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coronary flow reserve

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https://www.readbyqxmd.com/read/28214966/anomalous-coronary-arteries-and-myocardial-bridges-risk-stratification-in-children-using-novel-cardiac-catheterization-techniques
#1
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/28213449/optimal-adenosine-stress-for-maximum-stress-perfusion-coronary-flow-reserve-and-pixel-distribution-of-coronary-flow-capacity-by-kolmogorov-smirnov-analysis
#2
Danai Kitkungvan, Dejian Lai, Hongjian Zhu, Amanda E Roby, Nils P Johnson, Derek D Steptoe, Monica B Patel, Richard Kirkeeide, K Lance Gould
BACKGROUND: Different adenosine stress imaging protocols have not been systemically validated for absolute myocardial perfusion and coronary flow reserve (CFR) by positron emission tomography, where submaximal stress precludes assessing physiological severity of coronary artery disease. METHODS AND RESULTS: In 127 volunteers, serial rest-stress positron emission tomography scans using rubidium-82 with various adenosine infusion protocols identified (1) the protocol with maximum stress perfusion and CFR, (2) test-retest precision in same subject, (3) stress perfusion and CFR after adenosine compared with dipyridamole, (4) heterogeneity of coronary flow capacity combining stress perfusion and CFR, and (5) potential relevance for patients with risk factors or coronary artery disease...
February 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28207997/chronically-elevated-bilirubin-protects-from-cardiac-reperfusion-injury-in-the-male-gunn-rat
#3
Bhavisha Bakrania, Eugene F Du Toit, Kevin J Ashton, Karl-Heinz Wagner, John P Headrick, Andrew C Bulmer
AIMS: Bilirubin is associated with reduced risk of cardiovascular disease, as evidenced in conditions of mild hyperbilirubinaemia (Gilbert's Syndrome). Little is known regarding myocardial stress-resistance in hyperbilirubinemic conditions or whether life-long exposure modifies cardiac function, which might contribute to protection from cardiovascular disease. METHODS: Hyperbilirubinemic rats and littermate controls underwent echocardiography at 3, 6 and 12 mo of age, with hearts subsequently assessed for resistance to 30 min of ischaemia...
February 16, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28205113/cardiac-pet-ct-with-rb-82-optimization-of-image-acquisition-and-reconstruction-parameters
#4
P Chilra, S Gnesin, G Allenbach, M Monteiro, J O Prior, L Vieira, J A Pires Jorge
BACKGROUND: Our aim was to characterize the influence of time-of-flight (TOF) and point spread function (PSF) recovery corrections, as well as ordered subset expectation maximization (OSEM) reconstruction parameters, in (82)Rb PET/CT quantification of myocardial blood flow (MBF) and myocardial flow reserve (MFR). Rest and stress list-mode dynamic (82)Rb PET acquisition data from 10 patients without myocardial flow defects and 10 patients with myocardial blood flow defects were reconstructed retrospectively...
December 2017: EJNMMI Physics
https://www.readbyqxmd.com/read/28203465/st-segment-elevation-myocardial-infarction-and-normal-coronary-arteries-after-consuming-energy-drinks
#5
S Michael Gharacholou, Nkechinyere Ijioma, Emma Banwart, Freddy Del Carpio Munoz
The use of energy drinks, which often contain stimulants, is common among young persons, yet there have been few reports of adverse cardiac events. We report the case of a 27-year-old man who was admitted to our facility with an acute ST-segment elevation myocardial infarction in the setting of using energy drinks. Angiography revealed no obstructive coronary disease. The patient had elevation of cardiac troponin. Noninvasive testing with echocardiography and cardiac magnetic resonance imaging demonstrated both abnormalities in resting wall motion at the anterior apex along with late gadolinium enhancement of the anterior wall, respectively...
2017: Case Reports in 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
#6
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/28196358/wellens-syndrome-a-bad-omen
#7
Madalena Coutinho Cruz, Isabel Luiz, Lurdes Ferreira, Rui Cruz Ferreira
Wellens' syndrome is characterized by an electrocardiographic pattern of T-wave changes associated with a critical stenosis of the left anterior descending artery (LAD), which progresses to an extensive anterior myocardial infarction in the majority of cases. For this reason, its recognition and early treatment are extremely important. We report 2 cases of Wellens' syndrome: an 83-year-old male presenting with ill-characterized chest pain, biphasic T waves in V1-V3 during an asymptomatic period, negative cardiac biomarkers, and a 64% stenosis in LAD with a fractional flow reserve of 0...
February 15, 2017: Cardiology
https://www.readbyqxmd.com/read/28191876/clinical-and-angiographic-predictors-of-hemodynamically-significant-angiographic-lesions-development-and-validation-of-a-risk-score-to-predict-positive-fractional-flow-reserve
#8
Nishtha Sareen, Usman Baber, Safwan Kezbor, Sonny Sayseng, Melissa Aquino, Roxana Mehran, Joseph Sweeny, Nitin Barman, Annapoorna Kini, Samin K Sharma
AIMS: Coronary revascularization based upon physiological evaluation of lesions improves clinical outcomes. Angiographic or visual stenosis assessment alone is insufficient in predicting hemodynamic stenosis severity by Fractional Flow reserve (FFR) and therefore cannot be used to guide revascularization, particularly in the lesion subset (<70%). Accordingly, we sought to identify independent determinants of angiographic intermediate lesions with hemodynamic significance. METHODS AND RESULTS: We assessed consecutive intermediate lesions for patients from January 2014-April 2015 at our institution...
February 14, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28191874/instantaneous-wave-free-ratio-to-guide-coronary-revascularization-physiological-framework-validation-and-differences-with-fractional-flow-reserve
#9
Guus A de Waard, Carlo Di Mario, Amir Lerman, Patrick W Serruys, Niels van Royen
Determining the optimal treatment strategy for revascularization of coronary artery stenosis involves the use of fractional flow reserve (FFR). To improve the low clinical uptake of physiological lesion assessment to guide revascularization, the instantaneous wave-free period (iFR) was proposed as a simpler alternative to FFR that does not require adenosine administration. iFR is calculated as the ratio of blood pressure distal and proximal to a coronary artery stenosis during the diastolic wave- free period...
February 14, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28177123/katp-channel-inhibition-blunts-electromechanical-decline-during-hypoxia-in-left-ventricular-working-rabbit-hearts
#10
Kara Garrott, Sarah Kuzmiak-Glancy, Anastasia Wengrowski, Hanyu Zhang, Jack Rogers, Matthew Kay
Sarcolemmal KATP channel activation in isolated cells is generally understood, yet the relationship between myocardial oxygenation and KATP activation in excised working rabbit hearts remains unknown. We optically mapped action potentials (APs) in excised rabbit hearts to test the hypothesis that hypoxic changes would be more severe in LV working hearts (LWHs) than Langendorff (LANG) perfused hearts. We further hypothesized that KATP inhibition would prevent those changes. Optical APs were mapped while measuring LV developed pressure (LVDP), coronary flow rate (CFR), and oxygen consumption (MVO2 ) in LANG and LWHs...
February 8, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28169057/invasive-assessment-of-coronary-flow-reserve-impairment-in-severe-aortic-stenosis-and-ecochadiographic-correlations
#11
Alejandro Gutiérrez-Barrios, Sergio Gamaza-Chulián, Antonio Agarrado-Luna, Dolores Ruiz-Fernández, G Calle-Pérez, E Marante-Fuertes, R Zayas-Rueda, Miguel Alba-Sánchez, Jesús Oneto-Otero, R Vázquez-Garcia
OBJECTIVES AND BACKGROUND: Patients with aortic stenosis (AS) may have impaired coronary flow reserve (CFR) despite angiographically normal coronary arteries. This is the first report of invasive thermodilution-derived CFR and IMR in patients with AS and their associations with echocardiographic parameters for AS assessment. METHODS: Thirty-six consecutive severe AS patients and ten patients without AS underwent prospectively cardiac catheterization and coronary physiological parameters were determined in the left anterior descending (LAD)...
February 1, 2017: International Journal of Cardiology
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
#12
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)...
January 16, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28164013/stenotic-flow-reserve-derived-from-quantitative-coronary-angiography-has-modest-but-incremental-value-in-predicting-functionally-significant-coronary-stenosis-as-evaluated-by-fractional-flow-reserve
#13
Elizabeth L Potter, Colin Machado, Yuvaraj Malaiapan, Om Narayan, Brian S H Ko, Peter J Psaltis, Kiran Munnur, James D Cameron, Ian T Meredith, Dennis Thiam Leong Wong
BACKGROUND: Stenotic flow reserve (SFR) derived from quantitative coronary angiography (QCA) has been correlated with myocardial ischaemia as determined by pharmacological stress echocardiography. However, the diagnostic accuracy of SFR in predicting functionally significant coronary stenosis as assessed by the gold standard, fractional flow reserve (FFR), has not been previously characterised. METHODS: Patients who underwent coronary angiography and FFR assessment between January 2010 and February 2012 in a single tertiary centre were retrospectively assessed...
February 2017: Cardiovascular Diagnosis and Therapy
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
#14
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...
January 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28160376/fractional-flow-reserve-and-resting-indices-for-coronary-physiologic-assessment-practical-guide-tips-and-tricks
#15
Fabien Picard, Michele Pighi, Hung Q Ly
Physiologic assessment using fractional flow reserve (FFR) to guide percutaneous coronary interventions (PCI) has been demonstrated to improve clinical outcomes, compared to angiography-guided PCI. Recently, resting indices such as resting Pd/Pa, "instantaneous wave-free ratio", and contrast medium induced FFR have been evaluated for the assessment of the functional consequences of coronary lesions. Herein, we review and discuss the use of FFR and other indices for the functional assessment of coronary lesions...
February 4, 2017: Catheterization and Cardiovascular Interventions
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
#16
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/28154161/development-of-coronary-pulse-wave-velocity-new-pathophysiological-insight-into-coronary-artery-disease
#17
Brahim Harbaoui, Pierre-Yves Courand, Andrei Cividjian, Pierre Lantelme
BACKGROUND: Although aortic stiffness assessed by pulse wave velocity (PWV) is a strong predictor of coronary artery disease, the significance of local coronary stiffness has never been tackled. The first objective of this study was to describe a method of measuring coronary PWV (CoPWV) invasively and to describe its determinants. The second objective was to assess both CoPWV and aortic PWV in patients presenting with acute coronary syndromes or stable coronary artery disease. METHODS AND RESULTS: In 53 patients, CoPWV was measured from the delay in pressure wave and distance traveled as a pressure wire was withdrawn from the distal to the proximal coronary segment...
February 2, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28149663/left-ventricular-systolic-dysfunction-in-two-patients-with-ankylosing-spondylitis-what-is-the-role-of-corticosteroids
#18
Ahmad Amin, Mitra Chitsazan, Hossein Navid
Ankylosing spondylitis (AS) is a chronic inflammatory condition that most commonly affects the axial skeleton. The most common cardiac manifestation in patients with AS is the aortic root and valve disease, followed by conduction and rhythm abnormalities, decreased coronary flow reserve, myocardial infarction, and diastolic dysfunction. However, the presence of systolic dysfunction has been less described in patients with AS. Herein we present two cases of idiopathic dilated cardiomyopathy in patients with AS...
December 2016: European Journal of Rheumatology
https://www.readbyqxmd.com/read/28138813/noninvasive-pet-quantitative-myocardial-blood-flow-with-regadenoson-for-assessing-cardiac-allograft-vasculopathy-in-orthotopic-heart-transplantation-patients
#19
Miguel Hernandez Pampaloni, Uttam M Shrestha, Maria Sciammarella, Youngho Seo, Grant T Gullberg, Elias H Botvinick
BACKGROUND: Risk stratification and early detection of cardiac allograft vasculopathy (CAV) is essential in orthotopic heart transplantation (OHT) patients. This study assesses the changes in myocardial blood flow (MBF) noninvasively in OHT patients using quantitative cardiac PET with regadenoson. METHODS: Twelve patients (Group 1) (8 males, 4 females, mean age 55 ± 7 years) with no history of post OHT myocardial ischemia were enrolled 5.4 ± 2.0 years after OHT...
January 30, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28134124/the-impact-of-microvascular-resistance-on-the-discordance-between-anatomical-and-functional-evaluations-of-intermediate-coronary-disease
#20
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
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