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coronary microvascular resistance

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https://www.readbyqxmd.com/read/29901442/a-novel-experimental-thrombotic-myocardial-infarction-and-primary-angioplasty-model-in-swine
#1
Georgios Sideris, Nikolaos Magkoutis, Sebastian Voicu, Chantal Kang, Michel Bonneau, Demetris Yannopoulos, Claire Bal Dit Sollier, Jean-Guillaume Dillinger, Natacha Berge, Philippe Brouland, Patrick Henry, Ludovic Drouet
AIMS: We sought to develop a reproducible animal model for acute myocardial infarction (AMI) in adult atherosclerosis-prone pigs. METHODS AND RESULTS: A coil was placed in the right coronary artery or the left anterior descending artery in 26 downsized spontaneously hypercholesterolemic pigs and left untreated until thrombotic occlusion. Then, we crossed the thrombotic occlusion with a guidewire, followed by pre-dilatation, thrombus visualization with Optical Coherence Tomography (OCT) imaging and, finally, deployment of a stent and repeated OCT...
June 12, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29870805/mineralocorticoid-receptor-antagonism-reverses-diabetes-related-coronary-vasodilator-dysfunction-a-unique-vascular-transcriptomic-signature
#2
Scott M Brown, Alex I Meuth, J Wade Davis, R Scott Rector, Shawn B Bender
Coronary microvascular dysfunction predicts and may be a proximate cause of cardiac dysfunction and mortality in diabetes; however, few effective treatments exist for these conditions. We recently demonstrated that mineralocorticoid receptor (MR) antagonism reversed cardiovascular dysfunction in early-stage obesity/insulin resistance. The mechanisms underlying this benefit of MR antagonism and its relevance in the setting of long-term obesity complications like diabetes; however, remain unclear. Thus, the present study evaluated the impact of MR antagonism on diabetes-related coronary dysfunction and defines the MR-dependent vascular transcriptome in the Otsuka Long-Evans Tokushima Fatty (OLETF) rat recapitulating later stages of human diabetes...
June 2, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29870386/catheter-based-measurements-of-absolute-coronary-blood-flow-and-microvascular-resistance-feasibility-safety-and-reproducibility-in-humans
#3
Panagiotis Xaplanteris, Stephane Fournier, Daniëlle C J Keulards, Julien Adjedj, Giovanni Ciccarelli, Anastasios Milkas, Mariano Pellicano, Marcel Van't Veer, Emanuele Barbato, Nico H J Pijls, Bernard De Bruyne
BACKGROUND: The principle of continuous thermodilution can be used to calculate absolute coronary blood flow and microvascular resistance (R). The aim of the study is to explore the safety, feasibility, and reproducibility of coronary blood flow and R measurements as measured by continuous thermodilution in humans. METHODS AND RESULTS: Absolute coronary flow and R can be calculated by thermodilution by infusing saline at room temperature through a dedicated monorail catheter...
March 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29792403/index-of-microcirculatory-resistance-guided-therapy-with-pressure-controlled-intermittent-coronary-sinus-occlusion-improves-coronary-microvascular-function-and-reduces-infarct-size-in-patients-with-st-elevation-myocardial-infarction-the-oxford-acute-myocardial
#4
Giovanni Luigi De Maria, Mohammad Alkhalil, Alessandra Borlotti, Mathias Wolfrum, Lisa Gaughran, Erica Dall'Armellina, Jeremy P Langrish, Andrew J Lucking, Robin P Choudhury, Rajesh K Kharbanda, Keith M Channon, Adrian P Banning
AIMS: The Oxford Acute Myocardial Infarction PICSO (OxAMI-PICSO) study aimed to assess the efficacy of index of microcirculatory resistance (IMR)-guided therapy with pressure-controlled intermittent coronary sinus occlusion (PICSO) in anterior ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS: Patients with anterior STEMI treated with primary percutaneous coronary intervention (pPCI) were enrolled. Pre-stenting IMR was measured and PICSO treatment delivered if pre-stenting IMR was >40...
June 8, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29716756/coronary-microvascular-dysfunction-in-patients-with-stable-coronary-artery-disease-the-ce-marc-2-coronary-physiology-sub-study
#5
David Corcoran, Robin Young, David Adlam, Alex McConnachie, Kenneth Mangion, David Ripley, David Cairns, Julia Brown, Chiara Bucciarelli-Ducci, Andreas Baumbach, Rajesh Kharbanda, Keith G Oldroyd, Gerry P McCann, John P Greenwood, Colin Berry
BACKGROUND: In patients with angina undergoing invasive management, no obstructive coronary artery disease (NOCAD) is a common finding, and angina may persist following percutaneous coronary intervention (PCI). Coronary microvascular dysfunction may be relevant. We aimed to assess the proportion of patients presenting with suspected CAD who had coronary microvascular dysfunction. METHODS: Clinical Evaluation of Magnetic Resonance Imaging in Coronary Heart Disease 2 (CE-MARC 2) was a prospective multicenter randomised controlled trial of functional imaging versus guideline-based management in patients with suspected CAD...
September 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29688179/comprehensive-physiological-evaluation-of-epicardial-and-microvascular-coronary-domains-using-vascular-conductance-and-zero-flow-pressure
#6
Nina W van der Hoeven, Guus A de Waard, Alicia Quirós, Alfonso De Hoyos, Christopher Broyd, Sukhjinder S Nijjer, Tim P van de Hoef, Ricardo Petraco, Roel S Driessen, Hernán Mejía-Rentería, Yuetsu Kikuta, Mauro Echavarría Pinto, Peter M van de Ven, Martijn Meuwissen, Paul Knaapen, Jan J Piek, Justin E Davies, Niels van Royen, Javier Escaned
AIMS: Assessment of the coronary circulation has largely been based on pressure ratios (epicardial-) and resistance (micro-vessels). Simultaneous assessment of epicardial- (CEPI) and microvascular conductance (CMICRO) provides an intuitive approach using the same units for both compartments and expressing the actual deliverability of blood. The aim of study was to develop a novel integral method to assessing the functional severity of epicardial and microvascular disease. METHODS AND RESULTS: We performed intracoronary Doppler and pressure in 403 vessels in 261 stable patients...
April 24, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29680355/index-of-microcirculatory-resistance-as-a-tool-to-characterize-microvascular-obstruction-and-to-predict-infarct-size-regression-in-patients-with-stemi-undergoing-primary-pci
#7
Giovanni Luigi De Maria, Mohammad Alkhalil, Mathias Wolfrum, Gregor Fahrni, Alessandra Borlotti, Lisa Gaughran, Sam Dawkins, Jeremy P Langrish, Andrew J Lucking, Robin P Choudhury, Italo Porto, Filippo Crea, Erica Dall'Armellina, Keith M Channon, Rajesh K Kharbanda, Adrian P Banning
OBJECTIVES: This study aimed to compare the value of the index of microcirculatory resistance (IMR) and microvascular obstruction (MVO) measured by cardiac magnetic resonance (CMR) in patients treated for and recovering from ST-segment elevation myocardial infarction. BACKGROUND: IMR can identify patients with microvascular dysfunction acutely after primary percutaneous coronary intervention (pPCI), and a threshold of >40 has been shown to be associated with an adverse clinical outcome...
April 14, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29627899/influence-of-visual-functional-mismatch-on-coronary-flow-profiles-after-percutaneous-coronary-intervention-a-propensity-score-matched-analysis
#8
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
#9
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
#10
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
#11
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...
April 23, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29598865/pet-assessment-of-epicardial-intimal-disease-and-microvascular-dysfunction-in-cardiac-allograft-vasculopathy
#12
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
#13
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
#14
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
#15
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
#16
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 E A Blair
There are multiple proposed mechanisms for the pathophysiology of heart failure (HF) with preserved ejection fraction (HFpEF). We hypothesized that coronary microvascular dysfunction is common in these patients. In a prospective, observational study, patients undergoing cardiac catheterization with HFpEF [left ventricular (LV) ejection fraction ≥ 50% and with clinical HF] were compared with similar patients without HFpEF. Patients with ≥50% stenosis were excluded, and coronary flow reserve (CFR) and the index of microvascular resistance (IMR) were measured after adenosine administration using a guidewire, with CFR ≤ 2 and IMR ≥ 23 being abnormal...
May 1, 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
#17
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
#18
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
#19
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
#20
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
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