scholarly journals TCTAP A-134 Clinical Efficacy of Contrast Medium Induced Fractional Flow Reserve to Assess Functional Lesion Severity in Left Anterior Descending Artery

2016 ◽  
Vol 67 (16) ◽  
pp. S61
Author(s):  
Akihiro Suzuki ◽  
Hiroaki Takashima ◽  
Katsuhisa Waseda ◽  
Akiyoshi Kurita ◽  
Hirohiko Ando ◽  
...  
Keyword(s):  
Contrast Medium ◽  
Clinical Efficacy ◽  
Fractional Flow Reserve ◽  
Fractional Flow ◽  
Left Anterior Descending Artery ◽  
Flow Reserve ◽  
Lesion Severity

Fractional flow reserve and instantaneous wave-free ratio discordance in patients with severe aortic valve stenosis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Yamanaka ◽  
K Shishido ◽  
S Yokota ◽  
N Moriyama ◽  
Y Mashimo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Stenosis ◽  
Fractional Flow Reserve ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Aortic Valve Area ◽  
Fractional Flow ◽  
Left Anterior Descending Artery ◽  
Flow Reserve

Abstract Background It has been reported that discordance between fractional flow reserve (FFR) and Instantaneous Wave-Free Ratio (iFR) could occur in up to 20% of cases. However, there are no reports regarding discordance between FFR and iFR in patients with severe aortic valve stenosis (AS). Purpose We aimed to investigate the discordance between FFR and iFR in patients with severe AS. Methods Severe AS was defined as an aortic-valve area of ≤1.0 cm2, a mean aortic-valve gradient of 40mmHg or more, or a peak aortic-jet velocity of 4.0 m/s or more. Intermediate coronary artery stenosis was defined as 30% to 70% stenosis (visual estimation). FFR and iFR were calculated in 4 quadrants based on values of FFR ≤0.8 and iFR ≤0.89 (positive discordance; low FFR and high iFR, negative discordance; high FFR and low iFR). Results We examined consecutive 140 patients (164 intermediate coronary artery stenosis vessels). Mean FFR and iFR ± standard deviation was 0.82±0.09 and 0.82±0.14, respectively. The discordance was observed in 48 vessels (29.3%). In the discordant group, most of cases were negative discordance (45 cases, 93.6%). Binary logistic regression analysis showed that left anterior descending artery (Hazard Ratio 3.80; 1.55 to 9.31, p=0.0036) was independently associated with negative discordance. Conclusions In patients with severe AS, the discordance between FFR and iFR could be observed in 29.3% of the vessels, mostly negative discordance. The left anterior descending artery is an independent predictor for negative discordance. Funding Acknowledgement Type of funding source: None

scholarly journals Efficacy of coronary fractional flow reserve using contrast medium compared to adenosine

2016 ◽  
Vol 3 ◽  
pp. 212-216 ◽  
Author(s):  
Selim Topcu ◽  
Ibrahim Halil Tanboğa ◽  
Enbiya Aksakal ◽  
Uğur Aksu ◽  
Oktay Gulcu ◽  
...  
Keyword(s):  
Contrast Medium ◽  
Fractional Flow Reserve ◽  
Fractional Flow ◽  
Flow Reserve

scholarly journals Effective Radiation Dose, Time, and Contrast Medium to Measure Fractional Flow Reserve

2010 ◽  
Vol 3 (8) ◽  
pp. 821-827 ◽  
Author(s):  
Argyrios Ntalianis ◽  
Catalina Trana ◽  
Olivier Muller ◽  
Fabio Mangiacapra ◽  
Aaron Peace ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Contrast Medium ◽  
Fractional Flow Reserve ◽  
Fractional Flow ◽  
Effective Radiation Dose ◽  
Dose Time ◽  
Flow Reserve ◽  
Effective Radiation

scholarly journals The relationship between coronary stenosis morphology and fractional flow reserve: a computational fluid dynamics modelling study

2021 ◽  
Author(s):  
Roberto T F Newcombe ◽  
Rebecca C Gosling ◽  
Vignesh Rammohan ◽  
Patricia V Lawford ◽  
D Rodney Hose ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Coronary Artery ◽  
Fractional Flow Reserve ◽  
Computational Modelling ◽  
Fractional Flow ◽  
Cfd Modelling ◽  
Flow Reserve ◽  
The Relationship ◽  
Lesion Severity

Abstract Background International guidelines mandate the use of fractional flow reserve (FFR) and/or non-hyperaemic pressure ratios to assess the physiological significance of moderate coronary artery lesions to guide revascularisation decisions. However, they remain underused such that visual estimation of lesion severity continues to be the predominant decision-making tool. It would be pragmatic to have an improved understanding of the relationship between lesion morphology and haemodynamics. Aims To compute virtual FFR (vFFR) in idealised coronary artery geometries with a variety of stenosis and vessel characteristics Methods Coronary artery geometries were modelled, based upon physiologically realistic branched arteries. Common stenosis characteristics were studied, including % narrowing, length, eccentricity, shape, number, position relative to branch, and distal (myocardial) resistance. Computational fluid dynamics (CFD) modelling was used to calculate vFFRs using the VIRTUheartTM system. Results Percentage lesion severity had the greatest effect upon FFR. Any ≥80% diameter stenosis in two views (i.e. concentric) was physiologically significant (FFR ≤ 0.80), irrespective of length, shape or vessel diameter. Almost all eccentric stenoses and all 50% concentric stenoses were physiologically non-significant, whilst 70% uniform concentric stenoses about 10mm long straddled the ischaemic threshold (FFR 0.80). A low microvascular resistance (MVR) reduced FFR on average by 0.05, and a high MVR increased it by 0.03. Conclusions Using computational modelling, we have produced an analysis of virtual FFR that relates stenosis characteristics to haemodynamic significance. The strongest predictor of a positive virtual FFR was a concentric, ≥80% diameter stenosis. The importance of MVR was quantified. Other lesion characteristics have a limited impact.

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