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Fractional flow reserve

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https://www.readbyqxmd.com/read/29055128/a-generalized-outflow-boundary-condition-impedance-model-for-non-invasive-prediction-of-ischemia-in-diseased-coronary-arteries
#1
Iyad A Fayssal, Fadl Moukalled, Samir Alam, Hussain Isma'eel
This paper reports on a new boundary condition formulation to model the total coronary myocardial flow and impedance characteristics of the myocardial vascular bed for any specific patient when considered for non-invasive diagnosis of fractional flow reserve (FFR). The developed boundary condition model inherits an implicit representation of the downstream truncated vascular bed and is based on integrating patient-specific physiologic parameters that can be non-invasively extracted for each patient to account for blood flow demand to the myocardium at rest and hyperemic conditions...
October 21, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29054592/the-impact-of-tissue-doppler-index-e-e-ratio-on-instantaneous-wave-free-ratio
#2
Hiroyuki Arashi, Junichi Yamaguchi, Tonre Ri, Hisao Otsuki, Masashi Nakao, Kazuho Kamishima, Kentaro Jujo, Yuichiro Minami, Hiroshi Ogawa, Nobuhisa Hagiwara
BACKGROUND: The instantaneous wave-free ratio (iFR) is a vasodilator-free, invasive pressure wire index of the functional severity of coronary stenosis and is calculated under resting conditions. In a recent study, iFR was found to be more closely linked to coronary flow reserve (CFR) than fractional flow reserve (FFR). E/e' is a surrogate marker of left ventricular (LV) filling pressure and LV diastolic dysfunction. Coronary resting flow was found to be increased in patients with elevated E/e', and higher coronary resting flow was associated with lower CFR...
October 17, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29051079/reduced-myocardial-flow-reserve-is-associated-with-diastolic-dysfunction-and-decreased-left-atrial-strain-in-patients-with-normal-ejection-fraction-and-epicardial-perfusion
#3
Matthew C Konerman, Joshua C Greenberg, Theodore J Kolias, James R Corbett, Ravi V Shah, Venkatesh L Murthy, Scott L Hummel
INTRODUCTION: Coronary microvascular dysfunction (MVD) may contribute to the pathogenesis of heart failure with preserved ejection fraction (HFpEF). Speckle-tracking echocardiography is a feasible and reproducible method for identifying abnormalities in left ventricular (LV) and left atrial (LA) function among HFpEF patients. By assessing myocardial flow reserve (MFR), positron emission tomography (PET) imaging enables quantitative assessment of coronary MVD. We hypothesized that, in patients with risk factors for HFpEF and normal epicardial perfusion on cardiac PET, abnormal MFR is associated with LV diastolic dysfunction (DD) and reduced LV and LA strain...
October 16, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29050684/comparison-of-accuracy-of-one-use-methods-for-calculating-fractional-flow-reserve-by-intravascular-optical-coherence-tomography-to-that-determined-by-the-pressure-wire-method
#4
Sun-Joo Jang, Jung-Min Ahn, Boyoung Kim, Ji-Min Gu, Hyung Jin Sung, Seung-Jung Park, Wang-Yuhl Oh
Although the identification of the hemodynamic significance of coronary lesions becomes important for revascularization strategy, the potential role of 3-dimensional high-resolution intracoronary optical coherence tomography (OCT) for predicting functional significance of coronary lesions remains unclear. We assessed the diagnostic performance of 2 computational approaches for deriving fractional flow reserve (FFR) from intravascular OCT images. We developed 2 methods to derive FFR-OCT by AFD (FFR-OCTAFD) and FFR-OCT by CFD (FFR-OCTCFD)...
September 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29050683/correlation-of-fractional-flow-reserve-with-ischemic-burden-measured-by-cardiovascular-magnetic-resonance-perfusion-imaging
#5
Shazia T Hussain, Matthias Paul, Geraint Morton, Andreas Schuster, Amedeo Chiribiri, Divaka Perera, Eike Nagel
Cardiovascular magnetic resonance (CMR) perfusion imaging and fractional flow reserve (FFR) assess myocardial ischemia. FFR measures the pressure loss across a stenosis determining hemodynamic significance but does not assess the area subtended by the stenotic vessel. CMR perfusion imaging measures the extent of myocardial blood flow reduction (=ischemic burden). Both techniques allow for continuous rather than categorical evaluation, but their relationship is poorly understood. This study investigates the relationship between the FFR value and the extent of myocardial ischemia...
September 4, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29050558/similarity-and-difference-of-resting-distal%C3%A2-to-aortic-coronary-pressure-and%C3%A2-instantaneous-wave-free-ratio
#6
Joo Myung Lee, Jonghanne Park, Doyeon Hwang, Chee Hae Kim, Ki Hong Choi, Tae-Min Rhee, Yaliang Tong, Jin Joo Park, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Bon-Kwon Koo
BACKGROUND: Instantaneous wave-free ratio (iFR) has been used in clinical practice to identify functionally significant stenosis and to guide treatment strategy. However, there are limited clinical data regarding another resting pressure-derived index, resting distal to aortic coronary pressure (Pd/Pa), and similarities and differences between resting Pd/Pa and iFR. OBJECTIVES: The authors investigated the changes in resting Pd/Pa and iFR according to anatomic and hemodynamic stenosis severity and their prognostic implications...
October 24, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29050557/agreement-of-the-resting-distal-to%C3%A2-aortic%C3%A2-coronary-pressure-with-the%C3%A2-instantaneous-wave-free-ratio
#7
Yuhei Kobayashi, Nils P Johnson, Frederik M Zimmermann, Nils Witt, Colin Berry, Allen Jeremias, Bon-Kwon Koo, Giovanni Esposito, Gilles Rioufol, Seung-Jung Park, Takeshi Nishi, Dong-Hyun Choi, Keith G Oldroyd, Emanuele Barbato, Nico H J Pijls, Bernard De Bruyne, William F Fearon
BACKGROUND: Recently, 2 randomized controlled trials showed that the instantaneous wave-free ratio (iFR), a resting coronary physiological index, is noninferior to fractional flow reserve for guiding revascularization. The resting distal to aortic coronary pressure (Pd/Pa) measured at rest is another adenosine-free index widely available in the cardiac catheterization laboratory; however, little is known about the agreement of Pd/Pa using iFR as a reference standard. OBJECTIVES: The goal of this study was to investigate the agreement of Pd/Pa with iFR...
October 24, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29049831/improving-myocardial-fractional-flow-reserve-in-coronary-atherosclerosis-via-cx37-gene-silence-a-preclinical-validation-study-in-pigs
#8
Suxia Guo, Ying Yang, Zhenyu Yang, Huayan You, Yunke Shi, Zhao Hu, Zhaohui Meng, Jianming Xiao
OBJECTIVES: The purpose of this study was to evaluate the effect of CX37 gene silence on myocardial fractional flow reserve (FFR). METHODS: A total of 90 male pigs were randomly divided into saline, mock and 3 different doses (5, 10 and 20 µl) of CX37 viral suspension groups that could induce coronary plaque formation with high-fat diet. After performing myocardial FFR by intravascular ultrasound, different doses of CX37 viral suspension, saline and mock small interfering RNA (siRNA) were transfected into the related coronary...
July 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29046003/-ffr-guided-revascularisation-pros-and-cons
#9
Hannes Reuter, Stephan Baldus
An invasive measurement of the fractional flow reserve (FFR) allows the valuation of the individual risk for ischemic events in patients with coronary artery disease. Therefore, FFR has become a valuable tool to guide coronary revascularisations. The cut-off value ≤ 0.80 has been validated in many different subsets of patients. However, FFR values describe a risk continuum with an inverse correlation between FFR value and the risk of events. So FFR should always be interpreted regarding the patient's clinical context, especially in patients with a high risk for rapid disease progression...
October 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29045625/coronary-optical-coherence-tomography-derived-virtual-fractional-flow-reserve-ffr-anatomy-and-physiology-all-in-one
#10
Eric K W Poon, Vikas Thondapu, Eve Revalor, Andrew Ooi, Peter Barlis
No abstract text is available yet for this article.
October 17, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29045612/fractional-flow-reserve-and-myocardial-perfusion-by-computed-tomography-a-guide-to-clinical-application
#11
Joanne D Schuijf, Brian S Ko, Marcelo F Di Carli, Jacqueline Hislop-Jambrich, Abdul-Rahman Ihdayhid, Sujith K Seneviratne, João A C Lima
The aim of this paper is to provide a guide to the clinical application of the functional computed tomography (CT) techniques fractional flow reserve (CT FFR) and myocardial perfusion (CTP) in patients presenting for the evaluation of coronary artery disease (CAD). Both techniques have recently been introduced to complement coronary CT angiography (CTA) with physiological information. Evidence supporting their diagnostic accuracy accumulates at a fast pace, and both techniques are moving from research tools to clinical applications for specific subgroups of patients...
October 17, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29045201/instantaneous-wave-free-ratio-versus-fractional-flow-reserve
#12
LETTER
Deepak L Bhatt
New England Journal of Medicine, Volume 377, Issue 16, Page 1595-1599, October 2017.
October 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29045200/instantaneous-wave-free-ratio-versus-fractional-flow-reserve
#13
LETTER
Justin E Davies, Sayan Sen, Javier Escaned
No abstract text is available yet for this article.
October 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29045199/instantaneous-wave-free-ratio-versus-fractional-flow-reserve
#14
LETTER
Nico H J Pijls, Bernard De Bruyne
No abstract text is available yet for this article.
October 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29045198/instantaneous-wave-free-ratio-versus-fractional-flow-reserve
#15
LETTER
(no author information available yet)
No abstract text is available yet for this article.
October 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29042397/influence-of-contrast-media-dose-and-osmolality-on-the-diagnostic-performance-of-contrast-fractional-flow-reserve
#16
Takeshi Nishi, Nils P Johnson, Bernard De Bruyne, Colin Berry, K Lance Gould, Allen Jeremias, Keith G Oldroyd, Yuhei Kobayashi, Dong-Hyun Choi, Nico H J Pijls, William F Fearon
BACKGROUND: Contrast fractional flow reserve (cFFR) is a method for assessing functional significance of coronary stenoses, which is more accurate than resting indices and does not require adenosine. However, contrast media volume and osmolality may affect the degree of hyperemia and therefore diagnostic performance. METHODS AND RESULTS: cFFR, instantaneous wave-free ratio, distal pressure/aortic pressure at rest, and FFR were measured in 763 patients from 12 centers...
October 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29041887/-comparison-of-diagnostic-values-of-instantaneous-wave-free-r-atio-and-fractional-flow-r-eserve-with-noninvasive-methods-for-evaluating-myocardial-ischemia-in-assessment-of-the-functional-significance-of-intermediate-coronary-stenoses-in-patients-with-chronic
#17
A A Ansheles, B V Sergienko, I D Darenskiy, V V Gramovich, A E Zharova, G M Mitroshkin, G Y Matchin, V R Atanesyan
OBJECTIVE: To compare the diagnostic accuracy of instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR) with noninvasive methods in assessment of the functional significance of moderate coronary stenoses in patients with chronic ischemic heart disease (IHD). METHODS: We included in this study 50 patients with chronic or suspected IHD and moderate coronary stenoses (50-70%; 74 stenoses). Values of iFR and FFR were determined within 10 days after noninvasive stress tests (combination of stress-echo and SPECT)...
August 2017: Kardiologiia
https://www.readbyqxmd.com/read/29038225/role-of-proximal-optimization-technique-guided-by-intravascular-ultrasound-on-stent-expansion-stent-symmetry-index-and-side-branch-hemodynamics-in-patients-with-coronary-bifurcation-lesions
#18
Diaa Hakim, Arka Chatterjee, Olusuen Alli, Joshua Turner, Assad Sattar, Nicolas Foin, Massoud A Leesar
BACKGROUND: Bench models of coronary bifurcation lesions demonstrated that the proximal optimization technique (POT) expanded the stent and opened the side branch (SB). We investigated the role of POT guided by intravascular ultrasound on the main vessel (MV) stent expansion and SB fractional flow reserve (FFR) in patients with coronary bifurcation lesion. METHODS AND RESULTS: In 40 patients with coronary bifurcation lesion, 120 intravascular ultrasound examinations of the MV were performed at baseline, after MV stenting, and POT followed by 95 FFR measurements of the SB...
October 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29038224/effect-of-elective-percutaneous-coronary-intervention-on-hyperemic-absolute-coronary-blood-flow-volume-and-microvascular-resistance
#19
Yoshihisa Kanaji, Tadashi Murai, Taishi Yonetsu, Eisuke Usui, Makoto Araki, Junji Matsuda, Masahiro Hoshino, Masao Yamaguchi, Takayuki Niida, Masahiro Hada, Sadamitsu Ichijyo, Rikuta Hamaya, Yoshinori Kanno, Mitsuaki Isobe, Tsunekazu Kakuta
BACKGROUND: The hemodynamics involved in the relationship between absolute coronary blood flow (ABF) volume and myocardial resistance (MR) are complex, and the effect of percutaneous coronary intervention (PCI) on their changes remains unclear. The aim of this study was to investigate the differences in hyperemic ABF and MR before and after elective PCI using a thermodilution method. METHODS AND RESULTS: We investigated 28 vessels (right coronary artery, 9; left anterior descending coronary artery, 18; left circumflex coronary artery, 1) from 28 patients with stable angina pectoris undergoing elective PCI...
October 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29037762/evaluation-of-lesion-flow-coefficient-for-the-detection-of-coronary-artery-disease-in-patient-groups-from-two-academic-medical-centers
#20
Srikara V Peelukhana, Rupak K Banerjee, Tim P van de Hoef, Kranthi K Kolli, Mohamed Effat, Tarek Helmy, Massoud Leesar, Hanan Kerr, Jan J Piek, Paul Succop, Lloyd Back, Imran Arif
BACKGROUND: In this study, lesion flow coefficient (LFC: ratio of % area stenosis [%AS] to the square root of the ratio of the pressure drop across the stenosis to the dynamic pressure in the throat region), that combines both the anatomical (%AS) and functional measurements (pressure and flow), was assessed for application in a clinical setting. METHODS AND RESULTS: Pressure, flow, and anatomical values were obtained from patients in 251 vessels from two different centers...
September 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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