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coronary flow reserve

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https://www.readbyqxmd.com/read/27914491/impact-of-lesion-characteristics-on-the-prediction-of-optimal-poststent-fractional-flow-reserve
#1
Hirohiko Ando, Hiroaki Takashima, Akihiro Suzuki, Shinichiro Sakurai, Soichiro Kumagai, Akiyoshi Kurita, Katsuhisa Waseda, Tetsuya Amano
BACKGROUND: Poststent fractional flow reserve (FFR) is a useful indicator of optimal percutaneous coronary intervention, and higher poststent FFR is associated with favorable long-term clinical outcome. However, little is known about the factors influencing poststent FFR. The purpose of this study was to determine the impact of lesion characteristics on poststent FFR. METHODS: For patients who had scheduled stent implantation for stable angina, FFR measurements at maximum hyperemia were performed before and after coronary stent implantation...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27912739/comparing-the-adverse-clinical-outcomes-associated-with-fraction-flow-reserve-guided-versus-angiography-guided-percutaneous-coronary-intervention-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#2
Pravesh Kumar Bundhun, Chandra Mouli Yanamala, Feng Huang
BACKGROUND: Recently published randomized controlled trials have shown different results compared to the Fraction Flow Reserve Versus Angiography for Multi-vessel Evaluation (FAME) study. Therefore, this current analysis aimed to compare the adverse clinical outcomes associated with Fraction Flow Reserve (FFR)-guided versus standard angiography-guided Percutaneous Coronary Intervention (PCI) using a large number of randomized patients. METHODS: PubMed/Medline, EMBASE and the Cochrane library were searched for studies comparing FFR-guided with angiography-guided PCI...
December 3, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27908505/diagnostic-advantage-of-stress-computed-tomography-myocardial-perfusion-over-single-photon-emission-computed-tomography-for-the-assessment-of-myocardial-ischemia
#3
Yasushi Ueki, Atsushi Izawa, Daisuke Kashiwagi, Shigeki Nishiyama, Shinichi Aso, Chihiro Suzuki, Shumpei Sakurai, Kazuhiro Oguchi, Yoshikazu Yazaki, Uichi Ikeda, Koichiro Kuwahara
BACKGROUND: This study compared adenosine stress computed tomography myocardial perfusion (CTP) with single-photon emission computed tomography (SPECT) in the diagnosis of functionally significant coronary artery stenosis using fractional flow reserve (FFR) as reference standard. METHODS: We included a total of 93 coronary arteries from 31 patients in whom at least one vessel with ≥50% stenosis was detected with computed tomography coronary angiography. All patients underwent both SPECT and adenosine stress CTP, followed by invasive coronary angiography (ICA) and FFR...
November 28, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27906702/diagnostic-accuracy-of-intraluminal-blood-speckle-intensity-on-intravascular-ultrasound-for-physiological-assessment-of-coronary-artery-stenosis
#4
Yuichi Saito, Hideki Kitahara, Takashi Nakayama, Yoshihide Fujimoto, Yoshio Kobayashi
OBJECTIVES: The difference in intraluminal intensity of blood speckle (IBS) on integrated backscatter intravascular ultrasound (IVUS) across the coronary stenosis was reportedly correlated with fractional flow reserve (FFR) in the left descending coronary artery. The aim of this study was to investigate the novel physiological assessment using IVUS in all coronary arteries. PATIENTS AND METHODS: Fifty-four patients with 57 coronary lesions underwent both FFR and IVUS...
November 30, 2016: Coronary Artery Disease
https://www.readbyqxmd.com/read/27901333/fractional-flow-reserve-lessons-from-platform-and-future-perspectives
#5
Gianluca Pontone, Patrizia Carità, Massimo Verdecchia, Dario Buccheri, Daniele Andreini, Andrea I Guaricci, Mark Rabbat, Mauro Pepi
In the treatment of stable coronary artery disease (CAD) the identification of patients who may gain the highest benefit from further invasive treatments is of pivotal importance for the healthcare system. In this setting, it has been established that an ischemia-guided revascularization strategy yields improved clinical outcomes in a cost- effective fashion compared with anatomy-guided revascularization alone. Invasive fractional flow reserve (FFR) is considered the gold standard, especially in the intermediate-range atherosclerotic lesions, for assessing lesion specific ischemia at the time of invasive coronary angiography and has now become the standard of reference for studies assessing the diagnostic performance of the various non-invasive stress tests...
November 30, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27900990/prognostic-value-of-gai-s-plaque-score-and-agatston-coronary-artery-calcium-score-for-functionally-significant-coronary-artery-stenosis
#6
Chuang Zhang, Shuang Yang, Lu-Yue Gai, Zhi-Qi Han, Qian Xin, Xiao-Bo Yang, Jun-Jie Yang, Qin-Hua Jin
BACKGROUND: The prognostic values of the coronary computed tomography angiography (CCTA) score for predicting future cardiovascular events have been previously demonstrated in numerous studies. However, few studies have used the rich information available from CCTA to detect functionally significant coronary lesions. We sought to compare the prognostic values of Gai's plaque score and the coronary artery calcium score (CACS) of CCTA for predicting functionally significant coronary lesions, using fractional flow reserve (FFR) as the gold standard...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27899407/the-impact-study-influence-of-sensor-equipped-microcatheters-on-coronary-hemodynamics-and-the-accuracy-of-physiological-indices-of-functional-stenosis-severity
#7
Gilbert W M Wijntjens, Tim P van de Hoef, Robin P Kraak, Marcel A Beijk, Krischan D Sjauw, M Marije Vis, Maribel I Madera Cambero, Stijn L Brinckman, Jacobus Plomp, Jan Baan, Karel T Koch, Joanna J Wykrzykowska, José P Henriques, Robbert J de Winter, Jan J Piek
BACKGROUND: The Navvus pressure sensor-equipped microcatheter allows to measure functional stenosis severity over a work-horse guidewire and is used as a more feasible alternative to regular sensor-equipped wires. However, Navvus is larger in diameter than contemporary sensor-equipped guidewires and may, thereby, influence functional measurements. The present study evaluates the hemodynamic influence of the Navvus microcatheter. METHODS AND RESULTS: In patients with intermediate coronary stenosis, coronary pressure and flow velocity were measured using a dual sensor-equipped guidewire before and after introduction of Navvus...
December 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27899365/prevalence-and-clinical-significance-of-discordant-changes-in-fractional-and-coronary-flow-reserve-after-elective-percutaneous-coronary-intervention
#8
Junji Matsuda, Tadashi Murai, Yoshihisa Kanaji, Eisuke Usui, Makoto Araki, Takayuki Niida, Sadamitsu Ichijyo, Rikuta Hamaya, Tetsumin Lee, Taishi Yonetsu, Mitsuaki Isobe, Tsunekazu Kakuta
BACKGROUND: Fractional flow reserve (FFR) and coronary flow reserve (CFR) are well-validated physiological indices; however, changes in FFR and CFR after percutaneous coronary intervention (PCI) remain elusive. We sought to evaluate these changes and to investigate whether physiological indices predict cardiac event-free survival after PCI. METHODS AND RESULTS: Physiological assessment of 220 stenoses from 220 patients was performed before and after PCI. The changes in FFR and CFR were studied, and factors associated with CFR change were investigated...
November 29, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27892882/clinical-and-angiographic-predictors-of-persistently-ischemic-fractional-flow-reserve-after-percutaneous-revascularization
#9
Shiv Kumar Agarwal, Srikanth Kasula, Ahmed Almomani, Yalcin Hacioglu, Zubair Ahmed, Barry F Uretsky, Abdul Hakeem
AIMS: Despite optimal angiographic results after percutaneous coronary intervention (PCI), some lesions may continue to produce ischemia under maximal hyperemia. We evaluated the factors associated with persistently ischemic fractional flow reserve (FFR) after angiographically successful PCI. METHODS AND RESULTS: A total of 574 consecutive patients with 664 lesions undergoing PCI who had FFR pre- and post-PCI were analyzed. Percutaneous coronary intervention led to effective ischemia reduction from pre-FFR (0...
October 29, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27889555/correlation-between-microvascular-dysfunction-and-b-type-natriuretic-peptide-levels-in-non-ischemic-heart-failure-patients-with-cardiac-fibrosis
#10
Kyoko Hirakawa, Megumi Yamamuro, Tomoaki Uemura, Seiji Takashio, Koichi Kaikita, Daisuke Utsunomiya, Mina Nakayama, Eiichiro Yamamoto, Yasuyuki Yamashita, Seiji Hokimoto, Kenichi Tsujita
BACKGROUNDS: The relationship between microvascular dysfunction and plasma B-type natriuretic peptide (BNP) levels remains unclear in heart failure (HF) patients with cardiac fibrosis. METHODS: This study evaluated 55 consecutive non-ischemic HF patients in an effort to determine the relationship between endothelial independent coronary microvascular dysfunction and plasma BNP levels, as well as whether each measure is correlated with myocardial fibrosis. We evaluated plasma BNP levels in patients with stable HF...
November 8, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27884241/a-prospective-natural-history-study-of%C3%A2-coronary-atherosclerosis-using-fractional-flow-reserve
#11
Emanuele Barbato, Gabor G Toth, Nils P Johnson, Nico H J Pijls, William F Fearon, Pim A L Tonino, Nick Curzen, Zsolt Piroth, Gilles Rioufol, Peter Jüni, Bernard De Bruyne
BACKGROUND: In patients with coronary artery disease, clinical outcome depends on the extent of reversible myocardial ischemia. Whether the outcome also depends on the severity of the stenosis as determined by fractional flow reserve (FFR) remains unknown. OBJECTIVES: This study sought to investigate the relationship between FFR values and vessel-related clinical outcome. METHODS: We prospectively studied major adverse cardiovascular events (MACE) at 2 years in 607 patients in whom all stenoses were assessed by FFR and who were treated with medical therapy alone...
November 29, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27881570/excess-cardiovascular-risk-in-women-relative-to-men-referred-for-coronary-angiography-is-associated-with-severely-impaired-coronary-flow-reserve-not-obstructive-disease
#12
Viviany R Taqueti, Leslee J Shaw, Nancy R Cook, Venkatesh L Murthy, Nishant R Shah, Courtney R Foster, Jon Hainer, Ron Blankstein, Sharmila Dorbala, Marcelo F Di Carli
BACKGROUND: -Cardiovascular disease (CVD) fatality rates are higher for women as compared with men, yet obstructive coronary artery disease (CAD) is less prevalent in women. Coronary flow reserve (CFR), an integrated measure of large and small vessel CAD and myocardial ischemia, identifies patients at risk for CVD death, but is not routinely measured in clinical practice. We sought to investigate the impact of sex, CFR, and angiographic CAD severity on adverse cardiovascular events. METHODS: -Consecutive patients (N=329, 43% women) referred for invasive coronary angiography after stress testing with myocardial perfusion positron emission tomography (PET) and with left ventricular ejection fraction >40% were followed (median 3...
November 14, 2016: Circulation
https://www.readbyqxmd.com/read/27878495/evaluation-of-hemodynamic-significance-of-stenosis-in-multiple-involvement-of-the-coronary-vessels-by-mathematical-simulation
#13
S S Simakov, T M Gamilov, F Yu Kopylov, Yu V Vasilevskii
We use a mathematical model of one-dimensional blood flow in a network of blood vessels for in silico evaluation of hemodynamic significance of stenoses in multivessel coronary disease. Two cases were addressed: two stenosed vessels with different diameters and with the same degree of occlusion and two consecutive stenoses in the same vessel. We show that two criteria for the evaluation of hemodynamic significance based on the degree of stenosis and based on fractional flow reserve can give contradictory indications for surgical intervention...
November 23, 2016: Bulletin of Experimental Biology and Medicine
https://www.readbyqxmd.com/read/27876181/analysis-of-suboptimal-stent-deployment-using-intravascular-ultrasound-and-coronary-pressure-pullback-measurement
#14
Nobuhiro Tanaka, Nico H J Pijls, Jun Yamashita, Yo Kimura, Masashi Ogawa, Naotaka Murata, Kunihiro Sakoda, Kou Hoshino, Youhei Hokama, Akira Yamashina
BACKGROUND: There are some cases in whom a sufficient improvement in fractional flow reserve (FFR) could not be achieved even if anatomical results indicated satisfactory stent deployment. We investigated the relation of abnormal findings between intravascular ultrasound (IVUS) and coronary pressure pullback measurement (CP-PB). METHODS: IVUS and CP-PB were investigated after stent deployment in 60 vessels in 53 patients. CP-PB criterion for adequate stent deployment was defined as a ratio of coronary pressure at the stent distal edge to the proximal edge (Psd/Psp) that is greater than 0...
November 18, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27872119/efficacy-of-intravenous-nicorandil-for-fractional-flow-reserve-assessment-study-protocol-for-a-crossover-randomised-trial
#15
Takeshi Nishi, Hideki Kitahara, Yoshihide Fujimoto, Takashi Nakayama, Kazumasa Sugimoto, Kengo Nagashima, Hideki Hanaoka, Yoshio Kobayashi
INTRODUCTION: Nicorandil has vasodilatory effects on both the epicardial coronary arteries and the coronary microvasculature, thereby increasing coronary blood flow. Intravenous administration of nicorandil can be applicable for fractional flow reserve (FFR) measurement as a hyperaemic agent and a possible alternative to adenosine. However, the effectiveness of intravenous nicorandil infusion for FFR measurement is largely unclear. METHODS AND ANALYSIS: This crossover randomised study is being performed to investigate the efficacy of intravenous administration of nicorandil for FFR measurement...
November 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27870973/transthoracic-doppler-echocardiography-compared-with-positron-emission-tomography-for-assessment-of-coronary-microvascular-dysfunction-the-ipower-study
#16
Marie Mide Michelsen, Naja Dam Mygind, Adam Pena, Rasmus Huan Olsen, Thomas Emil Christensen, Adam Ali Ghotbi, Philip Hasbak, Andreas Kjaer, Ida Gustafsson, Peter Riis Hansen, Henrik Steen Hansen, Nis Høst, Jens Kastrup, Eva Prescott
BACKGROUND: Coronary microvascular function can be assessed by transthoracic Doppler echocardiography as a coronary flow velocity reserve (TTDE CFVR) and by positron emission tomography as a myocardial blood flow reserve (PET MBFR). PET MBFR is regarded the noninvasive reference standard for measuring coronary microvascular function but has limited availability. We compared TTDE CFVR with PET MBFR in women with angina pectoris and no obstructive coronary artery disease and assessed repeatability of TTDE CFVR...
November 7, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27867288/visual-functional-mismatch-between-coronary-angiography-fractional-flow-reserve-and-quantitative-coronary-angiography
#17
Morteza Safi, Vahid Eslami, Mohammad Hasan Namazi, Hossain Vakili, Habib Saadat, Saeid Alipourparsa, Ali Adibi, Mohammad Reza Movahed
Anatomical and functional mismatches are not uncommon in the assessment of coronary lesions. The aim of this study was to identify clinical and lesion-specific factors affecting angiographic, anatomical, and functional mismatch in intermediate coronary lesions. In patients who underwent coronary angiography for clinical reasons, fractional flow reserve (FFR), and quantitative coronary angiography (QCA) analyses for intermediate stenotic lesions were performed simultaneously. Mismatches between the measured values were analyzed...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27867139/in-vivo-validation-of-mathematically-derived-fractional-flow-reserve-for-assessing-hemodynamics-of-coronary-tandem-lesions
#18
Jihoon Kweon, Young-Hak Kim, Dong Hyun Yang, June-Goo Lee, Jae-Hyung Roh, Gary S Mintz, Seung-Whan Lee, Seong-Wook Park
AIMS: To propose a prediction model for the post-stenting fractional flow reserve (FFR'd,pred) at a position distal to the tandem lesion. METHODS AND RESULTS: Using the FFR at a position proximal to the tandem lesion (FFRp), the FFR gradients across proximal (ΔFFRp) and distal (ΔFFRd) stenoses, FFR'd,pred after treating either the distal or proximal lesion was predicted as FFRp-ΔFFRp/(1-1.33kΔFFRd) or FFRp- ΔFFRd/(1-1.33ΔFFRp), respectively. The flow fraction of the distal main branch (k) was estimated using the diameter ratio of side to distal main branches...
November 22, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27866677/pressure-drop-and-arterial-compliance-two-arterial-parameters-in-one-measurement
#19
Oren M Rotman, Uri Zaretsky, Avraham Shitzer, Shmuel Einav
Coronary artery pressure-drop and distensibility (compliance) are two major, seemingly unrelated, parameters in the cardiovascular clinical setting, which are indicative of coronary arteries patency and atherosclerosis severity. While pressure drop is related to flow, and therefore serves as a functional indicator of a stenosis severity, the arterial distensibility is indicative of the arterial stiffness, and hence the arterial wall composition. In the present study, we hypothesized that local pressure drops are dependent on the arterial distensibility, and hence can provide information on both indices...
November 12, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27863293/the-conical-stent-in-coronary-artery-improves-hemodynamics-compared-with-the-traditional-cylindrical-stent
#20
Yi Yu, Yujie Zhou, Qian Ma, Shuo Jia, Sijing Wu, Yan Sun, Xiaoli Liu, Yingxin Zhao, Yuyang Liu, Dongmei Shi
OBJECTIVES: This study sought to explore the efficacy of the conical stent implantation in the coronary artery by comparing the effects of cylindrical and conical stents on wall shear stress (WSS) and velocity of flow and fractional flow reserve (FFR). BACKGROUND: The traditional cylindrical stent currently used in the percutaneous coronary intervention (PCI) has a consistent diameter, which does not match the physiological change of the coronary artery. On the contrary, as a new patent, the conical stent with tapering lumen is consistent with the physiological change of vascular diameter...
November 8, 2016: International Journal of Cardiology
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