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Fractional flow reserve

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https://www.readbyqxmd.com/read/29470616/automated-spect-analysis-compared-with-expert-visual-scoring-for-the-detection-of-ffr-defined-coronary-artery-disease
#1
R S Driessen, P G Raijmakers, I Danad, W J Stuijfzand, S P Schumacher, J A Leipsic, J K Min, J Knuuti, A A Lammertsma, A C van Rossum, N van Royen, S R Underwood, P Knaapen
PURPOSE: Traditionally, interpretation of myocardial perfusion imaging (MPI) is based on visual assessment. Computer-based automated analysis might be a simple alternative obviating the need for extensive reading experience. Therefore, the aim of the present study was to compare the diagnostic performance of automated analysis with that of expert visual reading for the detection of obstructive coronary artery disease (CAD). METHODS: 206 Patients (64% men, age 58...
February 22, 2018: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29466605/continuous-sheath-free-separation-of-drug-treated-human-fungal-pathogen-cryptococcus-neoformans-by-morphology-in-biocompatible-polymer-solutions
#2
Di Li, Jessica Zielinski, Lukasz Kozubowski, Xiangchun Xuan
Cryptococcal meningitis caused by Cryptococcus neoformans is the leading cause of fungal central nervous system infections. Current antifungal treatments for cryptococcal infections are inadequate partly due to the occurrence of drug resistance. Recent studies indicate that the treatment of the azole drug fluconazole changes the morphology of C. neoformans to form enlarged "multimeras" that consist of three or more connected cells/buds. To analyze if these multimeric cells are a prerequisite for C...
February 21, 2018: Electrophoresis
https://www.readbyqxmd.com/read/29457618/accuracy-of-the-lowest-pd-pa-ratio-measurement-during-induced-hyperaemia-correct-fractional-flow-reserve-assessment
#3
Łukasz Kalińczuk, Kamil Zieliński, Mariusz A Dębski, Mirosław Skwarek
No abstract text is available yet for this article.
2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29454774/incremental-diagnostic-value-of-stress-computed-tomography-myocardial-perfusion-with-whole-heart-coverage-ct-scanner-in-intermediate-to-high-risk-symptomatic-patients-suspected-of-coronary-artery-disease
#4
Gianluca Pontone, Daniele Andreini, Andrea I Guaricci, Andrea Baggiano, Fabio Fazzari, Marco Guglielmo, Giuseppe Muscogiuri, Claudio Maria Berzovini, Annalisa Pasquini, Saima Mushtaq, Edoardo Conte, Giuseppe Calligaris, Stefano De Martini, Cristina Ferrari, Stefano Galli, Luca Grancini, Paolo Ravagnani, Giovanni Teruzzi, Daniela Trabattoni, Franco Fabbiocchi, Alessandro Lualdi, Piero Montorsi, Mark G Rabbat, Antonio L Bartorelli, Mauro Pepi
OBJECTIVES: The goal of this study was to evaluate the diagnostic accuracy of stress computed tomography myocardial perfusion (CTP) for the detection of functionally significant coronary artery disease (CAD) by using invasive coronary angiography (ICA) plus invasive fractional flow reserve (FFR) as the reference standard in consecutive intermediate- to high-risk symptomatic patients. BACKGROUND: Stress CTP recently emerged as a potential strategy to combine the anatomic and functional evaluation of CAD in a single scan...
February 9, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29454266/simplified-bernoulli-formula-to-predict-flow-limiting-stenosis-at-coronary-computed-tomography-angiography
#5
Nobuo Tomizawa, Kodai Yamamoto, Shinichi Inoh, Takeshi Nojo, Sunao Nakamura
OBJECTIVE: To compare the diagnostic performance of estimated energy loss (EEL) with diameter stenosis (DS) to estimate significant stenosis by fractional flow reserve (FFR). MATERIALS AND METHODS: One hundred twenty-five patients were included. EEL was calculated using DS, lesion length, minimal lumen area and left ventricular volume. FFR ≤ 0.80 was determined significant. RESULTS: EEL improved the accuracy from 63% (95% confidence interval (CI): 55-72%) to 83% (95% CI: 75-89%, p < 0...
February 6, 2018: Clinical Imaging
https://www.readbyqxmd.com/read/29449442/design-and-rationale-of-the-ripcord-2-trial-does-routine-pressure-wire-assessment-influence-management-strategy-at-coronary-angiography-for-diagnosis-of-chest-pain-a-randomized-controlled-trial-to-compare-routine-pressure-wire-assessment-with-conventional-angiography
#6
REVIEW
Mostafa Elguindy, Rod Stables, Zoe Nicholas, Ian Kemp, Nick Curzen
BACKGROUND: Investigation of anginal chest pain has traditionally involved either assessment of the coronary anatomy by angiography or noninvasive testing for reversible ischemia. Invasive pressure wire assessment at the time of angiography offers information on both anatomy and physiology. Fractional flow reserve-guided percutaneous coronary intervention is associated with lower resource utilization and improved clinical outcome compared with angiographic guidance alone. However, the value of routine fractional flow reserve of all major coronary vessels at the time of diagnostic angiography has not been established in a randomized trial despite persuasive observational data...
February 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29449325/quantitative-flow-ratio-identifies-nonculprit-coronary-lesions-requiring-revascularization-in-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-disease
#7
Giosafat Spitaleri, Matteo Tebaldi, Simone Biscaglia, Jelmer Westra, Salvatore Brugaletta, Andrea Erriquez, Giulia Passarini, Alessandro Brieda, Antonio Maria Leone, Andrea Picchi, Alfonso Ielasi, Domenico Di Girolamo, Carlo Trani, Roberto Ferrari, Johan H C Reiber, Marco Valgimigli, Manel Sabatè, Gianluca Campo
BACKGROUND: The nonculprit lesion (NCL) management in ST-segment-elevation myocardial infarction patients with multivessel disease is debated. We sought to assess whether quantitative flow ratio (QFR), a noninvasive tool to identify potentially flow-limiting lesions, may be reliable in this scenario. METHODS AND RESULTS: The present proof-of-concept study is based on a 3-step process: (1) identification of the QFR reproducibility in NCLs assessment (cohort A, n=31); (2) prospective validation of QFR diagnostic accuracy in respect to fractional flow reserve (cohort B, n=45); and (3) investigation of long-term clinical outcomes of NCLs stratified according to QFR (cohort C, n=110)...
February 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29449274/clinical-relevance-of-functionally-insignificant-moderate-coronary-artery-stenosis-assessed-by-3-vessel-fractional-flow-reserve-measurement
#8
Jonghanne Park, Joo Myung Lee, Bon-Kwon Koo, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Doyeon Hwang, Jinlong Zhang, Xinyang Hu, JianAn Wang, Fei Ye, Shaoliang Chen, Junqing Yang, Jiyan Chen, Nobuhiro Tanaka, Hiroyoshi Yokoi, Hitoshi Matsuo, Hiroaki Takashima, Yasutsugu Shiono, Takashi Akasaka
BACKGROUND: Understanding of the risk conferred by functionally insignificant lesions in multiple coronary vessels is limited. We investigated the prognostic implications of coronary artery disease (CAD) based on 3-vessel fractional flow reserve (FFR). METHODS AND RESULTS: A total of 1,136 patients underwent FFR measurement in the 3 major epicardial arteries. We defined vessels with "Moderate CAD" as vessels with FFR, 0.81 to 0.87. Patients were classified into Group 1: No apparent CAD (FFR>0...
February 15, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29447342/diagnosing-coronary-artery-disease-after-a-positive-coronary-computed-tomography-angiography-the-dan-nicad-open-label-parallel-head-to-head-randomized-controlled-diagnostic-accuracy-trial-of-cardiovascular-magnetic-resonance-and-myocardial-perfusion-scintigraphy
#9
L Nissen, S Winther, J Westra, J A Ejlersen, C Isaksen, A Rossi, N R Holm, G Urbonaviciene, L C Gormsen, L H Madsen, E H Christiansen, M Maeng, L L Knudsen, L Frost, L Brix, H E Bøtker, S E Petersen, M Bøttcher
Aims: Perfusion scans after coronary computed tomography angiography (CCTA) in patients with suspected coronary artery disease (CAD) may reduce unnecessary invasive coronary angiographies (ICAs). However, the diagnostic accuracy of perfusion scans after primary CCTA is unknown. The aim of this study was to determine the diagnostic accuracy of cardiac magnetic resonance (CMR) and myocardial perfusion scintigraphy (MPS) against ICA with fractional flow reserve (FFR) in patients suspected of CAD by CCTA...
February 13, 2018: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29446567/prognostic-value-of-the-index-of-microcirculatory-resistance-after-percutaneous-coronary-intervention-in-patients-with-non-st-segment-elevation-acute-coronary-syndrome
#10
Tadashi Murai, Taishi Yonetsu, Yoshihisa Kanaji, Eisuke Usui, Masahiro Hoshino, Masahiro Hada, Rikuta Hamaya, Yoshinori Kanno, Tetsumin Lee, Tsunekazu Kakuta
BACKGROUND: The prognostic value of physiological indices in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients undergoing percutaneous coronary intervention (PCI) is unknown. We investigated the prognostic efficacy of physiological indices obtained after PCI in patients with NSTE-ACS. METHODS: Eighty-three patients (men: n = 70, age: 63.7 ± 9.7 years) undergoing PCI for NSTE-ACS within 48 hr postadmission were investigated. Fractional flow reserve (FFR), coronary flow reserve (CFR), and the index of microcirculatory resistance (IMR) of the culprit vessels were measured after the completion of PCI...
February 15, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29437033/the-impact-of-objective-mathematical-analysis-during-fractional-flow-reserve-measurement-results-from-the-oma-ffr-study
#11
Martina I Sciola, Paul D Morris, Rebecca Gosling, Patricia V Lawford, D Rodney Hose, Julian P Gunn
AIMS: Fractional flow reserve (FFR), the reference-standard for guiding coronary revascularisation, is most commonly acquired during intravenous adenosine infusion. Results may be sensitive to system- and operator-dependent variability in how pressure data are analysed and interpreted. We developed a computational protocol to process the recorded pressure signals in a consistent manner to objectively quantify FFR. We studied the impact upon lesion (re)classification and compared this with the operator-selected FFR obtained during cardiac catheterisation...
February 13, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29433968/dynamic-stress-computed-tomography-myocardial-perfusion-for-detecting-myocardial-ischemia-a-systematic-review-and-meta-analysis
#12
Minjie Lu, Shuli Wang, Arlene Sirajuddin, Andrew E Arai, Shihua Zhao
BACKGROUND: Comparing to SPECT and MRI, with higher temporal and spatial resolution and development of radiation dose reduction, myocardial computed tomography perfusion has emerged as a potential method for evaluation of hemodynamic myocardial ischemia. This meta-analysis systematically analyzed the performance of dynamic CT myocardial perfusion (DCTMP) to diagnose myocardial ischemia (MI) with clinically established reference methods [MR/SPECT/PET perfusion and fractional flow reserve (FFR)] as the reference standard...
February 10, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29432130/combined-assessment-of-stress-myocardial-perfusion-cardiovascular-magnetic-resonance-and-flow-measurement-in-the-coronary-sinus-improves-prediction-of-functionally-significant-coronary-stenosis-determined-by-fractional-flow-reserve-in-multivessel-disease
#13
Shiro Nakamori, Hajime Sakuma, Kaoru Dohi, Masaki Ishida, Takashi Tanigawa, Akimasa Yamada, Shinichi Takase, Hiroshi Nakajima, Toshiki Sawai, Jun Masuda, Motonori Nagata, Yasutaka Ichikawa, Kakuya Kitagawa, Eitaro Fujii, Norikazu Yamada, Masaaki Ito
BACKGROUND: Recent studies using stress-rest perfusion cardiovascular magnetic resonance (CMR) demonstrated a close correlation between myocardial ischemia and reduced fractional flow reserve (FFR). However, its diagnostic concordance may be reduced in patients with multivessel disease. We sought to evaluate the concordance of adenosine stress-rest perfusion CMR for predicting reduced FFR, and to determine the additive value of measuring global coronary flow reserve (CFR) in the coronary sinus in multivessel disease...
January 26, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29431869/separation-of-plasma-derived-exosomes-into-cd3-and-cd3-fractions-allows-for-association-of-immune-cell-and-tumor-cell-markers-with-disease-activity-in-hnscc-patients
#14
Marie-Nicole Theodoraki, Thomas K Hoffmann, Theresa L Whiteside
Head and neck squamous cell carcinoma (HNSCC) is a highly immunosuppressive malignancy. Exosomes in HNSCC patients' plasma are enriched in inhibitory cargo and mediate immunosuppression. As these exosomes are products of various cells, the cellular origin of immunoregulatory proteins they carry is unknown. To test whether tumor- or T cell-derived exosomes in patient's plasma are immunosuppressive and impact on disease activity, we separated CD3(-) from CD3(+) exosomes by immunocapture using anti-CD3 Abs. The exosome protein cargo was evaluated for immunoregulatory proteins using on-bead flow cytometry...
February 12, 2018: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/29429843/invasive-in-the-cath-lab-assessment-of-myocardial-ischemia-in-patients-with-coronary-artery-disease-when-does-the-gold-standard-not-apply
#15
REVIEW
Stefano Benenati, Giovanni Luigi De Maria, Roberto Scarsini, Italo Porto, Adrian P Banning
International guidelines recommend that revascularization for coronary artery disease (CAD) should be guided by evidence of myocardial ischemia. Fractional flow reserve (FFR) and instantaneous free wave ratio (iFR) are the main invasive indices for assessing the ischemic potential of angiographically intermediate coronary stenosis as a large body of evidence supports their routine application. Both indices have been tested and validated in patients with isolated stable CAD, but notably their application outside this specific context is a matter of debate and investigation...
January 31, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29424571/coronary-microvascular-dysfunction-in-patients-with-heart-failure-with-preserved-ejection-fraction
#16
Kathryn Dryer, Mark Gajjar, Nikhil Narang, Margaret Lee, Jonathan Paul, Atman P Shah, Sandeep Nathan, Javed Butler, Charles J Davidson, William F Fearon, Sanjiv J Shah, John Edward Abellera Blair
BACKGROUND: There are multiple proposed mechanisms for the pathophysiology of heart failure (HF) with preserved ejection fraction (HFpEF). We hypothesize that coronary microvascular dysfunction is common in these patients. METHODS AND RESULTS: In a prospective, observational study, patients undergoing cardiac catheterization with HFpEF (left ventricular (LV) ejection fraction {greater than or equal to} 50% and with clinical HF), were compared to similar patients without HFpEF...
February 9, 2018: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29422416/incidence-and-predictors-of-lesion-specific-ischemia-by-ffrct-learnings-from-the-international-advance-registry
#17
Hironori Kitabata, Jonathon Leipsic, Manesh R Patel, Koen Nieman, Bernard De Bruyne, Campbell Rogers, Gianluca Pontone, Bjarne L Nørgaard, Jeroen J Bax, Gilbert Raff, Kavitha M Chinnaiyan, Mark Rabbat, Niels Peter Rønnow Sand, Philipp Blanke, Timothy A Fairbairn, Hitoshi Matsuo, Tetsuya Amano, Tomohiro Kawasaki, Yoshihiro Morino, Takashi Akasaka
BACKGROUND: To date, the clinical utility of coronary computed tomography angiography (CTA)-derived fractional flow reserve (FFRCT) has been limited to trials and single center experiences. We herein report the incidence of abnormal FFRCT (≤0.80) and the relationship of lesion-specific ischemia to subject demographics, symptoms, and degree of stenosis in the multicenter, prospective ADVANCE registry. METHODS: One thousand patients with suspected angina having documented coronary artery disease on coronary CTA and clinically referred for FFRCT were prospectively enrolled in the registry...
February 2, 2018: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29414521/association-between-epicardial-fat-volume-and-fractional-flow-reserve-an-analysis-of-the-determination-of-fractional-flow-reserve-defacto-study
#18
Ashley Beecy, Bríain Ó Hartaigh, Joshua Schulman-Marcus, Khalil Anchouche, Heidi Gransar, Subhi Al'Aref, Kimberly Elmore, Fay Y Lin, James K Min, Jessica M Peña
BACKGROUND: This study examines the relationship between epicardial fat volume (EFV) and lesion-specific ischemia by fractional flow reserve (FFR). METHODS: In a study of 173 patients (63.0 ± 8.3 years) undergoing FFR, EFV was determined using cardiac computed tomography. Relationships between EFV and FFR were assessed using multivariable linear and logistic regression. RESULTS: Using multivariable linear and logistic regression, no association between EFV and FFR was observed (β [SE] = -0...
February 2, 2018: Clinical Imaging
https://www.readbyqxmd.com/read/29413240/a-randomized-trial-comparing-the-neovas-sirolimus-eluting-bioresorbable-scaffold-and-metallic-everolimus-eluting-stents
#19
Yaling Han, Bo Xu, Guosheng Fu, Xiaozeng Wang, Kai Xu, Chongying Jin, Ling Tao, Lang Li, Yuqing Hou, Xi Su, Quan Fang, Lianglong Chen, Huiliang Liu, Bin Wang, Zuyi Yuan, Chuanyu Gao, Shenghua Zhou, Zhongwei Sun, Yanyan Zhao, Changdong Guan, Gregg W Stone
OBJECTIVES: The authors sought to evaluate the safety and effectiveness of the NeoVas bioresorbable scaffold (BRS) compared with metallic drug-eluting stents. BACKGROUND: BRS have the potential to improve very late outcomes compared with metallic drug-eluting stents, but some BRS have been associated with increased rates of device thrombosis before complete bioresorption. NeoVas is a new poly-l-lactic acid BRS that elutes sirolimus from a poly-D, l-lactide coating...
February 12, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29411509/initial-experience-with-the-use-of-fractional-flow-reserve-in-the-hemodynamic-evaluation-of-transplant-renal-artery-stenosis
#20
Manuel Pereira Marques Gomes Júnior, Cláudia Maria Rodrigues Alves, Adriano Henrique Pereira Barbosa, Adriano Caixeta, Marcelo Costa Batista, José Osmar Medina Pestana, Antônio Carlos Carvalho
OBJECTIVE: To describe and standardize an original protocol for fractional flow reserve (FFR) pre and postangioplasty in an initial series of patients with clinically manifested transplant renal artery stenosis (TRAS). BACKGROUND: There is no data in the literature about the use of FFR in TRAS. METHODS: Patients with TRAS detected in a noninvasive study were referred to diagnostic angiography and stenosis considered visually severe (≥ 60%) were included...
February 7, 2018: Catheterization and Cardiovascular Interventions
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