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coronary flow reserve

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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
#1
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/28540215/myocardial-flow-reserve-mfr-with-positron-emission-tomography-pet-computed-tomography-ct-clinical-impact-in-diagnosis-and-prognosis
#2
REVIEW
Maria Cecilia Ziadi
In recent years, radionuclide myocardial perfusion imaging (MPI) using positron emission tomography/computed tomography (PET/CT) has emerged as a robust tool for the diagnosis, risk stratification and management of patients with known or established coronary artery disease (CAD). Cardiac PET/CT imaging affords key advantages compared to single photon emission computed tomography (SPECT) that encompass: (I) improved diagnostic accuracy; (II) decreased radiation exposure due to the utilization of short-lived radiopharmaceuticals, and importantly; (III) the ability to quantify noninvasively myocardial blood flow (MBF) in absolute terms, that is in ml per minute per gram of tissue...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28540210/integration-of-non-invasive-functional-assessments-with-anatomical-risk-stratification-in-complex-coronary-artery-disease-the-non-invasive-functional-syntax-score
#3
REVIEW
Carlos Collet, Yoshinobu Onuma, Yosuke Miyazaki, Marie-Angèle Morel, Patrick W Serruys
Since the early days of coronary angiography, the extension and severity of coronary artery disease (CAD) have been used for risk stratification. The SYNTAX score objectively characterizes CAD in patients with multivessel disease. Furthermore, recalculating the SYNTAX score by the incorporation of the functional component coronary stenosis (i.e., FFR) increases the discrimination for the risk of adverse events. The calculation of the SYNTAX score derived from non-invasive modalities such as coronary computed tomography angiography (CTA) has emerged as a mean to obtain the SYNTAX score before invasive cardiac catheterization...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28540209/myocardial-blood-flow-quantification-for-evaluation-of-coronary-artery-disease-by-computed-tomography
#4
REVIEW
Filippo Cademartiri, Sara Seitun, Alberto Clemente, Ludovico La Grutta, Patrizia Toia, Giuseppe Runza, Massimo Midiri, Erica Maffei
During the last decade coronary computed tomography angiography (CTA) has become the preeminent non-invasive imaging modality to detect coronary artery disease (CAD) with high accuracy. However, CTA has a limited value in assessing the hemodynamic significance of a given stenosis due to a modest specificity and positive predictive value. In recent years, different CT techniques for detecting myocardial ischemia have emerged, such as CT-derived fractional flow reserve (FFR-CT), transluminal attenuation gradient (TAG), and myocardial CT perfusion (CTP) imaging...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28540075/fractional-flow-reserve-to-guide-surgical-coronary-revascularization
#5
REVIEW
Tara Shah, Joshua D Geleris, Ming Zhong, Rajesh V Swaminathan, Luke K Kim, Dmitriy N Feldman
Coronary angiography has traditionally been used as the final diagnostic tool in the evaluation of coronary artery disease (CAD). However, conventional angiography identifies anatomically obstructive coronary disease, but it is limited in its ability to identify hemodynamically significant lesions. The emergence of fractional flow reserve (FFR) technology, in conjunction with angiography, offers a functional, as well as anatomic, assessment of epicardial coronary obstructions. Several pivotal studies have demonstrated that FFR-guided coronary revascularization is a safe and effective in patients with single and multivessel CAD...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28539573/identification-of-the-state-of-maximal-hyperemia-in-the-assessment-of-coronary-fractional-flow-reserve-using-non-invasive-electrical-velocimetry
#6
Takahide Murasawa, Masao Takahashi, Masahiro Myojo, Arihiro Kiyosue, Atsushi Oguri, Jiro Ando, Issei Komuro
Previous research revealed that, in patients with coronary pressure-derived fractional flow reserve (FFR) in the 'grey zone' (0.75-0.85), repeated FFR assessments sometimes yield conflicting results. One of the causes of the fluctuations in FFR values around the grey zone may be imprecise identification of the point where maximal hyperemia is achieved. Identification of the state of maximal hyperemia during assessment of FFR can be challenging. This study aimed to determine whether non-invasive electrical velocimetry (EV) can be used to identify the state of maximal hyperemia...
May 23, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28538000/revascularization-for-patients-with-diabetes-mellitus-and-stable-ischemic-heart-disease-an-update
#7
G B John Mancini, Michael Farkouh, Subodh Verma
PURPOSE OF REVIEW: To provide an update on the management of patients with diabetes mellitus and requiring coronary revascularization. RECENT FINDINGS: Evidence continues to show that patients with diabetes mellitus and ischemic heart disease represent a very high-risk group of patients. Choice of stent appears important for minimizing target lesion and target vessel adverse events with everolimus eluting stents having the best performance, particularly in patients being treated with insulin...
May 19, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28536897/validation-of-myocardial-perfusion-quantification-by-dynamic-ct-in-an-ex-vivo-porcine-heart-model
#8
Gert Jan Pelgrim, Marco Das, Sjoerd van Tuijl, Marly van Assen, Frits W Prinzen, Marco Stijnen, Matthijs Oudkerk, Joachim E Wildberger, Rozemarijn Vliegenthart
To test the accuracy of quantification of myocardial perfusion imaging (MPI) using computed tomography (CT) in ex-vivo porcine models. Five isolated porcine hearts were perfused according to Langendorff. Hearts were perfused using retrograde flow through the aorta and blood flow, blood pressure and heart rate were monitored throughout the experiment. An inflatable cuff was placed around the circumflex (Cx) artery to create stenosis grades which were monitored using a pressure wire, analysing perfusion at several fractional flow reserve values of 1...
May 23, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28526473/coronary-flow-reserve-is-reduced-in-sarcoidosis
#9
Seref Kul, Gonul Aciksari Kutlu, Tolga Sinan Guvenc, Murat Kavas, Kenan Demircioglu, Yusuf Yilmaz, Halil Ibrahim Yakar, Asiye Kanbay, Sibel Boga, Mustafa Caliskan
BACKGROUND AND AIMS: Sarcoidosis is a multisystem disease with frequent cardiac involvement, albeit manifest cardiac disease is rare. Though epicardial coronary arteries are not frequently involved, microvascular disease is rather common in both symptomatic and asymptomatic patients. The mechanism of microvascular involvement has not been elaborated yet. The aim of this study is to investigate coronary flow velocity reserve (CFVR) using transthoracic echocardiography in patients with sarcoidosis but without known atherosclerotic coronary artery disease or risk factors for atherosclerosis...
May 4, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28526033/effects-of-exenatide-on-cardiac-function-perfusion-and-energetics-in-type-2-diabetic-patients-with-cardiomyopathy-a-randomized-controlled-trial-against-insulin-glargine
#10
Weena J Y Chen, Michaela Diamant, Karin de Boer, Hendrik J Harms, Lourens F H J Robbers, Albert C van Rossum, Mark H H Kramer, Adriaan A Lammertsma, Paul Knaapen
BACKGROUND: Multiple bloodglucose-lowering agents have been linked to cardiovascular events. Preliminary studies showed improvement in left ventricular (LV) function during glucagon-like peptide-1 receptor agonist administration. Underlying mechanisms, however, are unclear. The purpose of this study was to investigate myocardial perfusion and oxidative metabolism in type 2 diabetic (T2DM) patients with LV systolic dysfunction as compared to healthy controls. Furthermore, effects of 26-weeks of exenatide versus insulin glargine administration on cardiac function, perfusion and oxidative metabolism in T2DM patients with LV dysfunction were explored...
May 19, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28522275/impact-of-continuous-positive-airway-pressure-on-left-ventricular-systolic-loading-and-coronary-flow-reserve-in-healthy-young-men
#11
Volker Schulze, Christian Meyer, Christian Eickholt, Roberto Sansone, Stefanie Keymel, Christian Heiss, Tienush Rassaf, Malte Kelm, Stephan Steiner
BACKGROUND: Increased augmentation index (AIx) is accompanied by an elevated cardiovascular risk. A reduction of AIx is known for long-term continuous positive airway pressure (CPAP) therapy. We hypothesised that acute preload and left ventricular workload effects AIx and subendocardial viability ratio (SEVR) as a marker of coronary flow reserve. METHODS: Increased augmentation index and central blood pressure parameters were measured by radial artery tonometry in 17 healthy men (32/±6years) at rest and during CPAP ventilation at pressures of 5, 10mbar and after recovery...
March 31, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28521932/discordance-between-fractional-flow-reserve-and-coronary-flow-reserve-insights-from-intracoronary-imaging-and-physiological%C3%A2-assessment
#12
Sung Gyun Ahn, Jon Suh, Olivia Y Hung, Hee Su Lee, Yasir H Bouchi, Wenjie Zeng, Rounak Gandhi, Parham Eshtehardi, Bill D Gogas, Habib Samady
OBJECTIVES: The aim of this study was to investigate the epicardial and microvascular substrates associated with discordances between fractional flow reserve (FFR) and coronary flow reserve (CFR) values. BACKGROUND: Discordances between FFR and CFR remain poorly characterized. METHODS: FFR, hyperemic stenosis resistance (HSR), and intravascular ultrasound were performed as indexes of epicardial function and CFR and hyperemic microvascular resistance (HMR) as measures of microvascular function in 94 patients with moderate coronary stenosis...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28521918/what-is-the-clinical-relevance-of-the-discordance-between-fractional-flow-reserve-and-coronary-flow-reserve
#13
EDITORIAL
Bon-Kwon Koo
No abstract text is available yet for this article.
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28520220/endothelial-damage-effects-of-circulating-microparticles-from-patients-with-stable-angina-is-reduced-by-aspirin-though-erk-p38-mapks-pathways
#14
Cheng Gong, Xue-Feng Shan, Xu-Lang Wang, Wei-Wei Dong, Zhe Li, D Xin-Hong Liu, Wei Zhang, Kun Xing, Feng-Jun Chang
INTRODUCTION: Platelet activation participate in the development of both coronary artery disease (CAD) and circulating microparticles (MPs). As a commonly used medicine for coronary heart disease, whether aspirin affects the function of MPs remains unclear. AIMS: This study was designed to test MPs from healthy subjects, stable angina (SA) patients before and after aspirin administration were obtained. MPs origins were tested by flow cytometry. Rat thoracic aortas were incubated with MPs (with or without aspirin) to determine the effects of MPs on expression of ERK1/2, JNKs and p38 MAPK...
May 18, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28514394/-the-diagnostic-value-of-measuring-the-momentary-blood-flow-reserve-versus-non-invasive-methods-to-detect-myocardial-ischemia-in-assessing-the-functional-significance-of-borderline-coronary-artery-stenoses
#15
D I Darensky, V V Gramovich, E A Zharova, A A Ansheles, V B Sergienko, M G Mitroshkin, R V Atanesyan, Yu G Matchin
AIM: To estimate the diagnostic value of measuring the momentary blood flow reserve (MBFR) versus the surrogate non-invasive standard (SNS) for myocardial ischemia verification (MIV) (a combination of stress echocardiography and single-photon emission computed tomography). SUBJECTS AND METHODS: The investigation enrolled 50 patients with stable angina in the presence of chronic coronary heart disease (CHD) or suspected CHD, in whom coronary angiography (CA) revealed borderline coronary stenoses (50-70% lumen diameters)...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28514327/postoperative-assessment-of-myocardial-function-and-microcirculation-in-patients-with-acute-coronary-syndrome-by-myocardial-contrast-echocardiography
#16
Li Jiang, Hong Yao, Zhao-Guang Liang
BACKGROUND Postoperative myocardial function and microcirculation of acute coronary syndrome (ACS) was assessed by myocardial contrast echocardiography (MCE). MATERIAL AND METHODS Eighty-nine ACS patients treated with percutaneous coronary intervention (PCI) were detected by MCE and two-dimensional ultrasonography before and a month later after PCI respectively. Their myocardial perfusion was evaluated by myocardial contrast score (MSC) and contrast score index (CSI); cross-sectional area of microvessel (A), average myocardial microvascular impairment (β), and myocardial blood flow (MBF) were analyzed by cardiac ultrasound quantitative analysis (CUSQ), and fractional flow reserve (FFR) change was observed...
May 17, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28506646/virtual-resting-pd-pa-from-coronary-angiography-and-blood-flow-modelling-diagnostic-performance-against-fractional-flow-reserve
#17
Michail I Papafaklis, Takashi Muramatsu, Yuki Ishibashi, Christos V Bourantas, Dimitrios I Fotiadis, Emmanouil S Brilakis, Héctor M Garcia-Garcia, Javier Escaned, Patrick W Serruys, Lampros K Michalis
BACKGROUND: Fractional flow reserve (FFR) has been established as a useful diagnostic tool. The distal coronary pressure to aortic pressure (Pd/Pa) ratio at rest is a simpler physiologic index but also requires the use of the pressure wire, whereas recently proposed virtual functional indices derived from coronary imaging require complex blood flow modelling and/or are time-consuming. Our aim was to test the diagnostic performance of virtual resting Pd/Pa using routine angiographic images and a simple flow model...
May 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28504545/detection-of-hemodynamically-significant-coronary-artery-stenosis-with-ct-enhancement-ratio-a-validation-study-in-a-porcine-model
#18
Jun Chen, Yang Pu, Zhang Zhang, Xuefang Yu, Zhengwen Yang
OBJECTIVE: Although numerous techniques that are based on CT number analysis have been proposed, the assessment of hemodynamically significant coronary artery stenosis remains a great challenge. The purpose of this study is to validate use of the CT enhancement ratio in the detection of hemodynamically significant coronary artery stenosis in a porcine model. MATERIALS AND METHODS: Experiments involving eight closed-chest swine were performed. A balloon catheter was placed into the left anterior descending coronary artery to simulate different degrees of luminal stenosis...
May 15, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28500478/effect-of-stenosis-eccentricity-on-the-functionality-of-coronary-bifurcation-lesions-a-numerical-study
#19
Catherine Pagiatakis, Jean-Claude Tardif, Philippe L L'Allier, Rosaire Mongrain
Interventional cardiologists still rely heavily on angiography for the evaluation of coronary lesion severity, despite its poor correlation with the presence of ischemia. In order to improve the accuracy of the current diagnostic procedures, an understanding of the relative influence of geometric characteristics on the induction of ischemia is required. This idea is especially important for coronary bifurcation lesions (CBLs), whose treatment is complex and is associated with high rates of peri- and post-procedural clinical events...
May 13, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28497191/evaluation-of-the-coronary-circulation-and-calcification-in-children-on-regular-hemodialysis
#20
Mohammed Al-Biltagi, Maher Ahmed Abd ElHafez, Doaa Mohamed El Amrousy, Mohamed El-Gamasy, Hesham El-Serogy
BACKGROUND: The objective of this study was to evaluate the coronary circulation and calcification in children with end-stage renal disease (ESRD) on hemodialysis. METHODS: A total of 50 children with ESRD and 50 healthy controls were enrolled in the study. Cardiac functions and coronary blood flow were evaluated with conventional and tissue Doppler echocardiography. Coronary artery calcification (CAC) was evaluated using high-resolution multidetector computed tomography (CT)...
May 11, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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