scholarly journals Coronary flow reserve and microcirculatory resistance in patients with coronary tortuosity and without atherosclerosis

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095506
Author(s):  
Yang Li ◽  
Xiaoguo Zhang ◽  
Qiming Dai ◽  
Genshan Ma
Keyword(s):  
Coronary Artery ◽  
Coronary Flow Reserve ◽  
Coronary Flow ◽  
Coronary Atherosclerosis ◽  
Normal Coronary Artery ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Index Of Microcirculatory Resistance ◽  
The Mean ◽  
Coronary Tortuosity

Objective Coronary tortuosity may affect epicardial coronary arterial blood flow. This study aimed to investigate the effect of coronary tortuosity on coronary flow reserve and the coronary microcirculation in patients without apparent coronary atherosclerosis. Methods Prospective patients (n = 8, 3 men, mean age: 58 ± 6.0 years) with coronary tortuosity and without apparent coronary atherosclerosis were enrolled. Coronary tortuosity was defined by the finding of ≥three bends (defined as a ≥45° change in vessel direction) along the main trunk of the left anterior descending artery or left circumflex artery. Coronary flow reserve and the index of microcirculatory resistance were measured by the thermodilution technique. Results A total of eight coronary arteries with coronary tortuosity were analyzed. The mean fractional flow reserve was 0.98 ± 0.007. The mean coronary flow reserve was 1.5 ± 0.3, which is much lower than that in the normal coronary artery as reported in the literature. The mean index of microcirculatory resistance was 26.7 ± 2.3, which is much higher than that in the normal coronary artery. Conclusions Coronary tortuosity is associated with decreased coronary flow reserve and an increased index of microcirculatory resistance. Trial registration: This study is registered at the Chinese Clinical Trial Registry, NCT No: ChiCTR2000033671

Delineating the guide-wire flow obstruction effect in assessment of fractional flow reserve and coronary flow reserve measurements

2005 ◽  
Vol 289 (1) ◽  
pp. H392-H397 ◽  
Author(s):  
Abhijit Sinha Roy ◽  
Rupak K. Banerjee ◽  
Lloyd H. Back ◽  
Martin R. Back ◽  
Saeb Khoury ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Flow Reserve ◽  
Fractional Flow Reserve ◽  
Coronary Flow ◽  
Guide Wire ◽  
Microvascular Disease ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Mean Pressure ◽  
Distal Perfusion

Hemodynamic analysis was conducted to determine uncertainty in clinical measurements of coronary flow reserve (CFR) and fractional flow reserve (FFR) over pathophysiological conditions in a patient group with coronary artery disease during angioplasty. The vasodilation-distal perfusion pressure (CFR-p̃rh) curve was obtained for 0.35- and 0.46-mm guide wires. Our hypothesis is that a guide wire spanning the lesions elevates the pressure gradient and reduces the flow during hyperemic measurements. Maximal CFR-p̃rh was uniquely determined by the intersection of measured CFR and calculated p̃rh of native and residual epicardial lesions in patients without microvascular disease, during angioplasty. Extrapolation of the linear curve gave a zero-coronary flow mean pressure (p̃zf) of ∼20 mmHg and a corresponding p̃rh of 55 mmHg in the native lesions, which coincided with the level that causes ischemia in human hearts. On this linear curve, values of CFR and FFRmyo (pathophysiological condition) and CFRg and FFRmyog (in the presence of the guide wire) were obtained in native and residual lesions. A strong linear correlation was found between CFR and CFRg [CFR = CFRg × 0.689 + 1.271 ( R2 = 0.99) for 0.46 mm and CFR = CFRg × 0.757 + 1.004 ( R2 = 0.99) for 0.35 mm] and between FFRmyo and FFRmyog [FFRmyo = FFRmyog × 0.737 + 0.263 ( R2 = 0.99) for 0.46 mm and FFRmyo = FFRmyog × 0.790 + 0.210 ( R2 = 0.99) for 0.35 mm]. This study establishes a strong correlation between CFR and CFRg and between FFRmyo and FFRmyog, which could be used to obtain the true state of occlusion in the coronary artery during angioplasty.

scholarly journals TCT-533 Fractional Flow Reserve And Coronary Flow Reserve To Predict Outcomes in Coronary Artery Disease

2016 ◽  
Vol 68 (18) ◽  
pp. B215
Author(s):  
Jung-Min Ahn ◽  
Se Hun Kang ◽  
Tae-Hoon Kim ◽  
Frederik Zimmermann ◽  
Nils Johnson ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Flow Reserve ◽  
Fractional Flow Reserve ◽  
Coronary Flow ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Artery Disease

P811Functional assessment of microcirculation in Takotsubo cardiomyopathy - a pilot study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
V Brazdil ◽  
M Hudec ◽  
R Stipal ◽  
O Bocek ◽  
P Jerabek ◽  
...  
Keyword(s):  
Pilot Study ◽  
Coronary Flow Reserve ◽  
Coronary Arteries ◽  
Takotsubo Cardiomyopathy ◽  
Coronary Flow ◽  
Stress Factors ◽  
Functional Testing ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Index Of Microcirculatory Resistance

Abstract Background Takotsubo cardiomyopathy (TTC) is a severe cardiologic disorder with an increasing incidence that often mimics acute coronary syndrome. Both of the entities are characterized by systolic dysfunction of the left ventricle myocardium. However, this dysfunction is reversible in most cases of TTC. Takotsubo syndrome affects predominantly postmenopausal females, typically with a direct link to emotional or physical stress factors. The pathophysiology of TTC remains unclear. In this study, we aimed to assess the pathophysiology of TTC using the invasive functional testing of coronary microcirculation. Methods Ten female patients diagnosed with TTC in line with interTAK Diagnostic Criteria were included in this pilot study. In all subjects we measured fractional and coronary flow reserve in the left anterior descending and left circumflex coronary arteries (FFR LAD, FFR LCx, CFR LAD, CFR LCx), and the index of microcirculatory resistance in the same arteries (iMR LAD, iMR LCx) in addition to acute and late (after 12 weeks) transthoracic echocardiography (TTE) and acute cardiac biomarkers (troponin and NT-proBNP). The results of the microcirculatory assessment were statistically compared with normal population values. Results In all subjects, the troponin level was elevated in the acute phase and repeated TTE revealed transient dysfunction of the left myocardial ventricle. Whilst fractional flow reserve was normal in both assessed epicardial artery territories for all patients (mean FFR LAD: 0.92±0.04; mean FFR LCx: 0.98±0.046), both mean values of coronary flow reserve disclosed pathological microcirculatory findings (CFR LAD: 1.9±1.197; CFR LCx: 1.75±0.742) and were pathological in nine out of ten subjects. Index of microcirculatory resistance revealed abnormal values in five out of ten patients for LAD (31.03±18.515) and three out of ten for LCx (23.8±17.86). Conclusions Our pilot study confirmed non-obstructive findings in the epicardial coronary arteries assessed by FFR. On the other hand, the investigation of both CFR and iMR, microcirculatory functional testing, revealed pathological findings in a significant number of evaluated subjects. From this aspect, our study validates further research in the field of microcirculatory functions as a possible mechanism in the origin of TTS. Acknowledgement/Funding Supported by MH CZ - DRO (FNBr, 65269705)

scholarly journals Fractional flow reserve and pressure-bounded coronary flow reserve to predict outcomes in coronary artery disease

2017 ◽  
Vol 38 (25) ◽  
pp. 1980-1989 ◽  
Author(s):  
Jung-Min Ahn ◽  
Frederik M. Zimmermann ◽  
Nils P. Johnson ◽  
Eun-Seok Shin ◽  
Bon-Kwon Koo ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Flow Reserve ◽  
Fractional Flow Reserve ◽  
Coronary Flow ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Artery Disease
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