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Instantaneous wave free ratio

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https://www.readbyqxmd.com/read/28317458/use-of-the-instantaneous-wave-free-ratio-or-fractional-flow-reserve-in-pci
#1
Justin E Davies, Sayan Sen, Hakim-Moulay Dehbi, Rasha Al-Lamee, Ricardo Petraco, Sukhjinder S Nijjer, Ravinay Bhindi, Sam J Lehman, Darren Walters, James Sapontis, Luc Janssens, Christiaan J Vrints, Ahmed Khashaba, Mika Laine, Eric Van Belle, Florian Krackhardt, Waldemar Bojara, Olaf Going, Tobias Härle, Ciro Indolfi, Giampaolo Niccoli, Flavo Ribichini, Nobuhiro Tanaka, Hiroyoshi Yokoi, Hiroaki Takashima, Yuetsu Kikuta, Andrejs Erglis, Hugo Vinhas, Pedro Canas Silva, Sérgio B Baptista, Ali Alghamdi, Farrel Hellig, Bon-Kwon Koo, Chang-Wook Nam, Eun-Seok Shin, Joon-Hyung Doh, Salvatore Brugaletta, Eduardo Alegria-Barrero, Martijin Meuwissen, Jan J Piek, Niels van Royen, Murat Sezer, Carlo Di Mario, Robert T Gerber, Iqbal S Malik, Andrew S P Sharp, Suneel Talwar, Kare Tang, Habib Samady, John Altman, Arnold H Seto, Jasvindar Singh, Allen Jeremias, Hitoshi Matsuo, Rajesh K Kharbanda, Manesh R Patel, Patrick Serruys, Javier Escaned
Background Coronary revascularization guided by fractional flow reserve (FFR) is associated with better patient outcomes after the procedure than revascularization guided by angiography alone. It is unknown whether the instantaneous wave-free ratio (iFR), an alternative measure that does not require the administration of adenosine, will offer benefits similar to those of FFR. Methods We randomly assigned 2492 patients with coronary artery disease, in a 1:1 ratio, to undergo either iFR-guided or FFR-guided coronary revascularization...
March 18, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28317438/instantaneous-wave-free-ratio-versus-fractional-flow-reserve-to-guide-pci
#2
Matthias Götberg, Evald H Christiansen, Ingibjörg J Gudmundsdottir, Lennart Sandhall, Mikael Danielewicz, Lars Jakobsen, Sven-Erik Olsson, Patrik Öhagen, Hans Olsson, Elmir Omerovic, Fredrik Calais, Pontus Lindroos, Michael Maeng, Tim Tödt, Dimitrios Venetsanos, Stefan K James, Amra Kåregren, Margareta Nilsson, Jörg Carlsson, Dario Hauer, Jens Jensen, Ann-Charlotte Karlsson, Georgios Panayi, David Erlinge, Ole Fröbert
Background The instantaneous wave-free ratio (iFR) is an index used to assess the severity of coronary-artery stenosis. The index has been tested against fractional flow reserve (FFR) in small trials, and the two measures have been found to have similar diagnostic accuracy. However, studies of clinical outcomes associated with the use of iFR are lacking. We aimed to evaluate whether iFR is noninferior to FFR with respect to the rate of subsequent major adverse cardiac events. Methods We conducted a multicenter, randomized, controlled, open-label clinical trial using the Swedish Coronary Angiography and Angioplasty Registry for enrollment...
March 18, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28191874/instantaneous-wave-free-ratio-to-guide-coronary-revascularization-physiological-framework-validation-and-differences-with-fractional-flow-reserve
#3
Guus A de Waard, Carlo Di Mario, Amir Lerman, Patrick W Serruys, Niels van Royen
Determining the optimal treatment strategy for revascularization of coronary artery stenosis involves the use of fractional flow reserve (FFR). To improve the low clinical uptake of physiological lesion assessment to guide revascularization, the instantaneous wave-free period (iFR) was proposed as a simpler alternative to FFR that does not require adenosine administration. iFR is calculated as the ratio of blood pressure distal and proximal to a coronary artery stenosis during the diastolic wave- free period...
February 14, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28160376/fractional-flow-reserve-and-resting-indices-for-coronary-physiologic-assessment-practical-guide-tips-and-tricks
#4
Fabien Picard, Michele Pighi, Hung Q Ly
Physiologic assessment using fractional flow reserve (FFR) to guide percutaneous coronary interventions (PCI) has been demonstrated to improve clinical outcomes, compared to angiography-guided PCI. Recently, resting indices such as resting Pd/Pa, "instantaneous wave-free ratio", and contrast medium induced FFR have been evaluated for the assessment of the functional consequences of coronary lesions. Herein, we review and discuss the use of FFR and other indices for the functional assessment of coronary lesions...
February 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28121952/instantaneous-wave-free-ratio-derived-from-coronary-computed-tomography-angiography-in-evaluation-of-ischemia-causing-coronary-stenosis-feasibility-and-initial-clinical-research
#5
Yue Ma, Hui Liu, Yang Hou, Aike Qiao, Yingying Hou, Qingqing Yang, Qiyong Guo
The instantaneous wave-free ratio (iFR) closely related to fractional flow reserve (FFR) is a adenosine-independent physiologic index of coronary stenosis severity. We sought to evaluate whether iFR derived from coronary computed tomographic angiography (iFRCT) can be used as a novel noninvasive method for diagnosis of ischemia-causing coronary stenosis.We retrospectively enrolled 33 patients (47 lesions) with coronary artery disease (CAD) and examined with coronary computed tomographic angiography (CTA), invasive coronary angiography (ICA), and FFR...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27969908/tct-539-comparison-between-instantaneous-wave-free-ratio-and-fractional-flow-reserve-versus-morphometric-assessments-by-intracoronary-imaging-devices
#6
Kensuke Matsushita, Kiyoshi Hibi, Kozo Okada, Yasushi Matsuzawa, Yuichiro Kimura, Nobuhiko Maejima, Noriaki Iwahashi, Anton Moritz, Toshiaki Ebina, Peter J Fitzgerald, Yasuhiro Honda, Kazuo Kimura
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27969882/tct-516-instantaneous-wave-free-ratio-and-fractional-flow-reserve-comparison-in-patients-with-and-without-severe-aortic-valve-stenosis
#7
Roberto Scarsini, Gabriele Pesarini, Carlo Zivelonghi, Anna Piccoli, Alessia Gambaro, Corrado Vassanelli, Flavio Ribichini
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27969878/tct-515-prognostic-implications-of-instantaneous-wave-free-ratio-ifr-and-resting-distal-to-aortic-pressure-ratio-pd-pa-compared-with-fractional-flow-reserve-ffr-a-10-year-follow-up-study-after-deferral-of-revascularization
#8
Tim van de Hoef, Gilbert Wijntjens, Martijn Meuwissen, Mauro Echavarria Pinto, Martijn van Lavieren, Karel Koch, Steven Chamuleau, Michiel Voskuil, Robert de Winter, Jan Tijssen, Jan Piek
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27968774/assessment-of-left-anterior-descending-artery-stenosis-of-intermediate-severity-by-fractional-flow-reserve-instantaneous-wave-free-ratio-and-non-invasive-coronary-flow-reserve
#9
P Meimoun, J Clerc, D Ardourel, S Martis, U Djou, T Botoro, J Boulanger, F Elmkies, H Zemir
Assessment of the functional significance of left anterior descending coronary artery (LAD) stenosis of intermediate severity is challenging and often based on fractional flow reserve (FFR). The instantaneous wave-free ratio (IFR), a new vasodilator-free index of coronary stenosis severity, and non-invasive coronary flow reserve (CFR) by transthoracic Doppler echocardiography are also potentially useful. A direct comparison of FFR, IFR, and non-invasive CFR has never been performed. Our objective was to test the usefulness of non-invasive CFR by comparison to invasive FFR and IFR in patients with LAD stenosis of angiographic intermediate severity and stable coronary artery disease...
November 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27834663/discordance-between-resting-and-hyperemic-indices-of-coronary-stenosis-severity-the-verify-2-study-a-comparative-study-of-resting-coronary-pressure-gradient-instantaneous-wave-free-ratio-and-fractional-flow-reserve-in-an-unselected-population-referred-for-invasive
#10
Barry Hennigan, Keith G Oldroyd, Colin Berry, Nils Johnson, John McClure, Peter McCartney, Margaret B McEntegart, Hany Eteiba, Mark C Petrie, Paul Rocchiccioli, Richard Good, Martin M Lindsay, Stuart Hood, Stuart Watkins
BACKGROUND: Distal coronary to aortic pressure ratio (Pd/Pa) and instantaneous wave-free ratio (iFR) are indices of functional significance of a coronary stenosis measured without hyperemia. It has been suggested that iFR has superior diagnostic accuracy to Pd/Pa when compared with fractional flow reserve (FFR).We hypothesized that in comparison with FFR, revascularization decisions based on either binary cutoff values for iFR and Pd/Pa or hybrid strategies incorporating iFR or Pd/Pa will result in similar levels of disagreement...
November 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27752796/assessment-of-left-anterior-descending-artery-stenosis-of-intermediate-severity-by-fractional-flow-reserve-instantaneous-wave-free-ratio-and-non-invasive-coronary-flow-reserve
#11
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
https://www.readbyqxmd.com/read/27603377/diagnostic-performance-of-instantaneous-wave-free-ratio-for-the-evaluation-of-coronary-stenosis-severity-confirmed-by-fractional-flow-reserve-a-prisma-compliant-meta-analysis-of-randomized-studies
#12
REVIEW
Wanrong Man, Jianqiang Hu, Zhijing Zhao, Mingming Zhang, Tingting Wang, Jie Lin, Yu Duan, Ling Wang, Haichang Wang, Dongdong Sun, Yan Li
BACKGROUND: The instantaneous wave-free ratio (iFR) is a new vasodilator-free index of coronary stenosis severity. The aim of this meta-analysis is to assess the diagnostic performance of iFR for the evaluation of coronary stenosis severity with fractional flow reserve as standard reference. METHODS: We searched PubMed, EMBASE, CENTRAL, ProQuest, Web of Science, and International Clinical Trials Registry Platform (ICTRP) for publications concerning the diagnostic value of iFR...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27582367/intracoronary-pressure-measurement-differences-between-anter%C3%AF-ior-and-posterior-coronary-territories
#13
T Härle, S Meyer, W Bojara, F Vahldiek, A Elsässer
INTRODUCTION: Intracoronary pressure measurements have improved assessment of angiographic intermediate coronary stenoses. Methodically, pressure equalization and actual measurements are frequently performed at different height levels, depending on the particular coronary territory analyzed. Considering a hypothetical influence of hydrostatic pressure and the supine position of the patient, differences in the results of intracoronary measurements between anterior and posterior vessels seem likely...
August 31, 2016: Herz
https://www.readbyqxmd.com/read/27543706/ffr-prediction-model-based-on-conventional-quantitative-coronary-angiography-and-the-amount-of-myocardium-subtended-by-an-intermediate-coronary-artery-stenosis
#14
Luigi Di Serafino, Gabriella Scognamiglio, Maurizio Turturo, Giovanni Esposito, Riccardo Savastano, Saverio Lanzone, Bruno Trimarco, Carlo D'Agostino
BACKGROUND: Coronary angiography has poor predictive value for functionally significant coronary artery stenosis. The Fractional Flow Reserve (FFR) currently represents the gold standard to define the ischemic potential of epicardial stenosis and, recently, the instantaneous wave-free ratio (iFR), has also been introduced as alternative to the FFR, but it still remains an invasive procedure. We aimed this study in order to evaluate the accuracy of the "Angiography-DeriveD hEmoDynamic index" (ADDED index) to predict the FFR as compared with the iFR...
November 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27467730/haemodynamic-assessment-of-human-coronary-arteries-is-affected-by-degree-of-freedom-of-artery-movement
#15
Ashkan Javadzadegan, Andy S C Yong, Michael Chang, Martin K C Ng, Masud Behnia, Leonard Kritharides
Abnormal haemodynamic parameters are associated with atheroma plaque progression and instability in coronary arteries. Flow recirculation, shear stress and pressure gradient are understood to be important pathogenic mediators in coronary disease. The effect of freedom of coronary artery movement on these parameters is still unknown. Fluid-structure interaction (FSI) simulations were carried out in 25 coronary artery models derived from authentic human coronaries in order to investigate the effect of degree of freedom of movement of the coronary arteries on flow recirculation, wall shear stress (WSS) and wall pressure gradient (WPG)...
February 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/27342202/use-of-resting-non-hyperemic-indices-for-avoidance-of-fractional-flow-reserve-measurement-the-goal-of-100-accuracy
#16
Khawaja Afzal Ammar, Syed Shahab Kazmi, Mirza Nubair Ahmad, Mirza Mujadil Ahmad, Arsalan Riaz, Imran Husain, Fatima Husain, Suhail Allaqaband, Tanvir Bajwa, Anjan Gupta
OBJECTIVES: Recent studies have suggested that fractional flow reserve (FFR) measurement can be avoided by using similar ranges of baseline mean coronary pressure (Pd) to mean aortic pressure (Pa) ratio (0.88-0.95). Further studies have suggested that too many significant coronary stenoses are misclassified based on these ranges. We hypothesized that with a certain range of baseline Pd/Pa, 100% positive predictive value (PPV) and negative predictive value (NPV) can be achieved to avoid misclassification...
July 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27221377/ffr-and-ifr-guided-percutaneous-coronary-intervention
#17
REVIEW
Hitoshi Matsuo, Yoshiaki Kawase
Fractional flow reserve (FFR) is an invasive physiologic index measured in the cardiac catheterization laboratory to assess the functional significance of a coronary stenosis. It is now accepted as the reference standard to indicate whether a stenosis is likely to be responsible for ischemia. It is generally accepted that a stenosis with an ischemic value of FFR is responsible for symptom and a worse outcome and should be revascularized, whereas lesions with a non-ischemic FFR have a more favorable prognosis and can be treated medically...
July 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/27211352/-fractional-flow-reserve-and-instantaneous-wave-free-ratio-for-the-physiological-assessment-of-coronary-artery-stenosis-in-the-catheterization-laboratory-practical-tips
#18
F Picard, V X Tadros, M Pighi, V Spagnoli, Q De Hemptinne, H Q Ly
In recent years, a large body of evidence has revealed the limitations of angiographic evaluation in determining the physiological significance of coronary stenosis, particularly when these are intermediate lesions. Percutaneous coronary interventions (PCI) guided by physiological assessment using fractional flow reserve (FFR) have been shown to reduce cardiovascular events when compared to angiography alone. Recently, another coronary physiologic parameter has been introduced: the "instantaneous wave-free ratio" (iFR)...
February 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27134520/physiologic-assessment-of-coronary-artery-disease-focus-on-fractional-flow-reserve
#19
REVIEW
Doyeon Hwang, Joo Myung Lee, Bon-Kwon Koo
The presence of myocardial ischemia is the most important prognostic factor in patients with ischemic heart disease. Fractional flow reserve (FFR) is a gold standard invasive method used to detect the stenosis-specific myocardial ischemia. FFR-guided revascularization strategy is superior to angiography-guided strategy. The recently developed hyperemia-free index, instantaneous wave free ratio is being actively investigated. A non-invasive FFR derived from coronary CT angiography is now used in clinical practice...
May 2016: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/27101902/continuum-of-vasodilator-stress-from-rest-to-contrast-medium-to-adenosine-hyperemia-for-fractional-flow-reserve-assessment
#20
MULTICENTER STUDY
Nils P Johnson, Allen Jeremias, Frederik M Zimmermann, Julien Adjedj, Nils Witt, Barry Hennigan, Bon-Kwon Koo, Akiko Maehara, Mitsuaki Matsumura, Emanuele Barbato, Giovanni Esposito, Bruno Trimarco, Gilles Rioufol, Seung-Jung Park, Hyoung-Mo Yang, Sérgio B Baptista, George S Chrysant, Antonio M Leone, Colin Berry, Bernard De Bruyne, K Lance Gould, Richard L Kirkeeide, Keith G Oldroyd, Nico H J Pijls, William F Fearon
OBJECTIVES: This study compared the diagnostic performance with adenosine-derived fractional flow reserve (FFR) ≤0.8 of contrast-based FFR (cFFR), resting distal pressure (Pd)/aortic pressure (Pa), and the instantaneous wave-free ratio (iFR). BACKGROUND: FFR objectively identifies lesions that benefit from medical therapy versus revascularization. However, FFR requires maximal vasodilation, usually achieved with adenosine. Radiographic contrast injection causes submaximal coronary hyperemia...
April 25, 2016: JACC. Cardiovascular Interventions
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