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Fractional 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/28626148/prevalence-of-thin-cap-fibroatheroma-in-relation-to-the-severity-of-anatomical-and-physiological-stenosis
#2
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
#3
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/28616535/effect-of-intravenous-infusion-of-iodinated-contrast-media-on-the-coronary-blood-flow-in-dogs
#4
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
#5
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/28612908/association-between-fractional-flow-reserve-and-duke-treadmill-score-in-patients-with-single-vessel-disease
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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/28600860/estimating-the-accuracy-of-a-reduced-order-model-for-the-calculation-of-fractional-flow-reserve-ffr
#13
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
#14
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
#15
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/28595860/diagnostic-performance-of-a-novel-method-for-fractional-flow-reserve-computed-from-noninvasive-computed-tomography-angiography-novel-flow-study
#16
Ju-Hyun Chung, Kyung Eun Lee, Chang-Wook Nam, Joon-Hyung Doh, Hyung Il Kim, Soon-Sung Kwon, Eun Bo Shim, Eun-Seok Shin
Coronary computed tomography angiography (CCTA)-derived fractional flow reserve from computed tomography (CT-FFR) may provide better diagnostic performance over CCTA alone, but the complexity of its method limits the use in clinical environment. The aim of the present study is to validate a newly developed vessel-length based computational fluid dynamics scheme for the computation of FFR based on CCTA data, compare them with invasively measured FFR, and evaluate its diagnostic performance with that of CCTA...
May 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28595700/angiotensin-converting-enzyme-inhibition-early-after-heart-transplantation
#17
William F Fearon, Kozo Okada, Jon A Kobashigawa, Yuhei Kobayashi, Helen Luikart, Sean Sana, Tiffany Daun, Steven A Chmura, Seema Sinha, Garett Cohen, Yasuhiro Honda, Michael Pham, David B Lewis, Daniel Bernstein, Alan C Yeung, Hannah A Valantine, Kiran Khush
BACKGROUND: Cardiac allograft vasculopathy (CAV) remains a leading cause of mortality after heart transplantation (HT). Angiotensin-converting enzyme inhibitors (ACEIs) may retard the development of CAV but have not been well studied after HT. OBJECTIVES: This study tested the safety and efficacy of the ACEI ramipril on the development of CAV early after HT. METHODS: In this prospective, multicenter, randomized, double-blind, placebo-controlled trial, 96 HT recipients were randomized to undergo ramipril or placebo therapy...
June 13, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28594441/rapid-computation-of-single-pet-scan-rest-stress-myocardial-blood-flow-parametric-images-by-table-look-up
#18
Nicolas J Guehl, Marc D Normandin, Dustin W Wooten, Guy Rozen, Jeremy Ruskin, Timothy M Shoup, Jonghye Woo, Leon M Ptaszek, Georges El Fakhri, Nathaniel M Alpert
PURPOSE: We have recently reported a method for measuring rest-stress myocardial blood flow (MBF) using a single, relatively short, PET scan session. The method requires two IV tracer injections, one to initiate rest imaging and one at peak stress. We previously validated absolute flow quantitation in ml/min/cc for standard bull's eye, segmental analysis. In this work, we extend the method for fast computation of rest-stress MBF parametric images. METHODS: We provide an analytic solution to the single-scan rest-stress flow model which is then solved using a two-dimensional table lookup method (LM)...
June 8, 2017: Medical Physics
https://www.readbyqxmd.com/read/28584029/real-life-fractional-flow-reserve
#19
EDITORIAL
Bernard De Bruyne, Stephane Fournier, Emanuele Barbato
No abstract text is available yet for this article.
June 6, 2017: Circulation
https://www.readbyqxmd.com/read/28580809/cardiovascular-imaging-environment-will-the-future-be-cloud-based
#20
Nadine Kawel-Boehm, David A Bluemke
In cardiovascular CT and MR imaging large datasets have to be stored, post-processed, analyzed and distributed. Beside basic assessment of volume and function in cardiac magnetic resonance imaging e.g., more sophisticated quantitative analysis is requested requiring specific software. Several institutions cannot afford various types of software and provide expertise to perform sophisticated analysis. Areas covered: Various cloud services exist related to data storage and analysis specifically for cardiovascular CT and MR imaging...
June 13, 2017: Expert Review of Medical Devices
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