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https://www.readbyqxmd.com/read/27912739/comparing-the-adverse-clinical-outcomes-associated-with-fraction-flow-reserve-guided-versus-angiography-guided-percutaneous-coronary-intervention-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#1
Pravesh Kumar Bundhun, Chandra Mouli Yanamala, Feng Huang
BACKGROUND: Recently published randomized controlled trials have shown different results compared to the Fraction Flow Reserve Versus Angiography for Multi-vessel Evaluation (FAME) study. Therefore, this current analysis aimed to compare the adverse clinical outcomes associated with Fraction Flow Reserve (FFR)-guided versus standard angiography-guided Percutaneous Coronary Intervention (PCI) using a large number of randomized patients. METHODS: PubMed/Medline, EMBASE and the Cochrane library were searched for studies comparing FFR-guided with angiography-guided PCI...
December 3, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27908505/diagnostic-advantage-of-stress-computed-tomography-myocardial-perfusion-over-single-photon-emission-computed-tomography-for-the-assessment-of-myocardial-ischemia
#2
Yasushi Ueki, Atsushi Izawa, Daisuke Kashiwagi, Shigeki Nishiyama, Shinichi Aso, Chihiro Suzuki, Shumpei Sakurai, Kazuhiro Oguchi, Yoshikazu Yazaki, Uichi Ikeda, Koichiro Kuwahara
BACKGROUND: This study compared adenosine stress computed tomography myocardial perfusion (CTP) with single-photon emission computed tomography (SPECT) in the diagnosis of functionally significant coronary artery stenosis using fractional flow reserve (FFR) as reference standard. METHODS: We included a total of 93 coronary arteries from 31 patients in whom at least one vessel with ≥50% stenosis was detected with computed tomography coronary angiography. All patients underwent both SPECT and adenosine stress CTP, followed by invasive coronary angiography (ICA) and FFR...
November 28, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27906702/diagnostic-accuracy-of-intraluminal-blood-speckle-intensity-on-intravascular-ultrasound-for-physiological-assessment-of-coronary-artery-stenosis
#3
Yuichi Saito, Hideki Kitahara, Takashi Nakayama, Yoshihide Fujimoto, Yoshio Kobayashi
OBJECTIVES: The difference in intraluminal intensity of blood speckle (IBS) on integrated backscatter intravascular ultrasound (IVUS) across the coronary stenosis was reportedly correlated with fractional flow reserve (FFR) in the left descending coronary artery. The aim of this study was to investigate the novel physiological assessment using IVUS in all coronary arteries. PATIENTS AND METHODS: Fifty-four patients with 57 coronary lesions underwent both FFR and IVUS...
November 30, 2016: Coronary Artery Disease
https://www.readbyqxmd.com/read/27904032/coronary-microvascular-dysfunction%C3%A3-epidemiology-pathogenesis-prognosis-diagnosis-risk-factors-and-therapy
#4
Cheng Chen, Janet Wei, Ahmed AlBadri, Parham Zarrini, C Noel Bairey Merz
Angina has traditionally been thought to be caused by obstructive coronary artery disease (CAD). However, a substantial number of patients with angina are found to not have obstructive CAD when undergoing coronary angiography. A significant proportion of these patients have coronary microvascular dysfunction (CMD), characterized by heightened sensitivity to vasoconstrictor stimuli and limited microvascular vasodilator capacity. With the advent of non-invasive and invasive techniques, the coronary microvasculature has been more extensively studied in the past 2 decades...
November 29, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27903864/oral-thrombin-inhibitor-aggravates-platelet-adhesion-and-aggregation-during-arterial-thrombosis
#5
Tobias Petzold, Manuela Thienel, Ildiko Konrad, Irene Schubert, Ron Regenauer, Boj Hoppe, Michael Lorenz, Annekathrin Eckart, Sue Chandraratne, Carsten Lennerz, Christof Kolb, Daniel Braun, Janina Jamasbi, Richard Brandl, Siegmund Braun, Wolfgang Siess, Christian Schulz, Steffen Massberg
In patients with atrial fibrillation, oral anticoagulation with oral thrombin inhibitors (OTIs), in contrast to vitamin K antagonists (VKAs), associates with a modest increase in acute coronary syndromes (ACSs). Whether this observation is causatively linked to OTI treatment and, if so, whether OTI action is the result of a lower antithrombotic efficacy of OTI compared to VKA or reflects a yet undefined prothrombotic activity of OTI remain unclear. We analyzed platelet function in patients receiving OTI or dose-adapted VKA under static and flow conditions...
November 30, 2016: Science Translational Medicine
https://www.readbyqxmd.com/read/27903394/-correlation-between-epicardial-adipose-tissue-thickness-and-slow-flow-of-non-obstructive-coronary-artery
#6
Q Wu, B Yang
Objective: To investigate the correlation between epicardial adipose thickness and slow flow of non-obstructive coronary artery. Methods: Clinical data of patients with coronary angiography examination evidenced stenosis<50% in our department from May 2014 to May 2015 were retrospectively analyzed.According to the level of TIMI in angiography, patients were divided into slow blood flow group (TIMI Ⅰ-Ⅱ, n=16) and normal blood flow group (TIMI Ⅲ, n=127). All epicardial adipose thickness was determined by echocardiography and data of biochemical data (fibrinogen, whole blood viscosity at high shear rate, erythrocyte aggregation index, platelet count, and platelet aggregation rate) were also analyzed...
November 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/27901333/fractional-flow-reserve-lessons-from-platform-and-future-perspectives
#7
Gianluca Pontone, Patrizia Carità, Massimo Verdecchia, Dario Buccheri, Daniele Andreini, Andrea I Guaricci, Mark Rabbat, Mauro Pepi
In the treatment of stable coronary artery disease (CAD) the identification of patients who may gain the highest benefit from further invasive treatments is of pivotal importance for the healthcare system. In this setting, it has been established that an ischemia-guided revascularization strategy yields improved clinical outcomes in a cost- effective fashion compared with anatomy-guided revascularization alone. Invasive fractional flow reserve (FFR) is considered the gold standard, especially in the intermediate-range atherosclerotic lesions, for assessing lesion specific ischemia at the time of invasive coronary angiography and has now become the standard of reference for studies assessing the diagnostic performance of the various non-invasive stress tests...
November 30, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27900990/prognostic-value-of-gai-s-plaque-score-and-agatston-coronary-artery-calcium-score-for-functionally-significant-coronary-artery-stenosis
#8
Chuang Zhang, Shuang Yang, Lu-Yue Gai, Zhi-Qi Han, Qian Xin, Xiao-Bo Yang, Jun-Jie Yang, Qin-Hua Jin
BACKGROUND: The prognostic values of the coronary computed tomography angiography (CCTA) score for predicting future cardiovascular events have been previously demonstrated in numerous studies. However, few studies have used the rich information available from CCTA to detect functionally significant coronary lesions. We sought to compare the prognostic values of Gai's plaque score and the coronary artery calcium score (CACS) of CCTA for predicting functionally significant coronary lesions, using fractional flow reserve (FFR) as the gold standard...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27899851/cutoff-value-of-admission-n-terminal-pro-brain-natriuretic-peptide-which-predicts-poor-myocardial-perfusion-after-primary-percutaneous-coronary-intervention-for-st-segment-elevation-myocardial-infarction
#9
Khairy Abdel-Dayem, Inas I Eweda, Ashraf El-Sherbiny, Marc O Dimitry, Wail Nammas
BACKGROUND: We explored the value of admission levels of N-terminal pro-brain natriuretic peptide (NTProBNP) that best predicts poor myocardial tissue perfusion following primary percutaneous coronary intervention (PPCI) in patients admitted with acute ST-segment-elevation myocardial infarction (STEMI). METHODS: We enrolled 90 consecutive patients admitted with acute STEMI who underwent PPCI and achieved post-procedural TIMI flow grade 3 in the infarct-related artery...
November 2016: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27899850/evaluation-of-short-and-long-term-efficacy-of-combined-intracoronary-administration-of-high-dose-adenosine-and-tirofiban-during-primary-percutaneous-coronary-intervention
#10
Yanbing Li, Qiang Li, Feiou Li, Min Zong, Guobin Miao, Xinchun Yang, Zichuan Tong, Jianjun Zhang
BACKGROUND: To assess the influence of combined intracoronary application of high-dose adenosine and tirofiban in primary percutaneous coronary intervention (PCI) on clinical events and cardiac function. METHODS: Our study evaluated consecutive patients with acute ST-segment elevation myocardial infarction undergoing primary PCI, who were randomly divided into adenosine group (n = 130) and control group (n = 128). Combined with thrombus aspiration and then intracoronary tirofiban, the adenosine group received intracoronary adenosine (2 mg) through the aspiration catheter 2 times...
November 2016: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27899407/the-impact-study-influence-of-sensor-equipped-microcatheters-on-coronary-hemodynamics-and-the-accuracy-of-physiological-indices-of-functional-stenosis-severity
#11
Gilbert W M Wijntjens, Tim P van de Hoef, Robin P Kraak, Marcel A Beijk, Krischan D Sjauw, M Marije Vis, Maribel I Madera Cambero, Stijn L Brinckman, Jacobus Plomp, Jan Baan, Karel T Koch, Joanna J Wykrzykowska, José P Henriques, Robbert J de Winter, Jan J Piek
BACKGROUND: The Navvus pressure sensor-equipped microcatheter allows to measure functional stenosis severity over a work-horse guidewire and is used as a more feasible alternative to regular sensor-equipped wires. However, Navvus is larger in diameter than contemporary sensor-equipped guidewires and may, thereby, influence functional measurements. The present study evaluates the hemodynamic influence of the Navvus microcatheter. METHODS AND RESULTS: In patients with intermediate coronary stenosis, coronary pressure and flow velocity were measured using a dual sensor-equipped guidewire before and after introduction of Navvus...
December 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27899365/prevalence-and-clinical-significance-of-discordant-changes-in-fractional-and-coronary-flow-reserve-after-elective-percutaneous-coronary-intervention
#12
Junji Matsuda, Tadashi Murai, Yoshihisa Kanaji, Eisuke Usui, Makoto Araki, Takayuki Niida, Sadamitsu Ichijyo, Rikuta Hamaya, Tetsumin Lee, Taishi Yonetsu, Mitsuaki Isobe, Tsunekazu Kakuta
BACKGROUND: Fractional flow reserve (FFR) and coronary flow reserve (CFR) are well-validated physiological indices; however, changes in FFR and CFR after percutaneous coronary intervention (PCI) remain elusive. We sought to evaluate these changes and to investigate whether physiological indices predict cardiac event-free survival after PCI. METHODS AND RESULTS: Physiological assessment of 220 stenoses from 220 patients was performed before and after PCI. The changes in FFR and CFR were studied, and factors associated with CFR change were investigated...
November 29, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27898505/clinical-role-of-post-angioplasty-hyperemic-microvascular-resistances-in-chronic-ischemic-left-ventricular-dysfunction
#13
Riccardo Gorla, Edoardo Verna, Simone Scotti, Sergio Ghiringhelli, Laura Zoli, Stefano Provasoli, Silvana Garancini, Roberto De Ponti, Jorge A Salerno-Uriarte
AIMS: To investigate the impact of hyperemic microvascular resistances (HMRs) on myocardial perfusion and contractility after percutaneous coronary intervention (PCI) in chronic ischemic left ventricular dysfunction (CILVD). METHODS: The current retrospective study included 48 patients with CILVD of the left anterior descending territory undergoing HMRs assessment before and after PCI with a dual-sensor intracoronary pressure-flow wire. The severity of resting myocardial underperfusion and contractile dysfunction of the left anterior descending territory was scored as summed rest score (SRS-T) by single photon emission tomography, wall motion score index (WMSI-T) and left ventricular ejection fraction (LVEF) by transthoracic echocardiography before PCI and after 3 months...
November 24, 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/27894949/intravascular-hemodynamics-and-coronary-artery-disease-new-insights-and-clinical-implications
#14
REVIEW
Marina Zaromytidou, Gerasimos Siasos, Ahmet U Coskun, Michelle Lucier, Antonios P Antoniadis, Michail I Papafaklis, Konstantinos C Koskinas, Yannis Andreou, Charles L Feldman, Peter H Stone
Understanding of the pathophysiological mechanisms is the cornerstone of preventive and treatment strategies in the battle against coronary artery disease. Hyperlipidemia, arterial hypertension, smoking and diabetes, are established risk factors affecting coronary vasculature. However, the focal formation of atherosclerotic lesions in certain arterial regions underscores that local factors are implicated in the initiation and progression of atherosclerosis. Introduction of novel imaging modalities and technological advances offered new insights and acknowledged intravascular hemodynamics, and particularly flow-derived endothelial shear stress as a critical factor in the natural history of coronary artery disease...
November 25, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/27894326/preserved-autoregulation-of-coronary-flow-after-off-pump-coronary-artery-bypass-grafting-retrospective-assessment-of-intraoperative-transit-time-flowmetry-with-and-without-intra-aortic-balloon-counterpulsation
#15
Hiroyuki Nakajima, Atsushi Iguchi, Mimiko Tabata, Masaru Kambe, Masahiro Ikeda, Kazuhiko Uwabe, Toshihisa Asakura, Hiroshi Niinami
BACKGROUND: Intra-aortic balloon pumping (IABP) markedly increases graft flow after coronary artery bypass grafting (CABG) with cardiopulmonary bypass. We sought to delineate the effects of IABP on graft flow after off-pump CABG (OPCAB). METHODS: The clinical records of 32 patients (25 male, 7 female; mean age: 70 ± 9 years) who underwent OPCAB with IABP between January 2011 and May 2015 were retrospectively reviewed. Thirteen patients (41%) had a history of myocardial infarction, and 13 patients (41%) had a history of percutaneous coronary intervention...
November 28, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27894059/left-ventricular-diastolic-dysfunction-in-patients-with-st-elevation-myocardial-infarction-following-early-and-late-reperfusion-by-coronary-intervention
#16
Xianghui Chen, Fucheng Liu, Honggui Xu, Daogang Zha, Jiancheng Xiu, Jun Guo, Aidong Zhang
BACKGROUND: This study prospectively assessed the left ventricular (LV) diastolic function changes in patients with ST-elevation myocardial infarction (STEMI) and determined if the early revascularization of the infarct-related coronary artery in acute phase achieve a better recovery of diastolic function than late recanalization. METHODS: Forty-five consecutive patients (61.20±11.37years, 8 females) presenting with STEMI and treated with PCI were prospectively enrolled in this study...
November 24, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27893526/effect-of-oxygen-therapy-on-myocardial-salvage-in-st-elevation-myocardial-infarction-the-randomized-soccer-trial
#17
Ardavan Khoshnood, Marcus Carlsson, Mahin Akbarzadeh, Pallonji Bhiladvala, Anders Roijer, David Nordlund, Peter Höglund, David Zughaft, Lizbet Todorova, Arash Mokhtari, Håkan Arheden, David Erlinge, Ulf Ekelund
OBJECTIVE: Recent studies suggest that administration of O2 in patients with acute myocardial infarction may have negative effects. With the use of cardiac MRI (CMR), we evaluated the effects of supplemental O2 in patients with ST elevation myocardial infarction (STEMI) accepted for acute percutaneous coronary intervention (PCI). MATERIALS AND METHODS: This study was a randomized-controlled trial conducted at two university hospitals in Sweden. Normoxic STEMI patients were randomized in the ambulance to either supplemental O2 (10 l/min) or room air until the conclusion of the PCI...
November 23, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27892882/clinical-and-angiographic-predictors-of-persistently-ischemic-fractional-flow-reserve-after-percutaneous-revascularization
#18
Shiv Kumar Agarwal, Srikanth Kasula, Ahmed Almomani, Yalcin Hacioglu, Zubair Ahmed, Barry F Uretsky, Abdul Hakeem
AIMS: Despite optimal angiographic results after percutaneous coronary intervention (PCI), some lesions may continue to produce ischemia under maximal hyperemia. We evaluated the factors associated with persistently ischemic fractional flow reserve (FFR) after angiographically successful PCI. METHODS AND RESULTS: A total of 574 consecutive patients with 664 lesions undergoing PCI who had FFR pre- and post-PCI were analyzed. Percutaneous coronary intervention led to effective ischemia reduction from pre-FFR (0...
October 29, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27891375/flow-mediated-dilatation-carotid-intima-media-thickness-ankle-brachial-pressure-index-and-pulse-pressure-in-young-male-post-myocardial-infarction-patients-in-india
#19
Nikhil Gupta, Subhash Giri, Vinita Rathi, Gajender Singh Ranga
INTRODUCTION: Due to increase in Coronary Artery Disease (CAD) at a younger age, we should try to diagnose atherosclerotic process and population at risk, at the earliest. Flow Mediated Dilatation (FMD), Carotid Intima-Media Thickness (CIMT) and Ankle-Brachial Pressure Index (ABI) are probable markers for early atherosclerosis and may be useful in coronary risk stratification. AIM: To compare and correlate the FMD, CIMT, ABI and Pulse Pressure (PP) in young male patients of Myocardial Infarction (MI) with age and sex matched healthy controls...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27890881/non-convulsive-status-epilepticus-with-takotsubo-cardiomyopathy-a-case-report
#20
Jyunichi Uemura, Yuko Wada, Yoshiki Yagita
A 61-year-old woman was admitted to our hospital for speech disturbance and mild consciousness impairment. Despite the absence of seizures or loss of consciousness, electroencephalographic abnormalities were observed, and the cerebral blood flow scintigraphy revealed an increase in cerebral blood flow in the left temporal lobe. These findings suggested a diagnosis of non-convulsive status epilepticus. On the third day, a twelve-lead electrocardiogram showed a negative T-wave in I, II, aVf, and V2-6. Moreover, a transthoracic echocardiogram revealed left ventricular apical akinesis...
November 25, 2016: Rinshō Shinkeigaku, Clinical Neurology
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