan Sen, Sukhjinder Nijjer, Javier Escaned, Justin E Davies
In this review, the authors reflect upon the role of coronary physiology in the modern management of coronary artery disease. They critically appraise the scientific background of the instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR), from early experimental studies to validation studies against indexes of ischemia, to clinical trials assessing outcome. At this important juncture for the field, the authors make predictions for the future of physiological stenosis assessment, outlining developments for both iFR and FFR in new clinical domains beyond the confines of stable angina...
September 12, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28853190/diagnostic-accuracy-of-instantaneous-wave-free-ratio-in-clinical-practice
#2
Wern Yew Ding, Satheesh Nair, Clare Appleby
AIMS: To evaluate the correlation between iFR and FFR in real-world clinical practice. METHODS AND RESULTS: Retrospective, single-centre study of 229 consecutive pressure-wire studies (np  = 158). Real-time iFR and FFR measurements were performed for angiographically borderline stenoses. Functionally significant stenoses were defined as iFR <0.86 or FFR ≤0.80. An iFR between 0.86 and 0.93 was considered within the grey zone (Hybrid approach). Median iFR and FFR (IQR) were 0...
August 29, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28851731/exploring-coronary-circulatory-response-to-stenosis-and-its-association-with-invasive-physiologic-indices-using-absolute-myocardial-blood-flow-and-coronary-pressure
#3
Joo Myung Lee, Doyeon Hwang, Jonghanne Park, Jinlong Zhang, Yaliang Tong, Chee Hae Kim, Ji-In Bang, Minseok Suh, Jin Chul Paeng, Gi Jeong Cheon, Bon-Kwon Koo
Background -Although invasive physiologic assessment for coronary stenosis has become a standard practice to guide treatment strategy, coronary circulatory response and changes in invasive physiologic indices, according to different anatomical and hemodynamic lesion severity, have not been fully demonstrated in patients with coronary artery disease. Methods -One hundred fifteen patients with left anterior descending artery stenosis who underwent both (13)N-ammonia positron emission tomography (PET) and invasive physiologic measurement were analyzed...
August 29, 2017: Circulation
https://www.readbyqxmd.com/read/28846545/physiologic-evaluation-of-coronary-lesions-using-instantaneous-wave-free-ratio-ifr-in-patients-with-severe-aortic-stenosis-undergoing-trans-catheter-aortic-valve-implantation
#4
Roberto Scarsini, Gabriele Pesarini, Carlo Zivelonghi, Anna Piccoli, Valeria Ferrero, Mattia Lunardi, Leonardo Gottin, Claudia Zanetti, Giuseppe Faggian, Flavio Ribichini
AIMS: We sought to assess eventual changes in iFR measurements in patients with aortic stenosis (AS) before and after TAVI in coronary lesions with different degree of angiographic severity. METHODS AND RESULTS: The functional relevance of 145 coronary lesions was assessed by on-line iFR and FFR measurement in 66 patients with severe AS before and after TAVI, during the same procedure. The iFR-FFR classification agreement was calculated for pre- and post-TAVI measurements...
August 29, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28835979/-instantaneous-wave-free-ratio-ifr%C3%A2-in-patients-with-coronary-artery-disease
#5
REVIEW
S Baumann, A C Schaefer, A Hohneck, K Mueller, T Becher, M Behnes, M Renker, M Borggrefe, I Akin, D Lossnitzer
Coronary angiography is considered as the gold standard in the morphological representation of coronary artery stenosis. Coronary angiography is often performed without preprocedural non-invasive proof of ischemia and the assessment of the severity of a coronary lesion by morphology is very subjective. Thus, invasive fractional flow reserve (FFR) measurement represents the current standard for estimation of the hemodynamic relevance of coronary artery stenosis and facilitates decision making for percutaneous coronary intervention (PCI) and stenting...
August 23, 2017: Herz
https://www.readbyqxmd.com/read/28804200/making-aircraft-vortices-visible-to-radar-by-spraying-water-into-the-wake
#6
Karim Shariff
Aircraft trailing vortices pose a danger to following aircraft during take-off and landing. This necessitates spacing rules, based on aircraft type, to be enforced during approach in IFR (Instrument Flight Regulations) conditions; this can limit airport capacity. To help choose aircraft spacing based on the actual location and strength of the wake, it is proposed that wake vortices can be detected using conventional precipitation and cloud radars. This is enabled by spraying a small quantity water into the wake from near the wing...
December 2016: J Atmos Ocean Technol
https://www.readbyqxmd.com/read/28789845/discrepancy-between-fractional-flow-reserve-and-instantaneous-wave-free-ratio-clinical-and-angiographic-characteristics
#7
Joo Myung Lee, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Doyeon Hwang, Jonghanne Park, Kyung-Jin Kim, Jinlong Zhang, Bon-Kwon Koo
BACKGROUND: The invasive physiologic index such as fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR) is used in clinical practice to identify ischemia-causing stenosis and to guide treatment strategy. We investigated clinical and angiographic characteristics of lesions with discrepancy between FFR and iFR. METHODS: From the 3V FFR-FRIENDS study, 975 vessels (393 patients) with available pre-intervention FFR and iFR were included in this study...
August 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28758775/near-independent-capacities-and-highly-constrained-output-orders-in-the-simultaneous-free-recall-of-auditory-verbal-and-visuo-spatial-stimuli
#8
Cathleen Cortis Mack, Kevin Dent, Geoff Ward
Three experiments examined the immediate free recall (IFR) of auditory-verbal and visuospatial materials from single-modality and dual-modality lists. In Experiment 1, we presented participants with between 1 and 16 spoken words, with between 1 and 16 visuospatial dot locations, or with between 1 and 16 words and dots with synchronized onsets. We found that for dual-modality lists (a) overall performance, initial recalls, and serial position curves were largely determined by the within-modality list lengths, (b) there was only a small degree of dual-task trade-off (that was limited to the visuospatial items), and (c) there were strongly constrained output orders: participants tended to alternate between words and dots from equivalent or neighboring serial positions...
July 31, 2017: Journal of Experimental Psychology. Learning, Memory, and Cognition
https://www.readbyqxmd.com/read/28688551/pediatric-invasive-fungal-rhinosinusitis-an-investigation-of-17-patients
#9
Daniel Vinh, Michael Yim, Ankhi Dutta, John K Jones, Wei Zhang, Matthew Sitton
PURPOSE: To investigate outcomes of pediatric patients at a single institution with invasive fungal rhinosinusitis (IFRS) and to determine variables that impact overall survival. METHODS: All pediatric patients at a large tertiary children's hospital diagnosed with IFRS confirmed by surgical pathology from 2009 to 2015 were retrospectively reviewed. Demographics, underlying diseases, symptoms, antifungal therapy, absolute neutrophil count (ANC), surgical management,and outcomes were analyzed...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28660783/interview-with-justin-davies-and-andrew-tochterman
#10
Justin Davies, Andrew Tochterman
Justin Davies and Andrew Tochterman speak to Adam Price-Evans, Commissioning Editor of Future Cardiology: Justin Davies is a Senior Research Fellow and Honorary Consultant Cardiologist at the National Heart and Lung Institute, Imperial College London (UK). His main research interests include the development and application of pioneering technologies in engineering to aid understanding of disease mechanisms, and in the diagnosis of pathological disease states. After completing his undergraduate training at Imperial College, he was awarded a prestigious British Heart Foundation research fellowship to undertake his PhD at Imperial College...
July 2017: Future Cardiology
https://www.readbyqxmd.com/read/28643215/relationship-between-instantaneous-wave-free-ratio-and-fractional-flow-reserve-in-patients-receiving-hemodialysis
#11
Yuta Morioka, Hiroyuki Arashi, Hisao Otsuki, Junichi Yamaguchi, Nobuhisa Hagiwara
Instantaneous wave-free ratio (iFR) is a vasodilator-free index and is reported to have a good correlation with fractional flow reserve (FFR). Hemodialysis patients exhibit left ventricular hypertrophy, reduced arterial compliance, and impaired microcirculation. Such a coronary flow condition in these patients may influence the relationship between iFR and FFR. This study assessed the impact of hemodialysis on the relationship between iFR and FFR. The study enrolled 196 patients with 265 stenoses who underwent assessment via iFR, FFR assessment, and right heart catheterization...
June 22, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28612008/hybrid-instantaneous-wave-free-ratio-fractional-flow-reserve-versus-fractional-flow-reserve-in-the-real-world
#12
Kara Shuttleworth, Kristina Smith, Jonathan Watt, Jamie A L Smith, Stephen J Leslie
BACKGROUND: The instantaneous wave-free ratio (iFR) is a novel method to assess the ischemic potential of coronary artery stenoses. Clinical trial data have shown that iFR has acceptable diagnostic agreement with fractional flow reserve (FFR), the reference standard for the functional assessment of coronary stenoses. This study compares iFR measurements with FFR measurements in a real world, single-center setting. METHODS AND RESULTS: Instantaneous wave-free ratio and FFR were measured in 50 coronary artery lesions in 42 patients, with FFR ≤ 0...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28610962/coronary-physiology-in-patients-with-severe-aortic-stenosis-comparison-between-fractional-flow-reserve-and-instantaneous-wave-free-ratio
#13
Roberto Scarsini, Gabriele Pesarini, Carlo Zivelonghi, Anna Piccoli, Valeria Ferrero, Mattia Lunardi, Marco Barbierato, Francesco Caprioglio, Corrado Vassanelli, Flavio Ribichini
BACKGROUND: The functional assessment of coronary artery disease (CAD) in patients with aortic stenosis (AS) has not been validated so far, and the best strategy to physiologically investigate the relevance of coronary stenosis in this specific setting of patients remains undetermined. The aim of the study is to compare the diagnostic performance of instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR) in patients with severe AS. METHODS: The functional significance of 179 coronary lesions was investigated with on-line iFR and FFR measurements in 85 AS patients and compared with a control group formed by 167 patients (290 lesions) with stable CAD and without AS...
September 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28600102/physiologic-mechanism-of-discordance-between-instantaneous-wave-free-ratio-and-fractional-flow-reserve-insight-from-13-n-ammonium-positron-emission-tomography
#14
Joo Myung Lee, Doyeon Hwang, Jonghanne Park, Yaliang Tong, Bon-Kwon Koo
BACKGROUND: Invasive physiologic indices, such as fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR), are used in clinical practice. We sought to evaluate the physiological mechanism of discordance between iFR and FFR using (13)N-ammonia positron emission tomography (PET)-derived quantitative parameters. METHODS: Data from 113 patients, who underwent both (13)N-ammonia PET and invasive FFR and iFR measurement, were analyzed. Coronary circulatory indices, such as myocardial blood flow (MBF), coronary flow reserve (CFR), microvascular resistance, and trans-stenosis resistance were compared between patients with discordant results (low FFR despite high iFR) and those with concordant abnormal results (low FFR and low iFR), using cut-off values of FFR≤0...
September 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28557502/common-modality-effects-in-immediate-free-recall-and-immediate-serial-recall
#15
Rachel Grenfell-Essam, Geoff Ward, Lydia Tan
In 2 experiments, participants were presented with lists of between 2 and 12 words for either immediate free recall (IFR) or immediate serial recall (ISR). Auditory recall advantages at the end of the list (modality effects) and visual recall advantages early in the list (inverse modality effects) were observed in both tasks and the extent and magnitude of these effects were dependent upon list length. Both tasks displayed modality effects with short lists that were large in magnitude but limited to the final serial position, consistent with those observed in the typically short lists used in ISR, and both tasks displayed modality effects with longer lists that were small in magnitude and more extended across multiple end-of-list positions, consistent with those observed in the typically longer lists used in IFR...
May 29, 2017: Journal of Experimental Psychology. Learning, Memory, and Cognition
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
#16
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/28532572/rates-and-causes-of-accidents-for-general-aviation-aircraft-operating-in-a-mountainous-and-high-elevation-terrain-environment
#17
Marisa Aguiar, Alan Stolzer, Douglas D Boyd
BACKGROUND: Flying over mountainous and/or high elevation terrain is challenging due to rapidly changeable visibility, gusty/rotor winds and downdrafts and the necessity of terrain avoidance. Herein, general aviation accident rates and mishap cause/factors were determined (2001-2014) for a geographical region characterized by such terrain. METHODS: Accidents in single piston engine-powered aircraft for states west of the US continental divide characterized by mountainous terrain and/or high elevation (MEHET) were identified from the NTSB database...
May 19, 2017: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/28499678/saving-lives-for-35-years-sentara-nightingale-looks-forward
#18
Dale Gauding
The Nightingale Regional air Ambulance program, operated by Norfolk, VA-based not-for-profit Sentara Healthcare, is marking its 35th year of operation in 2017, having surpassed 20,000 safe flights. Looking ahead, the program is adding IFR capabilities, designated landing zones to rendezvous with EMS partners and clinical training in a simulation lab, and collaborating with cardiac and neurology services to provide quicker interventions for STEMI and stroke patients at Sentara Norfolk General Hospital.
May 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28496465/effect-of-nonionic-surfactants-dodecyl-maltoside-and-polysorbate-20-on-prevention-of-aggregation-and-conformational-changes-of-recombinant-human-ifn%C3%AE-_1b-induced-by-light
#19
Najmeh Mahjoubi, Ahmad Fazeli, Rassoul Dinarvand, Mohammad Reza Khoshayand, Maryam Shekarchi, Mohammad Reza Fazeli
Liquid protein formulations are prone to form aggregates. The effect of nonionic surfactants such as Polysorbate 20 (PS 20) and n-Dodecyl β-D-maltoside (DDM) on the prevention of aggregation and conformational changes of recombinant human IFNβ-1b (rhIFN β_1b) was explored. Polysorbate has been used in formulations of protein pharmaceuticals. There have been concerns about using PS 20 due to its residual peroxide content which may negatively affect protein efficacy. n-Dodecyl β-D-maltoside has been of interest and shown to be highly effective in prevention of aggregation...
2017: Iranian Journal of Pharmaceutical Research: IJPR
https://www.readbyqxmd.com/read/28432521/intermittent-food-restriction-initiated-late-in-life-prolongs-lifespan-and-retards-the-onset-of-age-related-markers-in-the-annual-fish-nothobranchius-guentheri
#20
Xia Wang, Xiaoyuan Du, Yang Zhou, Su Wang, Feng Su, Shicui Zhang
Two of the most studied and widely accepted conjectures on possible aging mechanisms are the oxidative stress hypothesis and the insulin/insulin-like growth factor 1 (IGF-1) signaling (IIS) pathway. Intermittent fasting (IF) is known to modulate aging and to prolong lifespan in a variety of organisms, but the mechanisms are still under debate. In this study, we first demonstrated that late-onset two consecutive days a week fasting, a form of IF, termed intermittent food restriction (IFR), exhibited a time-dependent effect, and long-term late-onset IFR extended the mean lifespan and maximum lifespan by approximately 3...
June 2017: Biogerontology
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