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coronary microvascular resistance

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https://www.readbyqxmd.com/read/29627899/influence-of-visual-functional-mismatch-on-coronary-flow-profiles-after-percutaneous-coronary-intervention-a-propensity-score-matched-analysis
#1
Masahiro Hoshino, Taishi Yonetsu, Tadashi Murai, Yoshihisa Kanaji, Eisuke Usui, Masahiro Hada, Rikuta Hamaya, Yoshinori Kanno, Tetsumin Lee, Tsunekazu Kakuta
The aims of this study are to clarify whether discrepancies between angiographic and fractional flow reserve (FFR) measurements (visual-functional mismatch) influence coronary flow profiles after percutaneous coronary intervention. While current guidelines FFR-guided revascularization, clinical practice most commonly relies on angiographic evaluation, which may under- or over-estimate the functional relevance of the lesion. Our retrospective analysis involved 274 vessels from 264 patients with stable angina pectoris who underwent FFR, index of microvascular resistance, and coronary flow reserve (CFR) measurements before and after PCI...
April 7, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29622448/long-term-prognostic-value-of-invasive-and-non-invasive-measures-early-after-heart-transplantation
#2
Yukari Kobayashi, Yuhei Kobayashi, Hyoung-Mo Yang, Sara Bouajila, Helen Luikart, Takeshi Nishi, Dong-Hyun Choi, Ingela Schnittger, Hannah A Valantine, Kiran K Khush, Alan C Y Yeung, Francois Haddad, William F Fearon
BACKGROUND: Invasively assessed coronary microvascular resistance early after heart transplantation predicts worse long-term outcome; however, little is known about the relationship between microvascular resistance, left ventricular function and outcomes in this setting. METHODS: A total of 100 cardiac transplant recipients had fractional flow reserve (FFR) and the index of microcirculatory resistance (IMR) measured in the left anterior descending artery and echocardiographic assessment of left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) at 1 year after heart transplantation...
June 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29614585/-coronary-microvascular-resistance-and-its-relevant-factors-in-patients-with-moderate-coronary-stenosis-and-chest-pain
#3
D F He, M Y Liu, L J Zhang, C J Guo, Y P Chi, L Zhao, X J Zhang
Objective: To evaluate the impact of cardiovascular risk factors on index of microvascular resistance (IMR) and coronary flow reserve (CFR) and to explore the characteristics of IMR and CFR and the relationship between IMR and angiographic features in patients with intermediate coronary stenosis and chest pain. Methods: Fractional flow reserve (FFR), CFR, and IMR were measured in patients who underwent invasive coronary angiography with 40%-70% stenosis by visual assessment. All patients with FFR>0.75 were enrolled and grouped with the cut-off points of IMR≥25 and CFR≤2...
April 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29605246/influence-of-local-myocardial-damage-on-index-of-microcirculatory-resistance-and-fractional-flow-reserve-in-target-and-nontarget-vascular-territories-in-a-porcine-microvascular-injury-model
#4
Joo Myung Lee, Hyun Kuk Kim, Kyung Seob Lim, Jun-Kyu Park, Ki Hong Choi, Jonghanne Park, Doyeon Hwang, Tae-Min Rhee, Jeong Hoon Yang, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Joo-Yong Hahn, Bon-Kwon Koo, Myung Ho Jeong
OBJECTIVES: The aim of this study was to investigate the influence of microvascular damage in one vessel territory on invasively measured physiological parameters in the other vessel, using a porcine microvascular damage model. BACKGROUND: Although fractional flow reserve (FFR)-guided decision-making for the nonculprit stenosis in patients with acute myocardial infarction has been reported to be better than angiography-guided revascularization, there have been debates regarding the influence of microvascular dysfunction on measured FFR in nonculprit vessels...
March 22, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29598865/pet-assessment-of-epicardial-intimal-disease-and-microvascular-dysfunction-in-cardiac-allograft-vasculopathy
#5
Sharon Chih, Aun Yeong Chong, Fernanda Erthal, Robert A deKemp, Ross A Davies, Ellamae Stadnick, Derek Y So, Christopher Overgaard, George Wells, Lisa M Mielniczuk, Rob S B Beanlands
BACKGROUND: Cardiac allograft vasculopathy (CAV) is a leading cause of graft failure and death after heart transplantation. Absolute myocardial blood flow (MBF) quantification using rubidium 82 (Rb-82) positron emission tomography (PET) could enable evaluation of diagnostically challenging diffuse epicardial and microvascular disease in CAV. OBJECTIVES: The authors aimed to evaluate Rb-82 PET detection of CAV. METHODS: Consecutive transplant recipients undergoing coronary angiography were prospectively evaluated with PET, multivessel intravascular ultrasound (IVUS), and intracoronary hemodynamics...
April 3, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29549347/non-invasive-coronary-physiology-based-on-computational-analysis-of-intracoronary-transluminal-attenuation-gradient
#6
Yong Gyun Bae, Seung Tae Hwang, Huan Han, Sung Mok Kim, Hyung-Yoon Kim, Il Park, Joo Myung Lee, Young-June Moon, Jin-Ho Choi
Invasive procedure is a prerequisite for studying coronary physiology. We established the measurement of non-invasive physiological parameters including coronary blood flow (CBF), flow velocity, and microvascular resistance using coronary computed tomography angiography (CCTA). Vessel-specific CBF was derived from transluminal attenuation flow encoding (TAFE) and then tested using three separate datasets consisted of computational simulation, human perfusion CT, and human CCTA. TAFE-derived CBF correlated well with measured vessel-specific myocardial blood flow and CBF...
March 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29495996/diagnosis-of-microvascular-angina-using-cardiac-magnetic-resonance
#7
Alexander Liu, Rohan S Wijesurendra, Joanna M Liu, John C Forfar, Keith M Channon, Michael Jerosch-Herold, Stefan K Piechnik, Stefan Neubauer, Rajesh K Kharbanda, Vanessa M Ferreira
BACKGROUND: In patients with angina and nonobstructive coronary artery disease (NOCAD), confirming symptoms due to coronary microvascular dysfunction (CMD) remains challenging. Cardiac magnetic resonance (CMR) assesses myocardial perfusion with high spatial resolution and is widely used for diagnosing obstructive coronary artery disease (CAD). OBJECTIVES: The goal of this study was to validate CMR for diagnosing microvascular angina in patients with NOCAD, compared with patients with obstructive CAD and correlated to the index of microcirculatory resistance (IMR) during invasive coronary angiography...
March 6, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29495995/gadolinium-free-cardiac-mr-stress-t1-mapping-to-distinguish-epicardial-from-microvascular-coronary-disease
#8
Alexander Liu, Rohan S Wijesurendra, Joanna M Liu, Andreas Greiser, Michael Jerosch-Herold, John C Forfar, Keith M Channon, Stefan K Piechnik, Stefan Neubauer, Rajesh K Kharbanda, Vanessa M Ferreira
BACKGROUND: Novel cardiac magnetic resonance (CMR) stress T1 mapping can detect ischemia and myocardial blood volume changes without contrast agents and may be a more comprehensive ischemia biomarker than myocardial blood flow. OBJECTIVES: This study describes the performance of the first prospective validation of stress T1 mapping against invasive coronary measurements for detecting obstructive epicardial coronary artery disease (CAD), defined by fractional flow reserve (FFR <0...
March 6, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29424571/coronary-microvascular-dysfunction-in-patients-with-heart-failure-with-preserved-ejection-fraction
#9
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/29419573/important-role-of-endothelial-caveolin-1-in-the-protective-role-of-endothelium-dependent-hyperpolarization-against-nitric-oxide-mediated-nitrative-stress-in-microcirculation-in-mice
#10
Hiroki Saito, Shigeo Godo, Saori Sato, Akiyo Ito, Yosuke Ikumi, Shuhei Tanaka, Tomoaki Ida, Shigemoto Fujii, Takaaki Akaike, Hiroaki Shimokawa
AIMS: Nitric oxide (NO) and endothelium-dependent hyperpolarization (EDH) play important roles in maintaining cardiovascular homeostasis. We have previously demonstrated that endothelial NO synthase (eNOS) plays diverse roles depending on vessel size, as a NO generating system in conduit arteries and an EDH-mediated system in resistance arteries, for which caveolin-1 (Cav-1) is involved. However, the physiological role of endothelial Cav-1 in microvessels remains to be elucidated. METHODS AND RESULTS: We newly generated endothelium-specific Cav-1-knockout (eCav-1-KO) mice...
February 2018: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/29344840/design-and-rationale-for-comparison-between-ticagrelor-and-clopidogrel-on-microcirculation-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-pleio-trial
#11
Kyungil Park, Young-Rak Cho, Jong-Sung Park, Tae-Ho Park, Moo-Hyun Kim, Young-Dae Kim
It has been previously demonstrated that ticagrelor can reduce mortality compared to clopidogrel in acute coronary syndrome (ACS) patients. However, the mechanism for this mortality reduction remains uncertain. The objective of the present study is to assess the impact of chronic ticagrelor treatment on microvascular circulation. A total of 120 participants aged 20-85 years with clinical diagnosis of ACS will be randomized in a 1:1 fashion to the following two groups: ticagrelor 90 mg twice daily; clopidogrel 75 mg once daily...
February 2018: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29336308/clinical-significance-of-concordance-or-discordance-between-fractional-flow-reserve-and-coronary-flow-reserve-for-coronary-physiological-indices-microvascular-resistance-and-prognosis-after-elective-percutaneous-coronary-intervention
#12
Eisuke Usui, Tadashi Murai, Yoshihisa Kanaji, Masahiro Hoshino, Masao Yamaguchi, Masahiro Hada, Rikuta Hamaya, Yoshinori Kanno, Tetsumin Lee, Taishi Yonetsu, Tsunekazu Kakuta
AIMS: We aimed to investigate the impact of concordance or discordance of fractional flow reserve (FFR) and coronary flow reserve (CFR) on coronary flow profiles and microvascular resistance after percutaneous coronary intervention (PCI), and the prognostic impact of the periprocedural physiological indices. METHODS AND RESULTS: Totally, 249 de novo physiologically significant coronary lesions from 231 patients who underwent FFR, CFR, and index of microcirculatory resistance (IMR) examinations before and after PCI were included...
January 16, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29317987/delineation-of-epicardial-stenosis-in-patients-with-microvascular-disease-using-pressure-drop-coefficient-a-pilot-outcome-study
#13
Ullhas Udaya Hebbar, Mohamed A Effat, Srikara V Peelukhana, Imran Arif, Rupak K Banerjee
AIM: To investigate the patient-outcomes of newly developed pressure drop coefficient (CDP) in diagnosing epicardial stenosis (ES) in the presence of concomitant microvascular disease (MVD). METHODS: Patients from our clinical trial were divided into two subgroups with: (1) cut-off of coronary flow reserve (CFR) < 2.0; and (2) diabetes. First, correlations were performed for both subgroups between CDP and hyperemic microvascular resistance (HMR), a diagnostic parameter for assessing the severity of MVD...
December 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/29222132/invasive-assessment-of-the-coronary-microvasculature-the-index-of-microcirculatory-resistance
#14
REVIEW
William F Fearon, Yuhei Kobayashi
Traditionally, invasive coronary physiological assessment has focused on the epicardial coronary artery. More recently, appreciation of the importance of the coronary microvasculature in determining patient outcomes has grown. Several invasive modalities for interrogating microvascular function have been proposed. Angiographic techniques have been limited by their qualitative and subjective nature. Doppler wire-derived coronary flow reserve has been applied in research studies, but its clinical role has been limited by its lack of reproducibility, its lack of a clear normal value, and the fact that it is not specific for the microvasculature but interrogates the entire coronary circulation...
December 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29215470/invasive-assessment-of-microvascular-function-in-patients-with-valvular-heart-disease
#15
Takeshi Nishi, Hideki Kitahara, Yuichi Saito, Tomoko Nishi, Takashi Nakayama, Yoshihide Fujimoto, Goro Matsumiya, Yoshio Kobayashi
BACKGROUND: The aim of this study was to investigate microvascular function in patients with valvular heart disease (VHD), which causes chronic left ventricular volume and/or pressure overload, therefore change in coronary microvascular hemodynamics. PATIENTS AND METHODS: We prospectively enrolled 30 patients with VHD considered for surgery (10 aortic stenosis, 12 aortic regurgitation, and eight mitral regurgitation) and 30 controls. Intracoronary physiological assessments were performed in the unobstructed left anterior descending artery using a pressure-temperature sensor guidewire at rest and hyperemia...
December 13, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/29209950/spect-myocardial-ischemia-in-the-absence-of-obstructive-cad-contribution-of-the-invasive-assessment-of-microvascular-dysfunction
#16
Loïc Djaïleb, Laurent Riou, Nicolas Piliero, Adrien Carabelli, Estelle Vautrin, Alexis Broisat, Julien Leenhardt, Jacques Machecourt, Daniel Fagret, Gerald Vanzetto, Gilles Barone-Rochette, Catherine Ghezzi
Coronary microvascular dysfunction has recently emerged as a major independent prognostic factor and can be invasively assessed by coronary flow reserve (CFR) and the index of microvascular resistance (IMR). The incremental prognostic value of myocardial ischemia from SPECT myocardial perfusion imaging (MPI) over clinical characteristics, cardiac risk factors, and stress test data for the prediction of hard cardiac events (myocardial infarction and cardiac death) has been well demonstrated over the last two decades regardless of the absence or presence of epicardial CAD...
December 5, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29196345/mitoprotection-attenuates-myocardial-vascular-impairment-in-porcine-metabolic-syndrome
#17
Fang Yuan, Ahmad F Hedayat, Christopher M Ferguson, Amir Lerman, Lilach O Lerman, Alfonso Eirin
INTRODUCTION: The metabolic syndrome (MetS) leads to cardiac vascular injury, which may reflect in increased retention of endothelial progenitor cells (EPC). Coronary endothelial cell (EC) mitochondria partly regulate vascular function and structure. We hypothesized that chronic mitoprotection would preserve EC mitochondria and attenuate coronary vascular injury and dysfunction in swine MetS. METHODS: Pigs were studied after 16 weeks of diet-induced MetS, MetS treated for the last 4 weeks with the mitochondria-targeted peptide elamipretide (ELAM, 0...
December 1, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29192067/effect-of-myostatin-deletion-on-cardiac-and-microvascular-function
#18
Joshua T Butcher, M Irfan Ali, Merry W Ma, Cameron G McCarthy, Bianca N Islam, Lauren G Fox, James D Mintz, Sebastian Larion, David J Fulton, David W Stepp
The objective of this study is to test the hypothesis that increased muscle mass has positive effects on cardiovascular function. Specifically, we tested the hypothesis that increases in lean body mass caused by deletion of myostatin improves cardiac performance and vascular function. Echocardiography was used to quantify left ventricular function at baseline and after acute administration of propranolol and isoproterenol to assess β -adrenergic reactivity. Additionally, resistance vessels in several beds were removed, cannulated, pressurized to 60 mmHg and reactivity to vasoactive stimuli was assessed...
December 2017: Physiological Reports
https://www.readbyqxmd.com/read/29169759/abnormal-coronary-vasoreactivity-in-transient-left-ventricular-apical-ballooning-tako-tsubo-syndrome
#19
Edoardo Verna, Stefano Provasoli, Sergio Ghiringhelli, Fabrizio Morandi, Jorge Salerno-Uriarte
BACKGROUND: The exact etiology and pathophysiologic mechanisms of tako-tsubo syndrome (TTS) remain controversial. OBJECTIVE: To further evaluate the abnormal coronary vasoreactivity and its possible anatomical substrate in TTS. METHODS: We studied 47 patients (46 women; age 67±12years) who underwent diagnostic cardiac catheterization and evaluation of coronary vasoreactivity by sequential acetylcholine (Ach), nitroglycerine and adenosine testing with angiographic and intracoronary pressure-Doppler flow monitoring...
January 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29154426/microvascular-dysfunction-and-cardiac-fibrosis-in-heart-failure-with-preserved-ejection-fraction-a-case-report
#20
Nikhil Narang, Diego Medvedofsky, Kathryn Dryer, Sanjiv J Shah, Charles J Davidson, Amit R Patel, John E A Blair
We report the case of a 55-year-old woman with heart failure with preserved ejection fraction (HFpEF), who presented with hypertensive urgency and pulmonary oedema. The patient was medically optimized and underwent cardiac catheterization revealing pulmonary hypertension, elevated pulmonary capillary wedge pressure, normal cardiac index, and non-obstructive coronary disease. Invasive evaluation of coronary flow revealed blunted coronary flow reserve and increased index of microvascular resistance. Cardiac magnetic resonance imaging demonstrated reduced global myocardial perfusion and diffuse interstitial fibrosis...
November 2017: ESC Heart Failure
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