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coronary flow reserve

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https://www.readbyqxmd.com/read/28629622/optical-coherence-tomography-compared-with-fractional-flow-reserve-guided-approach-in-acute-coronary-syndromes-a-propensity-matched-analysis
#1
Fabrizio D'Ascenzo, Mario Iannaccone, Ovidio De Filippo, Antonio Maria Leone, Giampaolo Niccoli, Filippo Zilio, Fabrizio Ugo, Enrico Cerrato, Massimo Fineschi, Massimo Mancone, Stefano Rigattieri, Nicolas Amabile, Marco Ferlini, Gennaro Sardella, Alberto Cresti, Umberto Barbero, Pascal Motreff, Francesco Colombo, Salvatore Colangelo, Roberto Garbo, Giuseppe Biondi-Zoccai, Corrado Tamburino, Antonio Montefusco, Pierlugi Omedè, Claudio Moretti, Maurizio D'amico, Geraud Souteyrand, Fiorenzo Gaita, Ugo Limbruno, Andrea Picchi
AIM: To compare in patients with ACS (acute coronary syndromes) a PCI (percutaneous coronary intervention) approach based on FFR (fractional flow reserve) vs. one based on OCT (optical coherence tomography). METHODS AND RESULTS: Consecutive patients admitted for ACS and treated with a PCI approach based on OCT or on FFR (recruited in two different studies) were compared and matched with propensity score analysis. Target Lesion revascularization (TLR) was the primary end point, while major adverse cardiovascular events [MACEs defined as the composite of death from cardiac causes, non-fatal MI, clinically driven target vessel revascularization (TVR), or re-hospitalization due to unstable angina] were the secondary ones...
June 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28627046/donor-specific-antibodies-are-associated-with-micro-and-macrovascular-coronary-disease-restrictive-myocardial-damage-and-poor-outcome-in-heart-transplanted-patients
#2
Tor Skibsted Clemmensen, Pernille Koefoed-Nielsen, Lis-Ann Jensen, Steen Hvitfeldt Poulsen, Niels Ramsing Holm, Brian Bridal Løgstrup, Evald Høj Christiansen, Jouke Dijkstra, Kamilla Pernille Bjerre Valen, Hans Eiskjaer
AIMS: We examined the relationship between donor-specific HLA antibody (DSA) presence and graft function, hemodynamics, cardiac allograft vasculopathy (CAV), and major adverse cardiac events (MACE) in stable long-term heart-transplanted (HTx) patients. METHODS: Sera from 79 patients (median 7.5 years after HTx) were analyzed for DSA presence. Graft function was evaluated by echocardiography and right heart catheterization. CAV-burden was determined by coronary angiography, optical coherence tomography (OCT), and coronary flow velocity reserve (CFVR)...
June 19, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28626148/prevalence-of-thin-cap-fibroatheroma-in-relation-to-the-severity-of-anatomical-and-physiological-stenosis
#3
Eisuke Usui, Taishi Yonetsu, Tadashi Murai, Yoshihisa Kanaji, Junji Matsuda, Masahiro Hoshino, Makoto Araki, Takayuki Niida, Masahiro Hada, Sadamitsu Ichijyo, Rikuta Hamaya, Yoshinori Kanno, Tetsumin Lee, Mitsuaki Isobe, Tsunekazu Kakuta
BACKGROUND: The relationship between the features of morphologically unstable plaque and physiological lesion severity remains elusive. We aimed to investigate this relationship using optical coherence tomography (OCT)-derived high-risk plaque characteristics and fractional flow reserve (FFR) as the degree of anatomical and physiological stenosis severity.Methods and Results:We investigated 286 de novo intermediate and severe coronary lesions in 248 patients who underwent OCT and FFR examinations...
June 16, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28622946/estimation-of-myocardial-flow-reserve-utilizing-an-ultrafast-cardiac-spect-comparison-with-coronary-angiography-fractional-flow-reserve-and-the-syntax-score
#4
Masao Miyagawa, Yoshiko Nishiyama, Teruyoshi Uetani, Akiyoshi Ogimoto, Shuntaro Ikeda, Hayato Ishimura, Emiri Watanabe, Rami Tashiro, Yuki Tanabe, Teruhito Kido, Akira Kurata, Teruhito Mochizuki
BACKGROUND: Quantitative assessment of myocardial flow reserve (MFR) by single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) is challenging but may facilitate evaluation of multi-vessel coronary artery disease (CAD). METHODS: We enrolled 153 patients with suspected or known CAD, referred for pharmacological stress MPI. They underwent a (99m)Tc-perfusion stress/rest SPECT with an ultrafast cadmium-zinc-telluride (CZT) camera. Dynamic data were acquired and time-activity curves fitted to a 1-tissue compartment analysis with input function...
June 13, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28616567/cyp2c19-variants-and-epoxyeicosatrienoic-acids-in-patients-with-microvascular-angina
#5
Tomonori Akasaka, Daisuke Sueta, Yuichiro Arima, Noriaki Tabata, Seiji Takashio, Yasuhiro Izumiya, Eiichiro Yamamoto, Kenichi Tsujita, Sunao Kojima, Koichi Kaikita, Ayami Kajiwara, Kazunori Morita, Kentaro Oniki, Junji Saruwatari, Kazuko Nakagawa, Seiji Hokimoto
BACKGROUND: Categorization as a cytochrome P450 (CYP) 2C19 poor metabolizer (PM) is reported to be an independent risk factor for cardiovascular disease. Epoxyeicosatrienoic acids (EETs) are metabolites of arachidonic acid by CYP2C19 epoxygenases and anti-inflammatory properties, especially in microvascular tissues. We examined the impact of CYP2C19 polymorphisms and EETs on the patients with microvascular angina (MVA) caused by coronary microvascular dysfunction. METHODS AND RESULTS: We examined CYP2C19 genotypes in patients with MVA (n = 81)...
June 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28616535/effect-of-intravenous-infusion-of-iodinated-contrast-media-on-the-coronary-blood-flow-in-dogs
#6
Thura T Abd, Asim I Shafique, Hayder S Yasir, Jung-Hee Seo, Richard T George, Rajat Mittal, Albert C Lardo
BACKGROUND: Coronary computed tomography angiography (CCTA) is obtained using peripheral intravenous iodinated contrast agents (ICA) injection. There is continuing attempts to derive coronary physiological information like coronary blood flow (CBF) and/or fractional flow reserve from CCTA images. However, no data is available regarding the effect of peripheral intravenous injection of ICA on CBF. METHODS: A series of 4 experiments was performed using healthy mongrel dogs...
September 2016: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28615234/impact-of-routine-fractional-flow-reserve-on-management-decision-and-1-year-clinical-outcome-of-patients-with-acute-coronary-syndromes-prime-ffr-insights-from-the-post-it-portuguese-study-on-the-evaluation-of-ffr-guided-treatment-of-coronary-disease-and-r3f
#7
Eric Van Belle, Sergio-Bravo Baptista, Luís Raposo, John Henderson, Gilles Rioufol, Lino Santos, Christophe Pouillot, Ruben Ramos, Thomas Cuisset, Rita Calé, Emmanuel Teiger, Elisabete Jorge, Loic Belle, Carina Machado, Didier Barreau, Marco Costa, Michel Hanssen, Eduardo Oliveira, Cyril Besnard, João Costa, Jean Dallongeville, João Pipa, Georgios Sideris, Nuno Fonseca, Christophe Bretelle, Jorge Guardado, Nicolas Lhoest, Bruno Silva, Pierre Barnay, Maria-João Sousa, Laurent Leborgne, João Carlos Silva, Flavien Vincent, Alberto Rodrigues, Luís Seca, Renato Fernandes, Patrick Dupouy
BACKGROUND: Fractional flow reserve (FFR) is not firmly established as a guide to treatment in patients with acute coronary syndromes (ACS). Primary goals were to evaluate the impact of integrating FFR on management decisions and on clinical outcome of patients with ACS undergoing coronary angiography, as compared with patients with stable coronary artery disease. METHODS AND RESULTS: R3F (French FFR Registry) and POST-IT (Portuguese Study on the Evaluation of FFR-Guided Treatment of Coronary Disease), sharing a common design, were pooled as PRIME-FFR (Insights From the POST-IT and R3F Integrated Multicenter Registries - Implementation of FFR in Routine Practice)...
June 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28613418/differences-in-optic-nerve-head-microcirculation-between-evening-and-morning-in-patients-with-coronary-artery-disease
#8
Tomoaki Shiba, Mao Takahashi, Tadashi Matsumoto, Yuichi Hori
PURPOSE: To determine whether differences or variation of blood flow in the optic nerve head (ONH) are independent risk factors for coronary artery disease (CAD). METHODS: We studied 144 consecutive patients whose ocular blood flow in the ONH was measured in the evening and morning by laser speckle flowgraphy (LSFG). We analysed the mean blur rate (MBR) throughout the ONH (MBR-A) and in the tissue (MBR-T) and vessels (MBR-V) in the ONH. We also evaluated the MBR-T, -V and -A values obtained in the evening and morning and the variation (Δ) between evening and morning values in each group...
June 14, 2017: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/28612908/association-between-fractional-flow-reserve-and-duke-treadmill-score-in-patients-with-single-vessel-disease
#9
Süleyman Kalaycı, Belma Kalaycı, Ekrem Şahan, Asiye Ayça Ayyılmaz Boyacı
BACKGROUND: Duke Treadmill score (DTS) is an index that provides prognostic information calculated at exercise stress test (EST). Fractional flow reserve (FFR) is an invasive method used to evaluate intermediate coronary stenosis. The direct relation of DTS and FFR has not been studied to date. AIM: The present study aims to investigate the relationship between the Duke Treadmill score (DTS) and fractional flow reserve (FFR). METHODS: The study population consisted of a total of 106 patients who have single-vessel disease, as confirmed by the coronary angiography (CAG), performed following EST, and whose FFRs have been measured...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28612008/hybrid-instantaneous-wave-free-ratio-fractional-flow-reserve-versus-fractional-flow-reserve-in-the-real-world
#10
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
#11
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...
June 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28608519/catheter-based-anatomic-and-functional-assessment-of-coronary-arteries-in-anomalous-aortic-origin-of-a-coronary-artery-myocardial-bridges-and-kawasaki-disease
#12
Athar M Qureshi, Hitesh Agrawal
Most diagnostic testing in patients with anomalous aortic origins of coronary arteries, myocardial bridges, and coronary artery changes after Kawasaki disease are performed with the use of noninvasive techniques. In some cases, however, further diagnostic information is needed to guide the clinician in treating these patients. In such instances, cardiac catheterization with invasive anatomic and functional testing is an invaluable tool. Moreover, interventional treatment in the cardiac catheterization laboratory may be performed in a small subset of these patients...
June 13, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28608183/acc-aats-aha-ase-asnc-scai-scct-sts-2017-appropriate-use-criteria-for-coronary-revascularization-in-patients-with-stable-ischemic-heart-disease-a-report-of-the-american-college-of-cardiology-appropriate-use-criteria-task-force-american-association-for-thoracic
#13
Manesh R Patel, John H Calhoon, Gregory J Dehmer, James Aaron Grantham, Thomas M Maddox, David J Maron, Peter K Smith
The American College of Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and American Association for Thoracic Surgery, along with key specialty and subspecialty societies, have completed a 2-part revision of the appropriate use criteria (AUC) for coronary revascularization. In prior coronary revascularization AUC documents, indications for revascularization in acute coronary syndromes and stable ischemic heart disease (SIHD) were combined into 1 document. To address the expanding clinical indications for coronary revascularization, and to align the subject matter with the most current American College of Cardiology/American Heart Association guidelines, the new AUC for coronary artery revascularization were separated into 2 documents addressing SIHD and acute coronary syndromes individually...
June 12, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28606887/comparison-of-the-prognostic-value-of-non-ischemic-fractional-flow-reserve-using-intracoronary-versus-intravenous-adenosine
#14
Naga Venkata Pothineni, Mohan M Edupuganti, Ahmed Almomani, Jason Payne, Sameer Raina, Shailesh Fnu, Amjad Abualsuod, Joseph Wong, Barry F Uretsky, Abdul Hakeem
AIMS: Intracoronary adenosine (ICA) yields similar fractional flow reserve (FFR) results as the "gold standard" of intravenous adenosine (IVA). Whether they have similar prognostic significance is unknown. METHODS AND RESULTS: 576 patients with 787 lesions in whom PCI was deferred based on FFR >0.75 were studied. Primary outcome was the first major adverse cardiovascular event [MACE defined as death, myocardial infarction (MI), or target vessel revascularization (TVR)] and secondary outcome was a composite of MI and target vessel failure (TVF)...
June 13, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28606883/physiological-assessment-of-left-main-coronary-artery-disease
#15
Bhavik N Modi, Tim P van de Hoef, Jan J Piek, Divaka Perera
The left main coronary artery (LMCA) is responsible for supplying the majority of the left ventricular myocardium. Visual estimation of stenosis severity on angiography has major limitations and methods to assess functional significance, such as Fractional Flow Reserve (FFR), have been shown to yield better outcomes but major trials examining the use of such physiological indices have excluded LMCA disease to date. Furthermore, LMCA disease commonly co-exists with downstream disease, which complicates interpretation of coronary physiological data...
June 13, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28605043/typical-angina-is-associated-with-greater-coronary-endothelial-dysfunction-but-not-abnormal-vasodilatory-reserve
#16
Ahmed AlBadri, Derek Leong, C Noel Bairey Merz, Janet Wei, Eileen M Handberg, Chrisandra L Shufelt, Puja K Mehta, Michael D Nelson, Louise E Thomson, Daniel S Berman, Leslee J Shaw, Galen Cook-Wiens, Carl J Pepine
BACKGROUND: Typical angina (TA) is defined as substernal chest pain precipitated by physical exertion or emotional stress and relieved with rest or nitroglycerin. Women and elderly patients are usually have atypical symptoms both at rest and during stress, often in the setting of nonobstructive coronary artery disease (CAD). HYPOTHESIS: To further understand this, we performed subgroup analysis comparing subjects who presented with TA vs nontypical angina (NTA) using baseline data of patients with nonobstructive CAD and coronary microvascular dysfunction (CMD) enrolled in a clinical trial...
June 12, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28600860/estimating-the-accuracy-of-a-reduced-order-model-for-the-calculation-of-fractional-flow-reserve-ffr
#17
Etienne Boileau, Sanjay Pant, Carl Roobottom, Igor Sazonov, Jingjing Deng, Xianghua Xie, Perumal Nithiarasu
Image-based non-invasive fractional flow reserve (FFR) is an emergent approach to determine the functional relevance of coronary stenoses. The present work aimed to determine the feasibility of using a method based on coronary computed tomography angiography (CCTA) and reduced-order models (0D-1D) for the evaluation of coronary stenoses. The reduced-order methodology (cFFRro ) was kept as simple as possible and did not include pressure drop or stenosis models. The geometry definition was incorporated into the physical model used to solve coronary flow and pressure...
June 9, 2017: International Journal for Numerical Methods in Biomedical Engineering
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
#18
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...
June 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28599829/noninvasive-coronary-flow-reserve-predicts-response-to-exercise-in-asymptomatic-severe-aortic-stenosis
#19
Patrick Meimoun, Daniel Czitrom, Jérome Clerc, Jean Christophe Seghezzi, Sonia Martis, Alain Berrebi, Frederic Elmkies
BACKGROUND: In patients with asymptomatic aortic stenosis (AS), exercise stress echocardiography (ESE) provides additional prognostic information beyond baseline. The coronary flow velocity reserve (CFVR) is impaired in AS, but its link with exertion is unknown in this setting. The aim of this study was to test the hypothesis that CFVR could predict exercise capacity and abnormal exercise test results in AS. METHODS: Noninvasive CFVR and symptom-limited semisupine ESE were prospectively performed the same day in 43 patients with asymptomatic isolated severe AS (mean age, 68...
June 6, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28599085/exploring-the-putative-role-of-trpv1-dependent-cgrp-release-in-remote-hind-preconditioning-induced-cardioprotection
#20
Puneet Kaur Randhawa, Amteshwar Singh Jaggi
Remote ischemic preconditioning (RIPC) is a phenomenon whereby transient non-lethal ischemia and reperfusion episodes confer protection against prolonged ischemia-reperfusion-induced injury. However, the underlying intracellular signaling has not been extensively explored. The present study aims to inspect the putative involvement of TRPV1 -dependent CGRP release in mediating remote hind limb preconditioning-induced cardioprotection. In the present study, remote hind limb preconditioning stimulus was delivered (4 consecutive episodes of 5 minutes of ischemia-reperfusion) using a blood pressure cuff tied at the inguinal level of the rat...
June 9, 2017: Cardiovascular Therapeutics
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