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Fractional flow reserve

Shu Yokota, Nanette Borren, Mohamed Mouden, Jorik R Timmer, Siert Knollema, Pieter L Jager, Jan Paul Ottervanger
Aims: Single-photon emission computed tomography (SPECT) is widely used for the assessment of coronary artery disease and for decision making regarding revascularization. Concerns about possible false negative findings exist. Our aim was to assess the prevalence of stenoses which are both functionally and anatomically significant in patients referred for invasive fractional flow reserve (FFR) measurements following a normal SPECT, because of persistent complaints. Methods and results: One hundred and thirty-three consecutive patients with normal SPECT were included, with a total of 180 FFR measurements...
September 20, 2018: European Heart Journal Cardiovascular Imaging
Deepak L Bhatt
No abstract text is available yet for this article.
September 13, 2018: JAMA: the Journal of the American Medical Association
Koen Nieman
No abstract text is available yet for this article.
September 17, 2018: European Heart Journal Cardiovascular Imaging
Ankur Gupta, Meagan Harrington, Christine M Albert, Navkaranbir S Bajaj, Jon Hainer, Victoria Morgan, Courtney F Bibbo, Paco E Bravo, Michael T Osborne, Sharmila Dorbala, Ron Blankstein, Viviany R Taqueti, Deepak L Bhatt, William G Stevenson, Marcelo F Di Carli
OBJECTIVES: This study sought to investigate the association of myocardial scar and ischemia with major arrhythmic events (MAEs) in patients with left ventricular ejection fraction (LVEF) ≤35%. BACKGROUND: Although myocardial scar is a known substrate for ventricular arrhythmias, the association of myocardial ischemia with ventricular arrhythmias in stable patients with left ventricular dysfunction is less clear. METHODS: A total of 439 consecutive patients (median age, 70 years; 78% male; 55% with implantable cardioverter defibrillator [ICD]) referred for stress/rest positron emission tomography (PET) and resting LVEF ≤35% were included...
September 2018: JACC. Clinical Electrophysiology
Ki Hong Choi, Joo Myung Lee, Hyun Kuk Kim, Jihoon Kim, Jonghanne Park, Doyeon Hwang, Tae-Min Rhee, Taek Kyu Park, Jeong Hoon Yang, Young Bin Song, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Joo-Yong Hahn, Jin-Ho Choi, Seung-Hyuk Choi, Bon-Kwon Koo, Hyeon-Cheol Gwon
OBJECTIVES: The aim of this study was to compare the changes of fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR) with severity of epicardial coronary stenosis between nonculprit vessel of acute myocardial infarction (AMI) and stable ischemic heart disease (SIHD). BACKGROUND: There has been debate regarding the reliability of FFR or iFR for nonculprit stenosis in the acute stage of AMI. METHODS: A total of 100 AMI patients underwent comprehensive physiologic assessment including FFR, iFR, coronary flow reserve (CFR), and index of microcirculatory resistance (IMR) for nonculprit vessel stenosis after primary percutaneous coronary intervention (PCI) for culprit vessel...
September 24, 2018: JACC. Cardiovascular Interventions
Yunxiao Chang, Liwei Chen, Jelmer Westra, Zhongwei Sun, Changdong Guan, Yimin Zhang, Daixin Ding, Bo Xu, Shengxian Tu
BACKGROUND: Quantitative flow ratio (QFR) is a novel approach to derive fractional flow reserve (FFR) from coronary angiography. This study sought to evaluate the reproducibility of QFR when analyzed in independent core laboratories. METHODS: All interrogated vessels in the FAVOR II China Study were separately analyzed using the AngioPlus system (Pulse medical imaging technology, Shanghai) by two independent core laboratories, following the same standard operation procedures...
September 20, 2018: Cardiology Journal
Rikuta Hamaya, Taishi Yonetsu, Yoshihisa Kanaji, Eisuke Usui, Masahiro Hoshino, Masahiro Hada, Yoshinori Kanno, Tadashi Murai, Tetsumin Lee, Tsunekazu Kakuta
This study aimed to investigate the combined efficacy in prediction of major adverse cardiac events (MACE) by coronary regional physiological indices including coronary flow reserve (CFR) or fractional flow reserve (FFR) and high-sensitivity cardiac troponin-I (hs-cTnI) or N-terminal pro brain natriuretic peptide (NT-proBNP). Impaired CFR, decreased FFR, elevated cardiac troponin, and NT-proBNP are all associated with increased MACE, while these interaction or collinearity remains uncertain. The study included 429 patients with stable coronary artery disease (CAD) evaluated hs-cTnI and NT-proBNP levels before regional physiological measurement during coronary angiography...
September 18, 2018: Heart and Vessels
Enrico Cerrato, Mauro Echavarria-Pinto, Fabrizio D'Ascenzo, Nieves Gonzalo, Giorgio Quadri, Alicia Quirós, José M de la Torre Hernández, Francesco Tomassini, Umberto Barbero, Luis Nombela-Franco, Ivan Nuñez-Gil, Giuseppe Biondi-Zoccai, Carlos Macaya, Ferdinando Varbella, Javier Escaned
BACKGROUND: Current guidelines recommend intravascular ultrasound (IVUS) or fractional flow reserve (FFR) to decide upon ambiguous left main (LM) disease. However, no study has compared the safety of LM revascularization deferral based on FFR or IVUS. METHODS: MEDLINE/PubMed was systematically screened for studies reporting on deferred treatment of angiographically ambiguous LM based upon FFR or IVUS evaluation. Baseline, angiographic and outcome data were appraised and pooled separately for each strategy according to random-effect models with inverse-variance weighting...
November 15, 2018: International Journal of Cardiology
Jiehan Hong, Min Su, Yanyan Yu, Zhiqiang Zhang, Rong Liu, Yaocai Huang, Peitian Mu, Hairong Zheng, Weibao Qiu
Both the morphological anatomy and functional parameters such as flow speed of the artery provide valuable information for the evaluation of cardiovascular diseases. Direct measurement of the arterial wall can be achieved by intravascular optical/ultrasound imaging methods, however no functional data are acquired with these methods. Fractional flow reserve (FFR) and Doppler wire have been used to assess the blood flow information, but do not provide cross-sectional images of the artery. This study is the first to design and fabricate a dual mode imaging catheter that contains a forward-looking ultrasonic transducer and a side-looking ultrasonic transducer together in one catheter...
September 12, 2018: IEEE Transactions on Medical Imaging
Csilla Celeng, Tim Leiner, Pál Maurovich-Horvat, Béla Merkely, Pim de Jong, Jan W Dankbaar, Hendrik W van Es, Brian B Ghoshhajra, Udo Hoffmann, Richard A P Takx
OBJECTIVES: This meta-analysis determined the diagnostic performance of coronary computed tomography (CT) angiography (CTA), CT myocardial perfusion (CTP), fractional flow reserve CT (FFRCT ), the transluminal attenuation gradient (TAG), and their combined use with CTA versus FFR as a reference standard for detection of hemodynamically significant coronary artery disease (CAD). BACKGROUND: CTA provides excellent anatomic, albeit limited functional information for the evaluation of CAD...
September 6, 2018: JACC. Cardiovascular Imaging
Carlos Collet, Patrick W Serruys
No abstract text is available yet for this article.
August 2018: Cardiovascular Diagnosis and Therapy
Yuhei Kobayashi, Jacob Lønborg, Andy Jong, Takeshi Nishi, Bernard De Bruyne, Dan Eik Høfsten, Henning Kelbæk, Jamie Layland, Chang-Wook Nam, Nico H J Pijls, Pim A L Tonino, Julie Warnøe, Keith G Oldroyd, Colin Berry, Thomas Engstrøm, William F Fearon
BACKGROUND: The residual SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score (RSS) quantitatively assesses angiographic completeness of revascularization after percutaneous coronary intervention (PCI) and has been shown to be a predictor of events after angiography-guided PCI. In stable patients undergoing functionally complete revascularization with fractional flow reserve (FFR) guidance, RSS did not predict outcome. Whether this is also true in patients with acute coronary syndromes (ACS) is unknown...
September 18, 2018: Journal of the American College of Cardiology
Michiel J Bom, Roel S Driessen, Pieter G Raijmakers, Henk Everaars, Adriaan A Lammertsma, Albert C van Rossum, Niels van Royen, Juhani Knuuti, Maija Mäki, Ibrahim Danad, Paul Knaapen
Aims: The longitudinal myocardial blood flow (MBF) gradient derived from positron emission tomography (PET) has been proposed as an emerging non-invasive index of haemodynamically significant coronary artery disease (CAD). This study aimed to investigate the diagnostic value of longitudinal MBF gradient for the presence of haemodynamically significant CAD. Methods and results: A total of 204 patients (603 vessels) with suspected CAD underwent [15O]H2O PET followed by invasive coronary angiography with fractional flow reserve (FFR) of all major coronary arteries...
September 12, 2018: European Heart Journal Cardiovascular Imaging
John C Moscona, Jason D Stencel, Gregory Milligan, Christopher Salmon, Rohit Maini, Paul Katigbak, Qusai Saleh, Ryan Nelson, Sudesh Srivastav, Owen Mogabgab, Rohan Samson, Thierry Le Jemtel
Background: An accurate diagnostic assessment of coronary artery disease is crucial for patients undergoing coronary artery bypass grafting (CABG). Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) to guide complete revascularization have not been adequately studied in patients prior to CABG. We compared an anatomic to a physiologic assessment of moderate coronary lesions (40-70% stenosis) in patients referred for CABG. Methods: We retrospectively reviewed 109 medical records of patients who underwent CABG at Tulane Medical Center from 2014 to 2016...
August 2018: Annals of Translational Medicine
Christian Langer, Agne Adukauskaite, Fabian Plank, Gudrun Feuchtner, Fabiola Cartes-Zumelzu
We report a rare case of a CADASIL-syndrome with cardiac involvement presenting as ANOCA (angina in the absence of obstructive coronary artery disease). Our case highlights the added value of non-invasive fractional flow reserve (FFR)CT over coronary CT angiography (CTA), and recommends CTA as useful indication in CADASIL patients for screening of occult coronary artery disease (CAD).
August 31, 2018: Journal of Cardiovascular Computed Tomography
S Manti, G F Parisi, V Giacchi, P Sciacca, L Tardino, C Cuppari, C Salpietro, A Chikermane, S Leonardi
AIM: This study determined cardiovascular impairment in young children with obstructive respiratory disease who were assessed using the opening interrupter technique (RINT). METHODS: This pilot study enrolled 41 children who had been referred to pulmonology and allergology specialists at the University of Catania, Italy, from March to July 2017: 23 (mean age 4.13 ±0.62 years) had chronic coughs and wheezing and 18 controls (mean age 4.27 ±0.66 years) had obstructive chest disease, but were otherwise healthy...
September 8, 2018: Acta Paediatrica
Amr Elfaramawy, Mohamed Hassan, Michael Nagy, Ahmed ElGuindy, Mahmoud F Elmahdy
Background: Fractional flow reserve (FFR) is the reference standard for the assessment of the functional significance of coronary artery stenoses, but remains underutilized. Our aims were to study whether FFR changed the decision for treatment of intermediate coronary lesions and to assess the clinical outcome in the deferred and intervention groups. Methods: In this retrospective study, coronary angiograms of patients with moderately stenotic lesions (40-70%) for which FFR was performed were re-analyzed by three experienced interventional cardiologists (blinded to FFR results) to determine its angiographic significance and whether to defer or perform an intervention...
September 2018: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
Lorena Casadonte, Jan J Piek, Ed VanBavel, Jos A E Spaan, Maria Siebes
BACKGROUND: Drift is a well-known issue affecting intracoronary pressure measurements. A small pressure offset at the end of the procedure is generally considered acceptable, while repeat assessment is advised for drift exceeding ±2 mmHg. This practice implies that drift assessed after wire pullback equals that at the time of stenosis appraisal, but this assumption has not been systematically investigated. Our aim was to compare intra-and post-procedural pressure sensor drift and assess benefits of correction for intra-procedural drift and its effect on diagnostic classification...
August 18, 2018: International Journal of Cardiology
A J J IJsselmuiden, E M Zwaan, R M Oemrawsingh, M J Bom, F J W M Dankers, M J de Boer, C Camaro, R J M van Geuns, J Daemen, D J van der Heijden, J W Jukema, A O Kraaijeveld, M Meuwissen, B E Schölzel, G Pundziute, P van der Harst, J van Ramshorst, M T Dirksen, C Zivelonghi, P Agostoni, J A S van der Heyden, J J Wykrzykowska, M J Scholte, H M Nef, M J M Kofflard, N van Royen, M Alings, E Kedhi
INTRODUCTION: Optical coherence tomography (OCT) enables detailed imaging of the coronary wall, lumen and intracoronary implanted devices. Responding to the lack of specific appropriate use criteria (AUC) for this technique, we conducted a literature review and a procedure for appropriate use criteria. METHODS: Twenty-one of all 184 members of the Dutch Working Group on Interventional Cardiology agreed to evaluate 49 pre-specified cases. During a meeting, factual indications were established whereupon members individually rated indications on a 9-point scale, with the opportunity to substantiate their scoring...
August 31, 2018: Netherlands Heart Journal
Timothy A Fairbairn, Koen Nieman, Takashi Akasaka, Bjarne L Nørgaard, Daniel S Berman, Gilbert Raff, Lynne M Hurwitz-Koweek, Gianluca Pontone, Tomohiro Kawasaki, Niels Peter Sand, Jesper M Jensen, Tetsuya Amano, Michael Poon, Kristian Øvrehus, Jeroen Sonck, Mark Rabbat, Sarah Mullen, Bernard De Bruyne, Campbell Rogers, Hitoshi Matsuo, Jeroen J Bax, Jonathon Leipsic, Manesh R Patel
Aims: Non-invasive assessment of stable chest pain patients is a critical determinant of resource utilization and clinical outcomes. Increasingly coronary computed tomography angiography (CCTA) with selective CCTA-derived fractional flow reserve (FFRCT) is being used. The ADVANCE Registry, is a large prospective examination of using a CCTA and FFRCT diagnostic pathway in real-world settings, with the aim of determining the impact of this pathway on decision-making, downstream invasive coronary angiography (ICA), revascularization, and major adverse cardiovascular events (MACE)...
August 25, 2018: European Heart Journal
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