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Instantaneous wave free ratio

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https://www.readbyqxmd.com/read/29129256/instantaneous-wave-free-ratio-and-fractional-flow-reserve-for-the-assessment-of-nonculprit-lesions-during-the-index-procedure-in-patients-with-st-segment-elevation-myocardial-infarction-the-wave-study
#1
Carmine Musto, Francesco De Felice, Stefano Rigattieri, Diana Chin, Andrea Marra, Marco Stefano Nazzaro, Alberta Cifarelli, Roberto Violini
BACKGROUND: Functional assessment of non-infarct-related artery lesions during primary percutaneous coronary intervention (PCI) might be useful to avoid revascularization of nonsignificant stenosis and staged procedures, thus reducing hospital stay. We aimed to assess the diagnostic performance of instantaneous wave-free ratio (iFR) as compared with fractional flow reserve (FFR) in this setting. METHODS: In the WAVE study, a prospective, observational, single-center registry (NCT02869906), paired iFR and FFR measurements were performed at the level of non-IRA lesions in patients with ST-segment elevation myocardial infarction both during primary PCI and during staged procedures (5-8 days after)...
November 2017: American Heart Journal
https://www.readbyqxmd.com/read/29103656/percutaneous-coronary-intervention-in-stable-angina-orbita-a-double-blind-randomised-controlled-trial
#2
Rasha Al-Lamee, David Thompson, Hakim-Moulay Dehbi, Sayan Sen, Kare Tang, John Davies, Thomas Keeble, Michael Mielewczik, Raffi Kaprielian, Iqbal S Malik, Sukhjinder S Nijjer, Ricardo Petraco, Christopher Cook, Yousif Ahmad, James Howard, Christopher Baker, Andrew Sharp, Robert Gerber, Suneel Talwar, Ravi Assomull, Jamil Mayet, Roland Wensel, David Collier, Matthew Shun-Shin, Simon A Thom, Justin E Davies, Darrel P Francis
BACKGROUND: Symptomatic relief is the primary goal of percutaneous coronary intervention (PCI) in stable angina and is commonly observed clinically. However, there is no evidence from blinded, placebo-controlled randomised trials to show its efficacy. METHODS: ORBITA is a blinded, multicentre randomised trial of PCI versus a placebo procedure for angina relief that was done at five study sites in the UK. We enrolled patients with severe (≥70%) single-vessel stenoses...
November 1, 2017: Lancet
https://www.readbyqxmd.com/read/29098379/influence-of-hydrostatic-pressure-on-intracoronary-indices-of-stenosis-severity-in-vivo
#3
Tobias Härle, Mareike Luz, Sven Meyer, Felix Vahldiek, Pim van der Harst, Randy van Dijk, Daan Ties, Javier Escaned, Justin Davies, Albrecht Elsässer
BACKGROUND: An influence of hydrostatic pressure on intracoronary indices of stenosis severity in vitro was recently reported. We sought to analyze the influence of hydrostatic pressure, caused by the height difference between the distal and proximal pressure sensor after guidewire positioning in the interrogated vessel, on intracoronary pressure measurements in vivo. METHODS AND RESULTS: In 30 coronary stenoses, intracoronary pressure measurements were performed in supine, left, and right lateral patient position...
November 2, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29054592/the-impact-of-tissue-doppler-index-e-e-ratio-on-instantaneous-wave-free-ratio
#4
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/29050558/similarity-and-difference-of-resting-distal%C3%A2-to-aortic-coronary-pressure-and%C3%A2-instantaneous-wave-free-ratio
#5
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
#6
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/29045201/instantaneous-wave-free-ratio-versus-fractional-flow-reserve
#7
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
#8
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
#9
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
#10
LETTER
Matthias Götberg, Ole Fröbert
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
#11
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
#12
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/28988450/feasibility-of-coronary-angiography-and-percutaneous-coronary-intervention-after-transcatheter-aortic-valve-replacement-using-a-medtronic%C3%A2-self-expandable-bioprosthetic-valve
#13
Wah Wah Htun, Cindy Grines, Theodore Schreiber
BACKGROUND AND OBJECTIVE: With aging, the progression of atherosclerosis in the coronary arteries is expected. The Medtronic™ self-expandable aortic bioprosthetic valve is deployed in the supra-annular position, and it has been challenging to selectively engage coronary arteries post-transcatheter aortic valve replacement (TAVR) even though there are diamond-shaped spaces in the mesh frame within the valve. Given the scarcity of data, we analyzed angiographic and clinical data from all patients requiring coronary angiography (CA) or intervention post-TAVR...
October 8, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28966160/association-between-fractional-flow-reserve-instantaneous-wave-free-ratio-and-dobutamine-stress-echocardiography-in-patients-with-stable-coronary-artery-disease
#14
Vasileios F Panoulas, Kalliopi Keramida, Olga Boletti, Michail I Papafaklis, Dimitris Flessas, Maria Petropoulou, Petros Nihoyannopoulos
AIMS: The association between fractional flow reserve (FFR) and dobutamine stress echocardiography (DSE) in real world stable angina patients is scant and controversial whereas no such comparison exists with instantaneous wave free ratio (iFR). The current retrospective study aimed to investigate the associations amongst these modalities in patients with stable coronary artery disease (CAD) and intermediate coronary lesions. METHODS AND RESULTS: We studied 62 consecutive stable angina patients who underwent DSE and subsequently coronary angiography with FFR (in all 62) and iFR (in 46/62 patients) assessment of intermediate single vessel lesions between 2014-2015...
October 3, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28963311/efficacy-and-safety-of-instantaneous-wave-free-ratio-in-patients-undergoing-coronary-revascularisation-protocol-for-a-systematic-review
#15
Joey S W Kwong, Sheyu Li, Wan-Jie Gu, Hao Chen, Chao Zhang, Xian-Tao Zeng, Cheuk-Man Yu
INTRODUCTION: Effective selection of coronary lesions for revascularisation is pivotal in the management of symptoms and adverse outcomes in patients with coronary artery disease. Recently, instantaneous 'wave-free' ratio (iFR) has been proposed as a new diagnostic index for assessing the severity of coronary stenoses without the need of pharmacological vasodilation. Evidence of the effectiveness of iFR-guided revascularisation is emerging and a systematic review is warranted. METHODS AND ANALYSIS: This is a protocol for a systematic review of randomised controlled trials and controlled observational studies...
September 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28882237/the-evolving-future-of-instantaneous%C3%A2-wave-free-ratio-and-fractional-flow%C3%A2-reserve
#16
REVIEW
Matthias Götberg, Christopher M Cook, Sayan Sen, Sukhjinder Nijjer, Javier Escaned, Justin E Davies
In this review, the authors reflect upon the role of coronary physiology in the modern management of coronary artery disease. They critically appraise the scientific background of the instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR), from early experimental studies to validation studies against indexes of ischemia, to clinical trials assessing outcome. At this important juncture for the field, the authors make predictions for the future of physiological stenosis assessment, outlining developments for both iFR and FFR in new clinical domains beyond the confines of stable angina...
September 12, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28853190/diagnostic-accuracy-of-instantaneous-wave-free-ratio-in-clinical-practice
#17
Wern Yew Ding, Satheesh Nair, Clare Appleby
AIMS: To evaluate the correlation between iFR and FFR in real-world clinical practice. METHODS AND RESULTS: Retrospective, single-centre study of 229 consecutive pressure-wire studies (np  = 158). Real-time iFR and FFR measurements were performed for angiographically borderline stenoses. Functionally significant stenoses were defined as iFR <0.86 or FFR ≤0.80. An iFR between 0.86 and 0.93 was considered within the grey zone (Hybrid approach). Median iFR and FFR (IQR) were 0...
August 29, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28851731/exploring-coronary-circulatory-response-to-stenosis-and-its-association-with-invasive-physiologic-indexes-using-absolute-myocardial-blood-flow-and-coronary-pressure
#18
COMPARATIVE STUDY
Joo Myung Lee, Doyeon Hwang, Jonghanne Park, Jinlong Zhang, Yaliang Tong, Chee Hae Kim, Ji-In Bang, Minseok Suh, Jin Chul Paeng, Gi Jeong Cheon, Bon-Kwon Koo
BACKGROUND: Although invasive physiological assessment for coronary stenosis has become a standard practice to guide treatment strategy, coronary circulatory response and changes in invasive physiological indexes, according to different anatomic and hemodynamic lesion severity, have not been fully demonstrated in patients with coronary artery disease. METHODS: One hundred fifteen patients with left anterior descending artery stenosis who underwent both (13)N-ammonia positron emission tomography and invasive physiological measurement were analyzed...
November 7, 2017: Circulation
https://www.readbyqxmd.com/read/28846545/physiologic-evaluation-of-coronary-lesions-using-instantaneous-wave-free-ratio-ifr-in-patients-with-severe-aortic-stenosis-undergoing-trans-catheter-aortic-valve-implantation
#19
Roberto Scarsini, Gabriele Pesarini, Carlo Zivelonghi, Anna Piccoli, Valeria Ferrero, Mattia Lunardi, Leonardo Gottin, Claudia Zanetti, Giuseppe Faggian, Flavio Ribichini
AIMS: We sought to assess eventual changes in iFR measurements in patients with aortic stenosis (AS) before and after TAVI in coronary lesions with different degree of angiographic severity. METHODS AND RESULTS: The functional relevance of 145 coronary lesions was assessed by on-line iFR and FFR measurement in 66 patients with severe AS before and after TAVI, during the same procedure. The iFR-FFR classification agreement was calculated for pre- and post-TAVI measurements...
August 29, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28835979/-instantaneous-wave-free-ratio-ifr%C3%A2-in-patients-with-coronary-artery-disease
#20
REVIEW
S Baumann, A C Schaefer, A Hohneck, K Mueller, T Becher, M Behnes, M Renker, M Borggrefe, I Akin, D Lossnitzer
Coronary angiography is considered as the gold standard in the morphological representation of coronary artery stenosis. Coronary angiography is often performed without preprocedural non-invasive proof of ischemia and the assessment of the severity of a coronary lesion by morphology is very subjective. Thus, invasive fractional flow reserve (FFR) measurement represents the current standard for estimation of the hemodynamic relevance of coronary artery stenosis and facilitates decision making for percutaneous coronary intervention (PCI) and stenting...
August 23, 2017: Herz
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