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https://www.readbyqxmd.com/read/27901333/fractional-flow-reserve-lessons-from-platform-and-future-perspectives
#1
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
#2
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/27899941/influence-of-increased-epicardial-adipose-tissue-volume-on-1-year-in-stent-restenosis-in-patients-who-received-coronary-stent-implantation
#3
Ying Zhou, Hua-Wei Zhang, Feng Tian, Jin-Song Chen, Tian-Wen Han, Ya-Hang Tan, Jia Zhou, Tao Zhang, Jing Jing, Yun-Dai Chen
BACKGROUND: Epicardial adipose tissue (EAT) is significantly associated with the formation and composition of coronary atherosclerotic plaque, cardiac events and the clinical prognosis of coronary heart disease. But, whether increased EAT deposition may affect the incidence of in-stent restenosis (ISR) is currently unclear. This study used coronary computed tomography angiography (CCTA) as a mean to investigate whether increased EAT volume was associated with ISR. METHODS: A total of 364 patients who underwent 64-slice CCTA examination for the evaluation of suspected coronary artery disease, and subsequently underwent percutaneous coronary intervention (PCI) for the first time, and then accepted coronary angiography (CA) follow-up for ISR examination in one year, were retrospectively included in this study...
September 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27895870/systolic-compression-of-a-myocardial-bridged-coronary-artery-and-its-morphologic-characteristics-a-combination-study-of-computed-tomography-angiography-and-invasive-angiography
#4
Abbas Arjmand Shabestari, Roxana Azma, Armin Nourmohammad, Madjid Shakiba
BACKGROUND: Myocardial bridging (MB) is a congenital anomaly in which a segment of a major epicardial coronary artery courses through the myocardium. This anomaly can lead to myocardial ischemia, arrhythmia, and even death. The effectiveness of coronary computed tomographic angiography (CCTA) in the detection of MB and its morphological features, and the accuracy of invasive coronary angiography (ICA) in the evaluation of systolic compression have been shown in some prior studies. OBJECTIVES: The present study aimed to evaluate the correlation between the depth and the length of MB as determined using CCTA, and the degree of luminal narrowing of the involved tunneled segment as calculated using the ICA...
October 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
https://www.readbyqxmd.com/read/27883201/effect-of-treatment-with-5-lipoxygenase-inhibitor-via-2291-atreleuton-on-coronary-plaque-progression-a-serial-ct-angiography-study
#5
Suguru Matsumoto, Reda Ibrahim, Jean C Grégoire, Philippe L L'Allier, Josephine Pressacco, Jean-Claude Tardif, Matthew J Budoff
BACKGROUND: Inflammation has a key role in the process of atherosclerosis. Production of leukotrienes by 5-lipoxygenase has been linked to atherosclerotic plaques and cardiovascular events. HYPOTHESIS: In this study, a selective 5-LO inhibitor will slow plaque progression using serial cardiac computed tomographic angiography (CCTA). METHODS: Patients with recent acute coronary syndrome (ACS) were prospectively assigned to one of 3 VIA-2291 doses (25 mg, 50 mg, 100 mg) or placebo by oral administration...
November 24, 2016: Clinical Cardiology
https://www.readbyqxmd.com/read/27865676/bailout-intravenous-esmolol-for-heart-rate-control-in-cardiac-computed-tomography-angiography
#6
Sílvia Aguiar Rosa, Ruben Ramos, Hugo Marques, Rosana Santos, Cecília Leal, Helena Casado, Márcia Saraiva, Luísa Figueiredo, Rui Cruz Ferreira
OBJECTIVE: To evaluate the efficacy and safety of a heart rate (HR) reduction protocol using intravenous esmolol as bailout for failed oral metoprolol regimens in patients undergoing coronary computed tomography angiography (CCTA) with 64-slice multidetector computed tomography (64-MDCT). METHODS: Patients who underwent cardiac 64-MDCT in a single institution between 2011 and 2014 were analyzed. Those with HR above 60 beats per minute (bpm) on presentation received oral metoprolol (50-200 mg) at least one hour before CCTA...
November 16, 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/27861199/heart-rate-reduction-with-adjusted-dose-ivabradine-in-patients-undergoing-coronary-computed-tomographic-angiography-a-randomized-trial
#7
Blaž Kacijan, Zala Novak, Borut Jug, Maja Dolenc Novak, Matjaž Vrtovec, Barbara Gužič Salobir
OBJECTIVE: Our prospective, randomized, open-label study assessed the efficacy of a heart rate-lowering, adjusted-dose protocol with ivabradine prior to coronary computed tomographic angiography (CCTA). METHODS: Patients undergoing CCTA were randomized to 7 days of adjusted-dose ivabradine or standard care (ie, no additional medication). Heart rate and β-blocker and antianxiety medication use on the day of the CCTA were recorded. RESULTS: One hundred one patients were randomized (mean age, 60 [SD, 13] years; 66% women)...
November 17, 2016: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/27848163/myocardial-ischemia-detection-with-single-phase-ct-perfusion-in-symptomatic-patients-using-high-pitch-helical-image-acquisition-technique
#8
Bernhard Bischoff, Simon Deseive, Martin Rampp, Andrei Todica, Marc Wermke, Stefan Martinoff, Steffen Massberg, Maximilian F Reiser, Hans-Christoph Becker, Jörg Hausleiter
Coronary CT angiography (CCTA) suffers from a reduced diagnostic accuracy in patients with heavily calcified coronary arteries or prior myocardial revascularisation due to artefacts caused by calcifications and stent material. CT myocardial perfusion imaging (CTMPI) yields high potential for the detection of myocardial ischemia and might help to overcome the above mentioned limitations. We analysed CT single-phase perfusion using high-pitch helical image acquisition technique in patients with prior myocardial revascularisation...
November 15, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27848160/coronary-flow-reserve-and-relative-flow-reserve-measured-by-n-13-ammonia-pet-for-characterization-of-coronary-artery-disease
#9
Sang-Geon Cho, Ki Seong Park, Jahae Kim, Sae-Ryung Kang, Ho-Chun Song, Ju Han Kim, Jae Yeong Cho, Young Joon Hong, Zeenat Jabin, Hee Jeong Park, Geum-Cheol Jeong, Seong Young Kwon, Jin Chul Paeng, Hyeon Sik Kim, Jung-Joon Min, Ernest V Garcia, Henry Hee-Seung Bom
OBJECTIVE: We evaluated the relationships between coronary flow reserve (CFR) and relative flow reserve (RFR) measured by N-13 ammonia positron emission tomography (PET) for characterization of epicardial coronary artery disease (CAD). METHODS: Sixty-nine consecutive stable angina patients underwent N-13 ammonia PET, coronary computed tomography angiography (CCTA), and if necessary, invasive coronary angiography (CAG) within 2 weeks. Myocardial blood flow (MBF), CFR, RFR, and coronary vascular resistance of the reference arterial territory (CVRref) were measured by N-13 ammonia PET...
November 15, 2016: Annals of Nuclear Medicine
https://www.readbyqxmd.com/read/27844238/normal-values-of-regional-left-ventricular-myocardial-thickness-mass-and-distribution-assessed-by-320-detector-computed-tomography-angiography-in-the-copenhagen-general-population-study
#10
Louise Hindsø, Andreas Fuchs, Jørgen Tobias Kühl, Emma Julia P Nilsson, Per Ejlstrup Sigvardsen, Lars Køber, Børge G Nordestgaard, Klaus Fuglsang Kofoed
Left ventricular (LV) hypertrophy is associated with cardiovascular complications and the geometry is important for prognosis. In some cardiovascular diseases, myocardial hypertrophy or dilation occurs regionally without modifying the global size of the heart. It is therefore relevant to determine regional normal reference values of the left ventricle. The aim of this study was to derive reference values of regional LV myocardial thickness (LVMT) and mass (LVMM) from a healthy study group of the general population using cardiac computed tomography angiography (CCTA)...
November 14, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27844188/correlation-and-predictive-value-of-aortic-root-calcification-markers-with-coronary-artery-calcification-and-obstructive-coronary-artery-disease
#11
Christian Tesche, Carlo N De Cecco, Andrew Stubenrauch, Brian E Jacobs, Akos Varga-Szemes, Sheldon E Litwin, B Devon Ball, Moritz Baquet, David Jochheim, Ullrich Ebersberger, Richard R Bayer, Ellen Hoffmann, Daniel H Steinberg, U Joseph Schoepf
OBJECTIVE: To evaluate the correlation between aortic root calcification (ARC) markers and coronary artery calcification (CAC) derived from coronary artery calcium scoring (CACS) and their ability to predict obstructive coronary artery disease (CAD). METHODS: We retrospectively analyzed 189 patients (47% male, age 60.3 ± 11.1 years) with an intermediate probability of CAD who underwent clinically indicated CACS and coronary CT angiography (CCTA). ARC markers [aortic root calcium score (ARCS) and volume (ARCV)] were calculated and compared to CAC markers: coronary artery calcium score (CACS), volume (CACV), and mass (CACM)...
November 14, 2016: La Radiologia Medica
https://www.readbyqxmd.com/read/27843187/coronary-ct-angiography-a-retrospective-study-of-220-cases
#12
V K Maurya, R Ravikumar, Pankaj Sharma, Naveen Agrawal, Mukul Bhatia
BACKGROUND: Coronary artery disease (CAD) is a common cause of morbidity and mortality worldwide. Although catheter coronary angiography (CCA) is the gold standard in the diagnosis and management of CAD, coronary CT angiography (CCTA) has shown promising results for the same. METHODS: CCTA was done using 40 slice multi-detector CT (Somatom Sensation, Siemens, Germany) machine in 220 patients of suspected CAD. Patients were classified as (a) normal (no calcific or soft plaque), (b) non-obstructive coronary disease (<50% stenosis), (c) obstructive coronary disease (>50% stenosis), or (d) a non-diagnostic study...
October 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/27833784/computed-tomography-angiography-with-a-192-slice-dual-source-computed-tomography-system-improvements-in-image-quality-and-radiation-dose
#13
Philip V M Linsen, Adriaan Coenen, Marisa M Lubbers, Marcel L Dijkshoorn, Mohamed Ouhlous, Koen Nieman
PURPOSE: This study aims to compare image quality, radiation dose, and the influence of the heart rate on image quality of high-pitch spiral coronary computed tomography angiography (CCTA) using 128-slice (second generation) dual-source CT (DSCT) and a 192-slice DSCT (third generation) scanner. MATERIALS AND METHODS: Two consecutive cohorts of fifty patients underwent CCTA by high-pitch spiral scan mode using 128 or 192-slice DSCT. The 192-slice DSCT system has a more powerful roentgen tube (2 × 120 kW) that allows CCTA acquisition at lower tube voltages, wider longitudinal coverage for faster table speed (732 m/s), and the use of iterative reconstruction...
2016: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/27824692/long-term-marathon-running-is-associated-with-low-coronary-plaque-formation-in-women
#14
William O Roberts, Robert S Schwartz, Stacia Merkel Kraus, Jonathan G Schwartz, Gretchen Peichel, Ross F Garberich, John R Lesser, Stephen N Oesterle, Kelly K Wickstrom, Thomas Knickelbine, Kevin M Harris
INTRODUCTION: Marathon running is presumed to improve cardiovascular risk, but health benefits of high volume running are unknown. High resolution coronary computed tomography angiography (CCTA) and a cardiac risk factor assessment were completed in women with long term marathon running histories to compare to sedentary women with similar risk factors. METHODS: Women who had run at least one marathon per year for 10-25 years underwent CCTA, 12-lead ECG, blood pressure and heart rate measurement, lipid panel, and a demographic/health risk factor survey...
November 7, 2016: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/27811121/automatic-valve-plane-localization-in-myocardial-perfusion-spect-ct-by-machine-learning-anatomical-and-clinical-validation
#15
Julian Betancur, Mathieu Rubeaux, Tobias Fuchs, Yuka Otaki, Yoav Arnson, Leandro Slipczuk, Dominik Benz, Guido Germano, Damini Dey, Chih-Jen Lin, Daniel Berman, Philipp Kaufmann, Piotr Slomka
: Precise definition of the mitral valve plane (VP) during segmentation of the left ventricle (LV) for single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) quantification often requires manual adjustment, which affects quantification of perfusion. We developed a machine learning approach using support vector machines (SVM) for automatic VP placement. METHODS: 392 consecutive patients undergoing fast SPECT MPI (99m)Tc-tetrofosmin stress (5 min, 300-350 MBq)/rest (5 min, 750-1050 MBq) attenuation corrected (AC) by computed tomography (CT) and same‑day coronary CT angiography (CCTA), including 48 patients with invasive angiography (ICA) and no known coronary artery disease, were studied...
November 3, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/27804072/long-term-prognostic-value-of-coronary-artery-calcium-scanning-coronary-computed-tomographic-angiography-and-stress-myocardial-perfusion-imaging-in-patients-with-suspected-coronary-artery-disease
#16
Carmela Nappi, Emanuele Nicolai, Stefania Daniele, Wanda Acampa, Valeria Gaudieri, Roberta Assante, Emilia Zampella, Sabrina Segreto, Massimo Imbriaco, Mario Petretta, Marco Salvatore, Alberto Cuocolo
BACKGROUND: We compared the long-term prognostic value of coronary artery calcium (CAC) scanning, coronary computed tomographic angiography (CCTA), and stress single-photon emission computed tomography myocardial perfusion imaging (MPI) in patients with suspected coronary artery disease (CAD). METHODS AND RESULTS: A total of 164 patients were studied. CAC score was measured according to the Agatston method and patients were categorized into 3 groups (0, 1-300, and >300)...
November 1, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27796852/functional-compared-to-anatomical-imaging-in-the-initial-evaluation-of-patients-with-suspected-coronary-artery-disease-an-international-multi-center-randomized-controlled-trial-iaea-spect-cta-study
#17
Ganesan Karthikeyan, Barbara Guzic Salobir, Borut Jug, Niveditha Devasenapathy, Erick Alexanderson, Joao Vitola, Otakar Kraft, Elgin Ozkan, Saket Sharma, Gaurav Purohit, Maja Dolenc Novak, Aloha Meave, Sergio Trevethan, Rodrigo Cerci, Sandra Zier, Lucia Gotthardtová, Tomáš Jonszta, Timucin Altin, Cigdem Soydal, Chetan Patel, Gurpreet Gulati, Diana Paez, Maurizio Dondi, Ravi Kashyap
OBJECTIVE: To test the hypothesis that, in the initial evaluation of patients with suspected coronary artery disease (CAD), stress myocardial perfusion imaging (MPI) would result in less downstream testing than coronary computed tomographic angiography (CCTA). METHODS: In this international, randomized trial, mildly symptomatic patients with an intermediate likelihood of having CAD, and asymptomatic patients at intermediate risk of cardiac events, underwent either initial stress-rest MPI or CCTA...
October 28, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27796727/diagnostic-performance-of-noninvasive-fractional-flow-reserve-derived-from-coronary-computed-tomography-angiography-in-ischemia-causing-coronary-stenosis-a-meta-analysis
#18
Aimin Ding, Guoqing Qiu, Wensheng Lin, Ling Hu, Guangliang Lu, Xiang Long, Xin Hong, Yaohua Chen, Xiaoping Luo, Qinqin Tang, Dongqin Deng
PURPOSE: Fractional flow reserve based on coronary computed tomographic angiography (CCTA; FFRCT) can evaluate functional severity in coronary artery disease (CAD). This study investigated the diagnostic value of FFRCT for determining CAD severity. MATERIALS AND METHODS: Medline, Cochrane, EMBASE, and Google Scholar databases were searched until June 16, 2016 using the following search terms: fractional flow reserve, coronary computed tomography angiography, myocardial ischemia...
December 2016: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/27783337/the-new-frontier-of-cardiac-computed-tomography-angiography-fractional-flow-reserve-and-stress-myocardial-perfusion
#19
REVIEW
Gianluca Pontone, Giuseppe Muscogiuri, Daniele Andreini, Andrea I Guaricci, Marco Guglielmo, Saima Mushtaq, Andrea Baggiano, Edoardo Conte, Virginia Beltrama, Andrea Annoni, Alberto Formenti, Elisabetta Mancini, Mark G Rabbat, Mauro Pepi
The increased number of patients with coronary artery disease (CAD) in developed countries is of great clinical relevance and involves a large burden of the healthcare system. The management of these patients is focused on relieving symptoms and improving clinical outcomes. Therefore the ideal test would provide the correct diagnosis and actionable information. To this aim, several non-invasive functional imaging modalities are usually used as gatekeeper to invasive coronary angiography (ICA), but their diagnostic yield remains low with limited accuracy when compared to obstructive CAD at the time of ICA or invasive fractional flow reserve (FFR)...
December 2016: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27782685/coronary-artery-analysis-computer-assisted-selection-of-best-quality-segments-in-multiple-phase-coronary-ct-angiography
#20
Chuan Zhou, Heang-Ping Chan, Lubomir M Hadjiiski, Aamer Chughtai, Jun Wei, Ella A Kazerooni
PURPOSE: The authors are developing an automated method to identify the best-quality coronary arterial segment from multiple-phase coronary CT angiography (cCTA) acquisitions, which may be used by either interpreting physicians or computer-aided detection systems to optimally and efficiently utilize the diagnostic information available in multiple-phase cCTA for the detection of coronary artery disease. METHODS: After initialization with a manually identified seed point, each coronary artery tree is automatically extracted from multiple cCTA phases using our multiscale coronary artery response enhancement and 3D rolling balloon region growing vessel segmentation and tracking method...
October 2016: Medical Physics
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