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Fractional flow reserve

Niels Peter Rønnow Sand, Karsten Tange Veien, Søren Steen Nielsen, Bjarne Linde Nørgaard, Pia Larsen, Allan Johansen, Søren Hess, Lone Deibjerg, Majed Husain, Anders Junker, Kristian Korsgaard Thomsen, Allan Rohold, Lisette Okkels Jensen
OBJECTIVES: This study sought to compare the per-patient diagnostic performance of coronary computed tomography angiography (CTA)-derived fractional flow reserve (FFRCT ) with that of single-photon emission computed tomography (SPECT), using a fractional flow reserve (FFR) value of ≤0.80 as the reference for diagnosing at least 1 hemodynamically significant stenosis in a head-to-head comparison of patients with intermediate coronary stenosis as determined by coronary CTA. BACKGROUND: No previous study has prospectively compared the diagnostic performance of FFRCT and myocardial perfusion imaging by SPECT in symptomatic patients with intermediate range coronary artery disease (CAD)...
June 9, 2018: JACC. Cardiovascular Imaging
Ravi Kiran Munnur, James D Cameron, Liam M McCormick, Peter J Psaltis, Nitesh Nerlekar, Brian S H Ko, Ian T Meredith, Sujith Seneviratne, Dennis T L Wong
BACKGROUND: Visual assessment of diameter-stenosis on Computed Tomography Coronary Angiography (CTCA) lacks specificity to determine functional significance of coronary artery stenosis. Percent-aggregate plaque volume (%APV) and ASLA score, which incorporates Area of Stenosis, Lesion length, and area of myocardium subtended estimated by APPROACH score (Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease) have been described to predict lesion specific ischaemia in focal lesions with intermediate stenosis...
June 8, 2018: International Journal of Cardiology
Giuseppe Tarantini, Alberto Barioli, Luca Nai Fovino, Chiara Fraccaro, Giulia Masiero, Sabino Iliceto, Massimo Napodano
BACKGROUND: Invasive physiological assessment of myocardial bridges (MBs) is largely unsettled. Unlike fractional flow reserve (FFR), instantaneous wave-free ratio (iFR) is a diastole-specific index. As such, its value might not be hampered by systolic pressure overshooting and negative systolic pressure gradient caused by the compression of the tunneled coronary artery. METHODS AND RESULTS: We prospectively enrolled 20 patients with angina and/or positive noninvasive stress test, absence of significant coronary artery stenosis, and angiographic suspicion/evidence of MB in the left anterior descending artery...
June 2018: Circulation. Cardiovascular Interventions
Kelsey N Sommer, Lauren Shepard, Nitant Vivek Karkhanis, Vijay Iyer, Erin Angel, Michael F Wilson, Frank J Rybicki, Dimitrios Mitsouras, Stephen Rudin, Ciprian N Ionita
Purpose: 3D printed patient specific vascular models provide the ability to perform precise and repeatable benchtop experiments with simulated physiological blood flow conditions. This approach can be applied to CT-derived patient geometries to determine coronary flow related parameters such as Fractional Flow Reserve (FFR). To demonstrate the utility of this approach we compared bench-top results with non-invasive CT-derived FFR software based on a computational fluid dynamics algorithm and catheter based FFR measurements...
February 2018: Proceedings of SPIE
Rory Hachamovitch
No abstract text is available yet for this article.
June 2018: Circulation. Cardiovascular Imaging
Do-Yoon Kang, Jung-Min Ahn, Young Woo Kim, Ji Young Moon, Joon Sang Lee, Bon-Kwon Koo, Pil Hyung Lee, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Seung-Jung Park
BACKGROUND: The impact of various coronary lesion geometries on fractional flow reserve (FFR) is poorly understood. METHODS AND RESULTS: A total of 1552 coronary lesions in 1236 patients from a prospective Interventional Cardiology Research In-cooperation Society Fractional Flow Reserve and Intravascular Ultrasound registry were assessed using quantitative coronary angiography, intravascular ultrasound, and FFR. Computational fluid dynamics simulation was performed for theoretical validation...
June 2018: Circulation. Cardiovascular Imaging
Panagiotis K Siogkas, Michail I Papafaklis, Lampros Lakkas, Themis P Exarchos, Dimitri Karmpaliotis, Ziad A Ali, Gualtiero Pelosi, Oberdan Parodi, Christos S Katsouras, Dimitrios I Fotiadis, Lampros K Michalis
AIMS: We aimed to investigate the performance of virtual functional assessment of coronary stenoses using intravascular ultrasound (IVUS)-based three-dimensional (3D) coronary artery reconstruction against the invasively measured fractional flow reserve (FFR). METHODS AND RESULTS: Twenty-two patients with either typical symptoms of stable angina or a positive stress test, who underwent IVUS and FFR, were included in this study. Five patients presented FFR values lower than the 0...
March 2, 2018: Heart, Lung & Circulation
Mengmeng Yu, Zhigang Lu, Wenbin Li, Meng Wei, Jing Yan, Jiayin Zhang
AIMS: To study the diagnostic performance of the ratio of Duke jeopardy score (DJS) to the minimal lumen diameter (MLD) at coronary computed tomographic angiography (CCTA) and machine learning based CT-FFR for differentiating functionally significant from insignificant lesions, with reference to fractional flow reserve (FFR). METHODS AND RESULTS: Patients who underwent both coronary CTA and FFR measurement at invasive coronary angiography (ICA) within 2 weeks were retrospectively included in our study...
August 15, 2018: International Journal of Cardiology
Karl A Brokstad, Marita Fredriksen, Fan Zhou, Brith Bergum, Johan G Brun, Rebecca J Cox, Kathrine Skarstein
Primary Sjögren's syndrome (pSS) is a chronic autoimmune disease characterized by exocrine gland dysfunction, mainly causing sicca symptoms. B cells have a prominent role in SS, and the T follicular helper (TFH ) cells provide B cells with survival- and specialization signals in germinal centers. Here we investigate peripheral TFH cells in pSS. Sixteen pSS patients and healthy controls were enrolled in the study, with thirteen women and three men in each group. Whole blood was collected and separated into PBMC and plasma, followed by cryopreservation...
June 8, 2018: Scandinavian Journal of Immunology
Jaromír Vašíček, Medhat Shehata, Susanne Schnabl, Martin Hilgarth, Rainer Hubmann, Ulrich Jäger, Miroslav Bauer, Peter Chrenek
Rabbits have many hereditary diseases common to humans and are therefore a valuable model for regenerative disease and hematopoietic stem cell (HSC) therapies. Currently, there is no substantial data on the isolation and/or enrichment of rabbit HSCs. This study was initiated to evaluate the efficiency of the commercially available anti-CD34 and anti-CD133 antibodies for the detection and potential enrichment of rabbit HSCs from peripheral blood. PBMCs from rabbit and human blood were labelled with different clones of anti-human CD34 monoclonal antibodies (AC136, 581 and 8G12) and rabbit polyclonal CD34 antibody (pCD34) and anti-human CD133 monoclonal antibodies (AC133 and 293C3)...
June 8, 2018: Biotechnology Progress
Firas R Al-Obaidi, William F Fearon, Andy S C Yong
Physiological measurements are now commonly used to assess coronary lesions in the cardiac catheterisation laboratory, and this practice is evidence-based and supported by clinical guidelines. Fractional flow reserve is currently the gold standard method to determine whether coronary lesions are functionally significant, and is used to guide revascularization. There are however several other physiological measurements that have been proposed as alternatives to the fractional flow reserve. This review aims to comprehensively discuss physiological indices that can be used in the cardiac catheterisation laboratory to determine the functional significance of coronary lesions...
March 2018: IJC Heart & Vasculature
Kristian A Øvrehus, Sara Gaur, Jonathon Leipsic, Jesper M Jensen, Damini Dey, Hans E Bøtker, Amir Ahmadi, Stephan Achenbach, Brian Ko, Bjarne L Nørgaard
BACKGROUND: Coronary stenosis and plaque evaluation by coronary computed tomography angiography (CTA) may contribute to identify hemodynamically relevant lesions. We evaluated the most stenotic lesion including plaques proximal to it versus a total vessel analyses combined with stenosis for ischemia. METHODS: Patients scheduled for clinically indicated invasive coronary angiography (ICA) for suspected coronary artery disease underwent coronary CTA and ICA including fractional flow reserve (FFR) as part of the NXT trial (clinicaltrials...
May 8, 2018: Journal of Cardiovascular Computed Tomography
Takeshi Nishi, Hideki Kitahara, Yoshihide Fujimoto, Takashi Nakayama, Kengo Nagashima, Hideki Hanaoka, Yoshio Kobayashi
Nicorandil has vasodilatory effects on both the epicardial coronary arteries and the coronary microvasculature, thereby increasing coronary blood flow. The objective of the present study was to investigate the effectiveness of intravenous (IV) nicorandil infusion for fractional flow reserve (FFR) measurement. In this crossover randomized study, 49 patients underwent FFR measurement with a consecutive randomized order of patient-blind infusions of continuous IV adenosine administration and a single bolus IV administration of nicorandil...
June 1, 2018: Heart and Vessels
Sangwon Han, Young-Hak Kim, Jung-Min Ahn, Soo-Jin Kang, Jungsu S Oh, Eonwoo Shin, Changhwan Sung, Sun Young Chae, Seung-Jung Park, Gillan Grimberg, Gil Kovalski, Dae Hyuk Moon
PURPOSE: We evaluated the feasibility of dynamic stress 201 Tl/rest 99m Tc-tetrofosmin SPECT imaging using a cardiac camera equipped with cadmium-zinc-telluride detectors for the quantification of myocardial perfusion reserve (MPR). METHODS: Subjects with stable known or suspected coronary artery disease (CAD) who had undergone or were scheduled to undergo fractional flow reserve (FFR) measurement were prospectively enrolled. Dynamic stress 201 Tl/rest 99m Tc-tetrofosmin SPECT imaging was performed using a dedicated multiple pinhole SPECT camera with cadmium-zinc-telluride detectors...
June 2, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Juhani Knuuti, Haitham Ballo, Luis Eduardo Juarez-Orozco, Antti Saraste, Philippe Kolh, Anne Wilhelmina Saskia Rutjes, Peter Jüni, Stephan Windecker, Jeroen J Bax, William Wijns
Aims: To determine the ranges of pre-test probability (PTP) of coronary artery disease (CAD) in which stress electrocardiogram (ECG), stress echocardiography, coronary computed tomography angiography (CCTA), single-photon emission computed tomography (SPECT), positron emission tomography (PET), and cardiac magnetic resonance (CMR) can reclassify patients into a post-test probability that defines (>85%) or excludes (<15%) anatomically (defined by visual evaluation of invasive coronary angiography [ICA]) and functionally (defined by a fractional flow reserve [FFR] ≤0...
May 29, 2018: European Heart Journal
Vincent Spagnoli, Fabien Picard, Victor-Xavier Tadros, Daniel Cournoyer, Serge Doucet, Jean François Tanguay, Gilbert Gosselin, Pierre de Guise, Richard Gallo
Background: Instantaneous wave free ratio (iFR) does not require adenosine, but has a relatively wide intermediate range where functional assessment remains inconclusive. In this pilot study, we sought to enhance iFR through with the use of intracoronary (IC) saline (iFRs) and contrast media (iFRc) and determine whether these techniques correlated well with fractional flow reserve (FFR). Methods: Patients with coronary artery stenosis (CAS) associated with an iFR in the intermediate zone (≥0...
April 2018: Cardiovascular Diagnosis and Therapy
Stephane Fournier, Gabor G Toth, Bernard De Bruyne, Nils P Johnson, Giovanni Ciccarelli, Panagiotis Xaplanteris, Anastasios Milkas, Teresa Strisciuglio, Jozef Bartunek, Marc Vanderheyden, Eric Wyffels, Filip Casselman, Frank Van Praet, Bernard Stockman, Ivan Degrieck, Emanuele Barbato
BACKGROUND: Fractional flow reserve (FFR)-guided coronary artery bypass graft (CABG) surgery has been associated with lower number of graft anastomoses, lower rate of on-pump surgery, and higher graft patency rate as compared with angiography-guided CABG surgery. However, no clinical benefit has been reported to date. METHODS AND RESULTS: Consecutive patients (n=627) treated by CABG between 2006 and 2010 were retrospectively included. In 198 patients, at least 1 stenosis was grafted according to FFR (FFR-guided group), whereas in 429 patients all stenoses were grafted based on angiography (angiography-guided group)...
June 2018: Circulation. Cardiovascular Interventions
R Agujetas, M R González-Fernández, J M Nogales-Asensio, J M Montanero
BACKGROUND: Fractional flow reverse (FFR) is the gold standard assessment of the hemodynamic significance of coronary stenoses. However, it requires the catheterization of the coronary artery to determine the pressure waveforms proximal and distal to the stenosis. On the contrary, computational fluid dynamics enables the calculation of the FFR value from relatively non-invasive computed tomography angiography (CTA). METHODS: We analyze the flow across idealized highly-eccentric coronary stenoses by solving the Navier-Stokes equations...
May 30, 2018: Biomedical Engineering Online
Clay M Barbin, Anupama Vasudevan, James W Choi, Peter A McCullough, Jeffrey M Schussler, Ravi C Vallabhan, Robert C Stoler
BACKGROUND: Fractional flow reserve(FFR) is a validated tool for evaluating functional severity and guiding the revascularization of angiographically moderate coronary artery lesions. OBJECTIVE: To study if there is a higher frequency of positive FFR measurements in the left anterior descending(LAD) versus other major coronary arteries and also evaluate the differences in the total length of the stent placed. METHODS: A retrospective cohort study including all subjects (January 2011 to December 2015) who had fractional flow reserve (FFR) measured during coronary catheterization was conducted...
April 25, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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