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coronary flow reserve

Cédric Garcia, Nicolas Montée, Julien Faccini, Jennifer Series, Olivier Meilhac, Anne-Valérie Cantero, Pauline Le Faouder, Meyer Elbaz, Bernard Payrastre, Cécile Vindis
BACKGROUND: While high-density lipoproteins (HDL) have anti-thrombotic effects by reducing platelet activation, the relationship between HDL levels and the risk of acute coronary syndrome (ACS) is unclear since HDL particles are heterogeneous in composition and biological properties OBJECTIVE: We characterized the effects of HDL2 and HDL3 subclasses from ACS patients and non-coronary artery disease (CAD) subjects on platelet activation. METHODS: We measured platelet aggregation and ex vivo thrombus formation, analyzed signaling pathways by flow cytometry and performed a targeted lipidomics analysis on HDL subclasses RESULTS: Analysis of human platelet aggregation in suspension, adhesion on von Willebrand factor and thrombus formation on collagen under arterial shear demonstrated that HDL2 subclass from ACS patients had a higher antiplatelet potency compared to ACS HDL3 particles and HDL subclasses from non-CAD subjects...
March 15, 2018: Journal of Thrombosis and Haemostasis: JTH
Ran Kornowski, Hana Vaknin-Assa, Abid Assali, Gabriel Greenberg, Orna Valtzer, Ifat Lavi
OBJECTIVES: To assess the diagnostic performance of angiography-derived fractional flow reserve (FFRangio) measurements in patients with stable coronary artery disease when used online in the catheterization laboratory during routine coronary angiography. BACKGROUND: FFR, an index of the hemodynamic severity of coronary stenosis, is derived from invasive measurements using a pressure-monitoring guidewire and hyperemic stimulus. While FFR is the gold standard, it remains under-utilized...
March 15, 2018: Journal of Invasive Cardiology
Basmah Safdar, Gail D'Onofrio, James Dziura, Raymond R Russell, Caitlin Johnson, Albert J Sinusas
AIMS: Coronary microvascular dysfunction (CMD) is common in patients with non-obstructive coronary arteries but has not been described in low-risk symptomatic patients. We therefore assessed the prevalence and characteristics of CMD in low to moderate risk patients with chest pain in an emergency department. METHODS AND RESULTS: We used three-dimensional Rb82 cardiac positron emission tomography/computed tomography to diagnose coronary artery disease (known or new regional defect, any coronary calcification) and CMD (low coronary flow reserve without coronary artery disease) in chest pain patients after being ruled out for acute myocardial infarction...
March 1, 2018: European Heart Journal. Acute Cardiovascular Care
Apostolos Kiaos, Ioannis Tziatzios, Stavros Hadjimiltiades, Charalambos Karvounis, Theodoros D Karamitsos
Stress perfusion cardiac magnetic resonance (CMR) has been proposed as an important gatekeeper for invasive coronary angiography (ICA) and percutaneous coronary interventions (PCI) in patients evaluated for possible coronary artery disease (CAD) (Fihn et al., 2012; Montalescot et al., 2013) [1], [2]. Several meta-analyses have evaluated the accuracy of stress perfusion CMR to diagnose CAD at the vessel level (Danad et al., 2017; Dai et al., 2016; Jiang et al., 2016; Takx et al., 2015; Li et al., 2015; Desai and Jha, 2013; Jaarsma et al...
February 2018: Data in Brief
Do-Yoon Kang, Jung-Min Ahn, Cheol Hyun Lee, Pil Hyung Lee, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
Aims: The optimal fractional flow reserve (FFR) cut-off value for revascularization is debated. We evaluated the prognosis for deferred and performed revascularization in coronary stenosis with FFR values in the grey zone (0.75-0.80). Methods and results: This study included 1334 native coronary stenosis with grey-zone FFR values in 1334 patients from the prospective multicentre Interventional Cardiology Research In-cooperation Society Fractional Flow Reserve registry...
February 24, 2018: European Heart Journal
Bart W Driesen, Evangeline G Warmerdam, Gert-Jan T Sieswerda, Paul H Schoof, Folkert J Meijboom, Felix Haas, Pieter R Stella, Adriaan O Kraaijeveld, Fabiola C M Evens, Pieter A F M Doevendans, Gregor J Krings, Arie P J van Dijk, Michiel Voskuil
OBJECTIVES: To describe the use of fractional flow reserve (FFR) and intravascular ultrasound (IVUS) in the evaluation of patients with anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS). BACKGROUND: ACAOS of the right and left coronary are rare, but may lead to symptoms and impose a risk for sudden cardiac death, depending on several anatomical features. Assessment and risk estimation is challenging in (nonathlete) adults, especially if they present without symptoms or with atypical complaints...
March 9, 2018: Catheterization and Cardiovascular Interventions
Alfredo E Rodriguez, Carlos Fernandez-Pereira, Juan Mieres, Hernan Pavlovsky, Juan Del Pozo, Alfredo M Rodriguez-Granillo, David Antoniucci
In recent years angiographic risk scores have been introduced in clinical practice to stratify different levels of risk after percutaneous coronary interventions (PCI). The SYNTAX score included all intermediate lesions in vessels ≥1.5 mm, consequently, multiple stent implantation was required. Four years ago, we built a new angiographic score in order to guide PCI strategy avoiding stent deployment both in intermediate stenosis as in small vessels, therefore these were not scored (ERACI risk score). The purpose of this mini review is to validate the strategy of PCI guided by this scoring, taking into account long term follow up outcomes of two observational and prospective registries where this policy was used...
February 13, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Takayuki Niida, Tadashi Murai, Taishi Yonetsu, Yoshihisa Kanaji, Eisuke Usui, Junji Matsuda, Masahiro Hoshino, Makoto Araki, Masao Yamaguchi, Masahiro Hada, Sadamitsu Ichijyo, Rikuta Hamaya, Yoshinori Kanno, Mitsuaki Isobe, Tsunekazu Kakuta
OBJECTIVES: The aim of this study is to investigate the association between fractional flow reserve (FFR) values and change in coronary physiological indices after elective percutaneous coronary intervention (PCI). BACKGROUND: Decision making for revascularization when FFR is 0.75-0.80 is controversial. METHODS: A retrospective analysis was performed of 296 patients with stable angina pectoris who underwent physiological examinations before and after PCI...
March 8, 2018: Catheterization and Cardiovascular Interventions
Samet Yılmaz, Uğur Canpolat, Kazım Başer, Sefa Ünal, Mevlüt Serdar Kuyumcu, Sinan Aydoğdu
OBJECTIVE: The aim of this study was to determine the relationship between the neutrophil-to-lymphocyte ratio (NLR) and the functional severity of coronary stenosis assessed according to the fractional flow reserve (FFR) in stable coronary artery disease (CAD). METHODS: The clinical and laboratory data of 420 patients who underwent index coronary angiography for stable angina pectoris were analyzed retrospectively. The functional severity of an intermediate lesion was determined by FFR...
March 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Helena U Westergren, Li-Ming Gan, Marianne Månsson, Sara Svedlund
Background: The impact of personalized exercise training and a healthy dietary lifestyle in healthy volunteers on coronary flow reserve and cardiovascular function remains to be investigated in a controlled study setting. Purpose: To examine the effects of a Mediterranean-inspired diet combined with regular physical exercise (standard) and a personalized supervised exercise program (DAPS) on coronary flow reserve and cardiovascular function. Results: The number of males were 10 (59%) and 9 (47%) and mean age was 54 ± 12 and 55 ± 5 years in standard versus DAPS group, respectively...
February 6, 2018: Oncotarget
Oliver Klein-Wiele, Walied Sherifa, Marietta Garmer, Kaffer Kara, Dietrich Grönemeyer, Birgit Hailer
Adenosine induces coronary vasodilation and simultaneously reduces splanchnic perfusion. This effect can be absent in adenosine non-responders. Imaging of splanchnic arteries under adenosine assessing this effect has not been performed in humans previously. In 26 patients, splenic artery color Doppler was performed during an infusion of adenosine. Peak velocity in the splenic artery was measured before the infusion and at 2 min. Results were compared qualitatively with perfusion imaging in magnetic resonance...
March 1, 2018: Ultrasound in Medicine & Biology
Grigoris V Karamasis, Andreas S Kalogeropoulos, Shah H Mohdnazri, Firas Al-Janabi, Rohan Jagathesan, Gerald J Clesham, Kare H Tang, Paul A Kelly, John R Davies, Thomas R Keeble
BACKGROUND: The aim of this study was to assess the impact of right atrial pressure (Pra) on non-CTO vessels FFR measurements in patients with a chronic total occlusion. METHODS: Consecutive patients who underwent PCI for a CTO of the right coronary artery (RCA) were included. Prior to RCA recanalization, FFR and FFRmyo were measured in non-CTO vessels. FFR was calculated using the Pd/Pa equation during maximum hyperaemia and also accounting for right atrial pressure (Pd-Pra/Pa-Pra)...
February 7, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Miao Chu, Clemens von Birgelen, Yingguang Li, Jelmer Westra, Junqing Yang, Niels R Holm, Johan H C Reiber, William Wijns, Shengxian Tu
BACKGROUND AND AIMS: The relation between FFR and local coronary flow patterns is incompletely understood. We aimed at developing a novel hemodynamic index to quantify disturbed coronary flow, and to investigate its relationship with lesion-associated pressure-drop, and fractional flow reserve (FFR). METHODS: Three-dimensional angiographic reconstruction and computational fluid dynamics were applied to simulate pulsatile coronary flow. Disturbed vorticity index (DVI) was derived to quantify the stenosis-induced flow disturbance...
February 16, 2018: Atherosclerosis
Ignatios Ikonomidis, Astrinos Voumvourakis, George Makavos, Helen Triantafyllidi, George Pavlidis, Konstantinos Katogiannis, Dimitris Benas, Dimitris Vlastos, Paraskevi Trivilou, Maria Varoudi, John Parissis, Efstathios Iliodromitis, John Lekakis
We investigated the association of endothelial glycocalyx damage with arterial stiffness, impairment of coronary microcirculatory function, and LV myocardial deformation in 320 untreated hypertensives and 160 controls. We measured perfused boundary region (PBR) of the sublingual microvessels, a marker inversely related with glycocalyx thickness, coronary flow reserve (CFR), and Global Longitudinal strain (GLS) by echocardiography, pulse wave velocity (PWV), and central systolic blood pressure (cSBP). Hypertensives had higher PBR, PWV cSBP, and lower CFR and GLS than controls (P < ...
March 2, 2018: Journal of Clinical Hypertension
Kaartiga Sivanesan, Subhi J Al'Aref, James K Min, Jessica M Peña, Fay Lin, Erica C Jones
PURPOSE OF REVIEW: Ischemic heart disease is a leading cause of morbidity and mortality for women and men around the world. However, traditional cardiovascular risk factors do not fully capture cardiac risk in women. This review summarizes sex-based differences in the clinical presentation, pathophysiology, and risk assessment of ischemic heart disease. We also examine the use of anatomic and functional imaging modalities in the diagnosis of ischemic heart disease in women. RECENT FINDINGS: Recent studies with women subjects have bolstered the predictive value of the coronary artery calcium (CAC) score in predicting atherosclerotic cardiovascular disease risk and major adverse cardiac events in a graded fashion...
March 2, 2018: Current Atherosclerosis Reports
Denis Agostini, Vincent Roule, Catherine Nganoa, Nathaniel Roth, Raphael Baavour, Jean-Jacques Parienti, Farzin Beygui, Alain Manrique
PURPOSE: We assessed the feasibility of myocardial blood flow (MBF) and flow reserve (MFR) estimation using dynamic SPECT with a novel CZT camera in patients with stable CAD, in comparison with15 O-water PET and fractional flow reserve (FFR). METHODS: Thirty patients were prospectively included and underwent FFR measurements in the main coronary arteries (LAD, LCx, RCA). A stenosis ≥50% was considered obstructive and a FFR abnormal if ≤0.8. All patients underwent a dynamic rest/stress99m Tc-sestamibi CZT-SPECT and15 O-water PET for MBF and MFR calculation...
March 1, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Fabiola Atzeni, Marco Corda, Luigi Gianturco, Maurizio Porcu, Piercarlo Sarzi-Puttini, Maurizio Turiel
The risk of cardiovascular (CV) events and mortality is significantly higher in patients with systemic rheumatic diseases than in the general population. Although CV involvement in such patients is highly heterogeneous and may affect various structures of the heart, it can now be diagnosed earlier and promptly treated. Various types of assessments are employed for the evaluation of CV risk such as transthoracic or transesophageal echocardiography, magnetic resonance imaging (MRI), and computed tomography (CT) to investigate valve abnormalities, pericardial disease, and ventricular wall motion defects...
2018: Frontiers in Medicine
Alexander Liu, Rohan S Wijesurendra, Joanna M Liu, John C Forfar, Keith M Channon, Michael Jerosch-Herold, Stefan K Piechnik, Stefan Neubauer, Rajesh K Kharbanda, Vanessa M Ferreira
BACKGROUND: In patients with angina and nonobstructive coronary artery disease (NOCAD), confirming symptoms due to coronary microvascular dysfunction (CMD) remains challenging. Cardiac magnetic resonance (CMR) assesses myocardial perfusion with high spatial resolution and is widely used for diagnosing obstructive coronary artery disease (CAD). OBJECTIVES: The goal of this study was to validate CMR for diagnosing microvascular angina in patients with NOCAD, compared with patients with obstructive CAD and correlated to the index of microcirculatory resistance (IMR) during invasive coronary angiography...
March 6, 2018: Journal of the American College of Cardiology
Alexander Liu, Rohan S Wijesurendra, Joanna M Liu, Andreas Greiser, Michael Jerosch-Herold, John C Forfar, Keith M Channon, Stefan K Piechnik, Stefan Neubauer, Rajesh K Kharbanda, Vanessa M Ferreira
BACKGROUND: Novel cardiac magnetic resonance (CMR) stress T1 mapping can detect ischemia and myocardial blood volume changes without contrast agents and may be a more comprehensive ischemia biomarker than myocardial blood flow. OBJECTIVES: This study describes the performance of the first prospective validation of stress T1 mapping against invasive coronary measurements for detecting obstructive epicardial coronary artery disease (CAD), defined by fractional flow reserve (FFR <0...
March 6, 2018: Journal of the American College of Cardiology
Balazs Tar, Csaba Jenei, Csaba Andras Dezsi, Sandor Bakk, Zoltan Beres, Janos Santa, Marianna Svab, Veronika Szentes, Peter Polgar, Csaba Bujaky, Daniel Czuriga, Zsolt Kőszegi
AIMS: To develop a simplified model of FFR calculation (FFRsim) deriving from 3-dimensional (3D) coronary angiographic data and classic fluid dynamic equations without using finite element analysis. METHODS AND RESULTS: Intracoronary pressure measurements were performed by pressure wire sensors. Lumens of the interrogated vessel segments were reconstructed in 3D. The coronary artery volumetric flow was calculated based on the velocity of the contrast material. Pressure gradients were computed by classic fluid dynamic equations...
February 27, 2018: EuroIntervention
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