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Instantaneous wave free ratio

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https://www.readbyqxmd.com/read/29790478/validation-of-a-novel-non-hyperaemic-index-of-coronary-artery-stenosis-severity-the-resting-full-cycle-ratio-validate-rfr-study
#1
Johan Svanerud, Jung-Min Ahn, Allen Jeremias, Marcel van 't Veer, Ankita Gore, Akiko Maehara, Aaron Crowley, Nico H J Pijls, Bernard De Bruyne, Nils P Johnson, Barry Hennigan, Stuart Watkins, Colin Berry, Keith G Oldroyd, Seung-Jung Park, Ziad A Ali
AIMS: Randomised controlled trials have reported instantaneous wave-free ratio (iFR) to be non-inferior to fractional flow reserve (FFR) for major adverse cardiovascular events at one year; however, iFR is limited by sensitive landmarking of the pressure waveform, and the assumption that maximal flow and minimal resistance occur during a fixed period of diastole. We sought to validate the resting full-cycle ratio (RFR), a novel non-hyperaemic index of coronary stenosis severity based on unbiased identification of the lowest distal coronary pressure to aortic pressure ratio (Pd/Pa), independent of the ECG, landmark identification, and timing within the cardiac cycle...
May 23, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29789302/fractional-flow-reserve-and-instantaneous-wave-free-ratio-as-predictors-of-the-placebo-controlled-response-to-percutaneous-coronary-intervention-in-stable-single-vessel-coronary-artery-disease-physiology-stratified-analysis-of-orbita
#2
Rasha Al-Lamee, James P Howard, Matthew J Shun-Shin, David Thompson, Hakim-Moulay Dehbi, Sayan Sen, Sukhjinder Nijjer, Ricardo Petraco, John Davies, Thomas Keeble, Kare Tang, Iqbal S Malik, Christopher Cook, Yousif Ahmad, Andrew S P Sharp, Robert Gerber, Christopher Baker, Raffi Kaprielian, Suneel Talwar, Ravi Assomull, Graham Cole, Niall G Keenan, Gajen Kanaganayagam, Joban Sehmi, Roland Wensel, Frank E Harrell, Jamil Mayet, Simon A Thom, Justin E Davies, Darrel P Francis
BACKGROUND : There are no data on how fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are associated with the placebo-controlled efficacy of percutaneous coronary intervention (PCI) in stable single-vessel coronary artery disease. METHODS : We report the association between prerandomization invasive physiology within ORBITA (Objective Randomised Blinded Investigation With Optimal Medical Therapy of Angioplasty in Stable Angina), a placebo-controlled trial of patients who have stable angina with angiographically severe single-vessel coronary disease clinically eligible for PCI...
May 22, 2018: Circulation
https://www.readbyqxmd.com/read/29748874/correction-to-acc-aats-aha-ase-asnc-scai-scct-sts-2017-appropriate-use-criteria-for-coronary-revascularization-in-patients-with-stable-ischemic-heart-disease
#3
Manesh R Patel, John H Calhoon, Gregory J Dehmer, James Aaron Grantham, Thomas M Maddox, David J Maron, Peter K Smith
To more clearly reflect the relationship between iFR (instantaneous wave-free ratio) and FFR (fractional flow reserve), this Correction document highlights the following changes to the original document published in the Journal of Nuclear Cardiology; the version available at JACC [1] has been updated to reflect the changes, with JACC's Correction document available at [2].
May 10, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29743914/angiographic-co-registration-of-instantaneous-wave-free-ratio-and-intravascular-ultrasound-improves-functional-assessment-of-borderline-lesions-in-the-coronary-artery
#4
Jerzy Sacha, Przemysław Lipski, Piotr Feusette
No abstract text is available yet for this article.
2018: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/29707808/pooled-diagnostic-accuracy-of-resting-distal-to-aortic-coronary-pressure-referenced-to-fractional-flow-reserve-the-importance-of-resting-coronary-physiology
#5
Rohit Maini, John Moscona, Gursukhman Sidhu, Paul Katigbak, Camilo Fernandez, Anand Irimpen, Owen Mogabgab, Charisse Ward, Rohan Samson, Thierry LeJemtel
INTRODUCTION: Both resting and hyperemic physiologic methods to guide coronary revascularization improve cardiovascular outcomes compared with angiographic guidance alone. Fractional flow reserve (FFR) remains underutilized due to concerns regarding hyperemia, prompting study of resting distal to aortic coronary pressure (Pd/Pa). Pd/Pa is a vasodilator-free resting index unlike FFR. While Pd/Pa is similar to another resting index, instantaneous wave-free ratio (iFR), it is a whole-cycle measurement not limited to the wave-free diastolic period...
April 29, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29673508/instantaneous-wave-free-ratio-pressure-pullback-with-virtual-percutaneous-coronary-intervention-planning-seeing-the-future-of-coronary-interventions
#6
EDITORIAL
Morton J Kern, Arnold H Seto
No abstract text is available yet for this article.
April 23, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29673507/pre-angioplasty-instantaneous-wave-free-ratio-pullback-predicts-hemodynamic-outcome-in-humans-with-coronary-artery-disease-primary-results-of-the-international-multicenter-ifr-gradient-registry
#7
Yuetsu Kikuta, Christopher M Cook, Andrew S P Sharp, Pablo Salinas, Yoshiaki Kawase, Yasutsugu Shiono, Alessandra Giavarini, Masafumi Nakayama, Salvatore De Rosa, Sayan Sen, Sukhjinder S Nijjer, Rasha Al-Lamee, Ricardo Petraco, Iqbal S Malik, Ghada W Mikhail, Raffi R Kaprielian, Gilbert W M Wijntjens, Shinsuke Mori, Arata Hagikura, Martin Mates, Atsushi Mizuno, Farrel Hellig, Kelvin Lee, Luc Janssens, Kazunori Horie, Shah Mohdnazri, Raul Herrera, Florian Krackhardt, Masahiro Yamawaki, John Davies, Hideo Takebayashi, Thomas Keeble, Seiichi Haruta, Flavio Ribichini, Ciro Indolfi, Jamil Mayet, Darrel P Francis, Jan J Piek, Carlo Di Mario, Javier Escaned, Hitoshi Matsuo, Justin E Davies
OBJECTIVES: The authors sought to evaluate the accuracy of instantaneous wave-Free Ratio (iFR) pullback measurements to predict post-percutaneous coronary intervention (PCI) physiological outcomes, and to quantify how often iFR pullback alters PCI strategy in real-world clinical settings. BACKGROUND: In tandem and diffuse disease, offline analysis of continuous iFR pullback measurement has previously been demonstrated to accurately predict the physiological outcome of revascularization...
April 23, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29661951/role-of-invasive-functional-assessment-in-surgical-revascularization-of-coronary-artery-disease
#8
REVIEW
Bipul Baibhav, Maheedhar Gedela, Michael Moulton, Gregory Pavlides, Vincent Pompili, Tanveer Rab, George Dangas, Deepak L Bhatt, Aleem Siddique, Yiannis S Chatzizisis
In patients with stable coronary artery disease, percutaneous coronary intervention is associated with improved outcomes if the lesion is deemed significant by invasive functional assessment using fractional flow reserve. Recent studies have shown that a revascularization strategy using instantaneous wave-free ratio is noninferior to fractional flow reserve in patients with intermediate-grade stenoses. The decision to perform coronary artery bypass grafting surgery is usually based on anatomic assessment of stenosis severity by coronary angiography...
April 17, 2018: Circulation
https://www.readbyqxmd.com/read/29581085/qualitative-resting-coronary-pressure-wave-form-analysis-to-predict-fractional-flow-reserve
#9
Mitsuaki Matsumura, Akiko Maehara, Nils P Johnson, William F Fearon, Bernard De Bruyne, Keith G Oldroyd, Nico H J Pijls, Paul Jenkins, Ziad A Ali, Gary S Mintz, Gregg W Stone, Allen Jeremias
AIMS: To evaluate the predictability of resting distal coronary pressure wave forms for fractional flow reserve (FFR). METHODS AND RESULTS: Resting coronary wave forms were qualitatively evaluated for the presence of (i) dicrotic notch; (ii) diastolic dipping; and (iii) ventricularization. In a development cohort (n=88) a scoring system was developed that was then applied to a validation cohort (n=428) using a multivariable linear regression model to predict FFR and receiver operating characteristics (ROC) to predict FFR ≤0...
March 27, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29569332/the-impact-of-coronary-chronic-total-occlusion-percutaneous-coronary-intervention-upon-donor-vessel-fractional-flow-reserve-and-instantaneous-wave-free-ratio-implications-for-physiology-guided-pci-in-patients-with-cto
#10
Shah R Mohdnazri, Grigoris V Karamasis, Firas Al-Janabi, Christopher M Cook, James Hampton-Till, Jufen Zhang, Rasha Al-Lamee, Jason N Dungu, Swamy Gedela, Kare H Tang, Paul A Kelly, Justin E Davies, John R Davies, Thomas R Keeble
OBJECTIVE: To investigate the immediate and short term impact of right coronary artery (RCA) chronic total coronary occlusion (CTO) percutaneous coronary intervention (PCI) upon collateral donor vessel fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR). BACKGROUND: CTO PCI influences collateral donor vessel physiology, making the indication and/or timing of donor vessel revascularization difficult to determine. METHODS: In patients with RCA CTO, FFR, iFR, and collateral function index (FFRcoll ) were measured in LAD and LCx pre-CTO PCI, immediately post and at 4 month follow-up...
March 22, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29562079/physiology-guided-management-of-serial-coronary-artery-disease-a-review
#11
Bhavik N Modi, Kalpa De Silva, Ronak Rajani, Nick Curzen, Divaka Perera
Importance: Ischemia-guided revascularization is the cornerstone of contemporary management of coronary artery disease and has evolved from noninvasive functional evaluation to real-time assessment with invasive physiological indices during diagnostic catheterization. However, serial/diffuse disease is common, and revascularization decisions often need to be made about individual lesions within the same vessel. It is unclear whether current physiological techniques, such as fractional flow reserve, can be reliably used to discern the individual contribution of lesions within a serially diseased vessel with erroneous measurements, potentially leading to suboptimal revascularization decisions...
March 21, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29557104/functional-approach-for-coronary-artery-disease-filling-the-gap-between-evidence-and-practice
#12
REVIEW
Joo Myung Lee, Joon Hyung Doh, Chang Wook Nam, Eun Seok Shin, Bon Kwon Koo
The presence of myocardial ischemia is the most important prognostic factor in patients with coronary artery disease, and ischemia-directed revascularization has been a standard of care. Fractional flow reserve (FFR) is an invasive method used to detect the functionally significant epicardial coronary stenosis, and FFR-guided revascularization strategy has been proven to be superior to angiography-guided strategy. Recently, a hyperemia-free index, instantaneous wave free ratio (iFR), was developed and showed its non-inferiority for clinical outcomes compared with FFR-guided strategy...
March 2018: Korean Circulation Journal
https://www.readbyqxmd.com/read/29551700/past-present-and-future-of-coronary-physiology
#13
Takayuki Warisawa, Christopher M Cook, Yoshihiro J Akashi, Justin E Davies
It is well known that the apparent significant coronary stenosis on angiography sometimes does not cause significant ischemia, and vice versa. For this reason, decision-making based on coronary physiology is becoming more and more important. Fractional flow reserve (FFR), which has emerged as a useful tool to determine which lesions need revascularization in the catheterization laboratory, now has a class IA indication in the European Society of Cardiology guidelines. More recently, the instantaneous wave-free ratio, which is considered easier to use than FFR, has been graded as equivalent to FFR...
March 15, 2018: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29482446/technical-aspects-and-limitations-of-fractional-flow-reserve-measurement
#14
Stepan Jerabek, Tomas Kovarnik
BACKGROUND: The only indication for coronary revascularization is elimination of ischaemia. Invasive hemodynamic methods (fractional flow reserve - FFR and instantaneous wave-free ratio (iFR) are superior to coronary angiography in detection of lesions causing myocardial ischaemia. Current European guidelines for myocardial revascularization recommend using of FFR for detection of functional assessment of lesions severity in category IA and number of these procedures increases. However, routine usage of these methods requires knowledge of technical requirements and limitations...
February 27, 2018: Acta Cardiologica
https://www.readbyqxmd.com/read/29471949/impact-of-routine-invasive-physiology-at-time-of-angiography-in-patients-with-multivessel-coronary-artery-disease-on-reclassification-of-revascularization-strategy-results-from-the-define-real-study
#15
MULTICENTER STUDY
Eric Van Belle, Robert Gil, Volker Klauss, Mohammed Balghith, Martijn Meuwissen, Jérôme Clerc, Bernhard Witzenbichler, Miha Cercek, Marios Vlachojannis, Irene Lang, Philippe Commeau, Flavien Vincent, Luca Testa, Wojciech Wasek, Nicolas Debry, Stephan Kische, Gabriele Gabrielli, Gennaro Sardella
OBJECTIVES: This study sought to prospectively assess the impact of routine invasive physiology at the time of angiography on reclassification of therapeutic management of multivessel disease (MVD) patients, and to assess how implementation of instantaneous wave-free ratio (iFR) alters the process. BACKGROUND: Routine invasive physiology in intermediate coronary lesions at the time of diagnostic angiography, primarily in patients with single-vessel disease and using fractional flow reserve (FFR), reclassifies coronary revascularization management in 26% to 44% of patients...
February 26, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29429843/invasive-in-the-cath-lab-assessment-of-myocardial-ischemia-in-patients-with-coronary-artery-disease-when-does-the-gold-standard-not-apply
#16
REVIEW
Stefano Benenati, Giovanni Luigi De Maria, Roberto Scarsini, Italo Porto, Adrian P Banning
International guidelines recommend that revascularization for coronary artery disease (CAD) should be guided by evidence of myocardial ischemia. Fractional flow reserve (FFR) and instantaneous free wave ratio (iFR) are the main invasive indices for assessing the ischemic potential of angiographically intermediate coronary stenosis as a large body of evidence supports their routine application. Both indices have been tested and validated in patients with isolated stable CAD, but notably their application outside this specific context is a matter of debate and investigation...
January 31, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29371084/instantaneous-wave-free-ratio-as-an-alternative-to-fractional-flow-reserve-in-assessment-of-moderate-coronary-stenoses-a-meta-analysis-of-diagnostic-accuracy-studies
#17
Rohit Maini, John Moscona, Paul Katigbak, Camilo Fernandez, Gursukhmandeep Sidhu, Qusai Saleh, Anand Irimpen, Rohan Samson, Thierry LeJemtel
BACKGROUND/PURPOSE: Fractional flow reserve (FFR) remains underutilized due to practical concerns related to the need for hyperemic agents. These concerns have prompted the study of instantaneous wave-free ratio (iFR), a vasodilator-free index of coronary stenosis. Non-inferior cardiovascular outcomes have been demonstrated in two recent randomized clinic trials. We performed this meta-analysis to provide a necessary update of the diagnostic accuracy of iFR referenced to FFR based on the addition of eight more recent studies and 3727 more lesions...
December 27, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29326150/diagnostic-performance-of-the-instantaneous-wave-free-ratio-comparison-with-fractional-flow-reserve
#18
Salvatore De Rosa, Alberto Polimeni, Ricardo Petraco, Justin E Davies, Ciro Indolfi
BACKGROUND: Aim of the present study was to perform a meta-analysis of all available studies comparing the instantaneous wave-free ratio (iFR) with fractional flow reserve (FFR). METHODS AND RESULTS: Published trials comparing the iFR with FFR were searched for in PubMed, Google Scholar, and Scopus electronic databases. A total of 23 studies were available for the analysis, including 6381 stenoses. First, a meta-analysis of all studies was performed exploring the correlation between FFR and iFR...
January 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29240905/coronary-autoregulation-and-assessment-of-stenosis-severity-without-pharmacological-vasodilation
#19
Guus A de Waard, Christopher M Cook, Niels van Royen, Justin E Davies
For identification of myocardial ischaemia by non-invasive imaging or invasive physiological assessment, administration of a vasodilating or positive inotropic agent is often considered indispensable to exhaust the cardiac compensation mechanisms. Indeed, microcirculatory dilatation is needed for assessment of myocardial perfusion or coronary blood flow. However, three different modalities exist that quantify myocardial ischaemia without recourse to pharmacological stress agents, using either myocardial contrast echocardiography, imaging of myocardial blood volume or invasive coronary pressure measurement with the instantaneous wave-free ratio (iFR)...
December 11, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29229617/is-instantaneous-wave-free-ratio-a-new-standard-of-care-for-physiologic-assessment-of-coronary-lesions-more-questions-than-answers
#20
Morton J Kern, Arnold H Seto
No abstract text is available yet for this article.
December 12, 2017: Circulation
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