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Fractional flow reserve

Shazia T Hussain, Geraint Morton, Kalpa De Silva, Roy Jogiya, Andreas Schuster, Matthias Paul, Divaka Perera, Eike Nagel
AIMS: This study assesses the relationship between classical anatomical jeopardy scores, functional jeopardy scores (combined anatomical and haemodynamic data), and the extent of ischaemia identified on cardiovascular magnetic resonance (CMR) perfusion imaging. METHODS AND RESULTS: In 42 patients with stable angina and suspected coronary artery disease (CAD), CMR perfusion imaging was performed. Fractional Flow Reserve (FFR) was measured in vessels with ≥50 % stenosis...
October 20, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Vladimir Lakhter, Mohamad Alkhouli, Chad J Zack, Huaqing Zhao, Howard A Cohen, Brian P O'Neill, Brian O'Murchu, Alfred A Bove, Riyaz Bashir
BACKGROUND: Women with coronary artery disease are less likely to be revascularized than men based on angiography alone. Recent studies have shown that female patients have higher fractional flow reserve (FFR) values for a given severity of coronary stenosis. However, gender differences in coronary revascularization rates following FFR assessment are unknown. METHODS: The nationwide inpatient sample database was used to identify all patients who underwent FFR in the United States between January 2009 and December 2010...
October 18, 2016: Journal of Women's Health
Enrico Agabiti Rosei
Current Hypertension Guidelines emphasize the importance of assessing the presence of preclinical organ damage. In fact, an extensive evaluation of organ damage may increase the number of patients classified at high CV risk and therefore strongly influence the clinical management of patients. Hypertensive heart disease remains to date the form of organ damage for which there is the greatest amount of evidence of a strong independent prognostic significance. In the presence of a chronic pressure overload, a parallel addition of sarcomers takes place with an increase in myocyte width, which in turn increases left ventricular wall thickness; myocyte hypertrophy is also associated with apoptosis, collagen deposition and ventricular fibrosis with an impairment of coronary hemodynamics as well, thus profoundly influencing functional properties of the left (and right) ventricle...
September 2016: Journal of Hypertension
P Meimoun, J Clerc, D Ardourel, U Djou, S Martis, T Botoro, F Elmkies, H Zemir, A Luycx-Bore, J Boulanger
To test the usefulness of non-invasive coronary flow reserve (CFR) by transthoracic Doppler echocardiography by comparison to invasive fractional flow reserve (FFR) and instantaneous wave-free ratio (IFR), a new vasodilator-free index of coronary stenosis severity, in patients with left anterior descending artery (LAD) stenosis of intermediate severity (IS) and stable coronary artery disease. 94 consecutive patients (mean age 68 ± 10 years) with angiographic LAD stenosis of IS (50-70 % diameter stenosis), were prospectively studied...
October 17, 2016: International Journal of Cardiovascular Imaging
Kamales Kumar Saha, Saurab Goel, Ajay Kumar, Kakalee K Saha
A 64 years old male diabetic patient with ejection fraction of 16% and renal dysfunction underwent off-pump CABG using both in situ internal mammary artery grafts. Left internal mammary artery was used to bypass left anterior descending artery and right internal mammary artery was used as composite graft. Patient had uneventful recovery and left ventricular ejection fraction improved to 34% within 8 months after surgery. In presence of left ventricular dysfunction, both internal thoracic artery grafting should be preferred for better patency rate and flow reserve...
September 2016: Indian Heart Journal
Grzegorz J Horszczaruk, Przemysław Kwasiborski, Jolanta Miśko, Tomasz Pasierski
No abstract text is available yet for this article.
2016: Kardiologia Polska
Sebastian Völz, Sara Svedlund, Bert Andersson, Gan Li-Ming, Bengt Rundqvist
Resistant hypertension is associated with increased risk for cardiovascular events. Coronary flow reserve (CFR) is impaired in patients with hypertension and an independent predictor of cardiac mortality. However, there are no published data on CFR in the subset of treatment-resistant hypertension. The aim of this study was to assess CFR in patients with resistant hypertension. Twenty-five consecutive patients with primary resistant hypertension, scheduled for renal denervation, 25 matched patients with controlled hypertension, and 25 healthy controls underwent transthoracic colour Doppler echocardiography at rest and during adenosine infusion...
October 17, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Jack H Boyd, Vedant S Pargaonkar, David H Scoville, Ian S Rogers, Takumi Kimura, Shigemitsu Tanaka, Ryotaro Yamada, Michael P Fischbein, Jennifer A Tremmel, Robert Scott Mitchell, Ingela Schnittger
BACKGROUND: Left anterior descending artery myocardial bridges (MBs) range from clinically insignificant incidental angiographic findings to a potential cause of sudden cardiac death. Within this spectrum, a group of patients with isolated, symptomatic, and hemodynamically significant MBs despite maximally tolerated medical therapy exist for whom the optimal treatment is controversial. We evaluated supraarterial myotomy, or surgical unroofing, of the left anterior descending MBs as an isolated procedure in these patients...
October 1, 2016: Annals of Thoracic Surgery
Sara Gaur, Charles A Taylor, Jesper M Jensen, Hans Erik Bøtker, Evald H Christiansen, Anne K Kaltoft, Niels R Holm, Jonathon Leipsic, Christopher K Zarins, Stephan Achenbach, Sophie Khem, Alan Wilk, Hiram G Bezerra, Jens F Lassen, Bjarne L Nørgaard
OBJECTIVES: This study sought to determine the diagnostic performance of noninvasive fractional flow reserve (FFR) derived from coronary computed tomography angiography (CTA) (FFRCT) for the diagnosis of lesion-specific ischemia in nonculprit vessels of patients with recent in ST-segment elevation myocardial infarction (STEMI). BACKGROUND: In patients with stable angina, FFRCT has high diagnostic performance in identification of ischemia-causing lesions. The potential value of FFRCT for assessment of multivessel disease in patients with recent STEMI has not been evaluated...
October 6, 2016: JACC. Cardiovascular Imaging
Kady Fischer, Dominik P Guensch, Nancy Shie, Julie Lebel, Matthias G Friedrich
BACKGROUND: Breathing maneuvers can elicit a similar vascular response as vasodilatory agents like adenosine; yet, their potential diagnostic utility in the presence of coronary artery stenosis is unknown. The objective of the study is to investigate if breathing maneuvers can non-invasively detect inducible ischemia in an experimental animal model when the myocardium is imaged with oxygenation-sensitive cardiovascular magnetic resonance (OS-CMR). METHODS AND FINDINGS: In 11 anesthetised swine with experimentally induced significant stenosis (fractional flow reserve <0...
2016: PloS One
Wei Tang, Jun Zhou, Lili Miao, GuoCao Shi
OBJECTIVE: Cough variant asthma (CVA) is a subtype of asthma that is characterized by a chronic cough. We compared the clinical characteristics and pulmonary function in patients with CVA who had normal and high exhaled fractional nitric oxide (FeNO) levels. METHODS: We collected the clinical history and pulmonary function data from 99 patients with newly diagnosed CVA. RESULT: Newly diagnosed subjects with CVA were divided into a high FeNO group (FeNO value over or equal to 25 ppb, n=52) and a normal FeNO group (FeNO lower than 25 ppb, n=47)...
October 12, 2016: Clinical Respiratory Journal
Mark W Kennedy, Enrico Fabris, Alexander J Ijsselmuiden, Holger Nef, Sebastian Reith, Javier Escaned, Fernando Alfonso, Niels van Royen, Wojtek Wojakowski, Adam Witkowski, Ciro Indolfi, Jan Paul Ottervanger, Harry Suryapranata, Elvin Kedhi
BACKGROUND: Fractional flow reserve (FFR) is a widely used tool for the identification of ischaemia-generating stenoses and to guide decisions on coronary revascularisation. However, the safety of FFR-based decisions in high-risk subsets, such as patients with Diabetes Mellitus (DM) or vulnerable stenoses presenting thin-cap fibro-atheroma (TCFA), is unknown. This study will examine the impact of optical coherence tomography (OCT) plaque morphological assessment and the identification of TCFA, in combination with FFR to better predict clinical outcomes in DM patients...
October 10, 2016: Cardiovascular Diabetology
Jae-Sik Jang, Ho-Cheol Shin, Jong Seok Bae, Han-Young Jin, Jeong-Sook Seo, Tae-Hyun Yang, Dae-Kyeong Kim, Kyoung-Im Cho, Bo-Hyun Kim, Yong Hyun Park, Hyung-Gon Je, Dong-Soo Kim
BACKGROUND AND OBJECTIVES: Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention frequently results in unnecessary stenting due to the low positive predictive value of IVUS-derived minimal lumen area (MLA) for identification of functionally significant coronary stenosis. We appraised the diagnostic accuracy of IVUS-derived MLA compared with the fractional flow reserve (FFR) to assess intermediate coronary stenosis. SUBJECTS AND METHODS: We searched MEDLINE and Cochrane databases for studies using IVUS and FFR methods to establish the best MLA cut-off values to predict significant non-left main coronary artery stenosis...
September 2016: Korean Circulation Journal
Tetsuma Kawaji, Hiroki Shiomi, Hiroshi Morishita, Takeshi Morimoto, Charles A Taylor, Shotaro Kanao, Koji Koizumi, Satoshi Kozawa, Kazuhisa Morihiro, Hirotoshi Watanabe, Junichi Tazaki, Masao Imai, Naritatsu Saito, Satoshi Shizuta, Koh Ono, Kaori Togashi, Takeshi Kimura
Non-invasive fractional flow reserve measured by coronary computed tomography angiography (FFRCT) has demonstrated a high diagnostic accuracy for detecting coronary artery disease (CAD) in selected patients in prior clinical trials. However, feasibility of FFRCT in unselected population have not been fully evaluated. Among 60 consecutive patients who had suspected significant CAD by coronary computed tomography angiography (CCTA) and were planned to undergo invasive coronary angiography, 48 patients were enrolled in this study comparing FFRCT with invasive fractional flow reserve (FFR) without any exclusion criteria for the quality of CCTA image...
October 7, 2016: International Journal of Cardiovascular Imaging
H M Nef, O Dörr, H Möllmann, A Elsässer
Bifurcation lesions are a therapeutic challenge in the interventional treatment of coronary artery disease. Thus, consideration of anatomical aspects and selection of the most appropriate strategy for an individual bifurcation have an impact on the interventional outcome. Accordingly, assessment of the type of bifurcation stenosis, including the relevance of the side branches, vessel diameter and the angle between the two branches are critical for the optimal choice of interventional strategy. The fractional flow reserve (FFR) is a parameter that provides a measure of the severity of coronary stenosis and despite some limitations, FFR can be applied to bifurcation lesions...
October 7, 2016: Herz
Asim Rizvi, Bríain Ó Hartaigh, Paul Knaapen, Jonathon Leipsic, Leslee J Shaw, Daniele Andreini, Gianluca Pontone, Subha Raman, Muhammad Akram Khan, Michael Ridner, Faisal Nabi, Alessia Gimelli, James Jang, Jason Cole, Ryo Nakazato, Christopher Zarins, Donghee Han, Ji Hyun Lee, Jackie Szymonifika, Millie J Gomez, Quynh A Truong, Hyuk-Jae Chang, Fay Y Lin, James K Min
BACKGROUND: Coronary computed tomography angiography (CCTA) allows for non-invasive assessment of obstructive coronary artery disease (CAD) beyond measures of stenosis severity alone. This assessment includes atherosclerotic plaque characteristics (APCs) and calculation of fractional flow reserve (FFR) from CCTA (FFRCT). Similarly, stress imaging by myocardial perfusion scintigraphy (MPS) provides vital information. To date, the diagnostic performance of integrated CCTA assessment versus integrated MPS assessment for diagnosis of vessel-specific ischemia remains underexplored...
October 6, 2016: BMC Cardiovascular Disorders
Don P Giddens
No abstract text is available yet for this article.
October 10, 2016: JACC. Cardiovascular Interventions
Shengxian Tu, Jelmer Westra, Junqing Yang, Clemens von Birgelen, Angela Ferrara, Mariano Pellicano, Holger Nef, Matteo Tebaldi, Yoshinobu Murasato, Alexandra Lansky, Emanuele Barbato, Liefke C van der Heijden, Johan H C Reiber, Niels R Holm, William Wijns
OBJECTIVES: The aim of this prospective multicenter study was to identify the optimal approach for simple and fast fractional flow reserve (FFR) computation from radiographic coronary angiography, called quantitative flow ratio (QFR). BACKGROUND: A novel, rapid computation of QFR pullbacks from 3-dimensional quantitative coronary angiography was developed recently. METHODS: QFR was derived from 3 flow models with: 1) fixed empiric hyperemic flow velocity (fixed-flow QFR [fQFR]); 2) modeled hyperemic flow velocity derived from angiography without drug-induced hyperemia (contrast-flow QFR [cQFR]); and 3) measured hyperemic flow velocity derived from angiography during adenosine-induced hyperemia (adenosine-flow QFR [aQFR])...
October 10, 2016: JACC. Cardiovascular Interventions
Yosuke Saga, Yoshihisa Nakayama, Ken-Ichi Inoue, Tomoko Yamagata, Masashi Hashimoto, Léon Tremblay, Masahiko Takada, Eiji Hoshi
The thalamic reticular nucleus (TRN) collects inputs from the cerebral cortex and thalamus and, in turn, sends inhibitory outputs to the thalamic relay nuclei. This unique connectivity suggests that the TRN plays a pivotal role in regulating information flow through the thalamus. Here, we analyzed the roles of TRN neurons in visually guided reaching movements. We first used retrograde transneuronal labeling with rabies virus, and showed that the rostro-dorsal sector of the TRN (TRNrd) projected disynaptically to the ventral premotor cortex (PMv)...
October 5, 2016: European Journal of Neuroscience
Adriaan Coenen, Marisa M Lubbers, Akira Kurata, Atsushi Kono, Admir Dedic, Raluca G Chelu, Marcel L Dijkshoorn, Alexia Rossi, Robert-Jan M van Geuns, Koen Nieman
OBJECTIVES: To investigate the additional value of transmural perfusion ratio (TPR) in dynamic CT myocardial perfusion imaging for detection of haemodynamically significant coronary artery disease compared with fractional flow reserve (FFR). METHODS: Subjects with suspected or known coronary artery disease were prospectively included and underwent a CT-MPI examination. From the CT-MPI time-point data absolute myocardial blood flow (MBF) values were temporally resolved using a hybrid deconvolution model...
October 4, 2016: European Radiology
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