scholarly journals Percutaneous Revascularization in a Case of Vasospastic Angina Associated with Polymorphic Ventricular Tachycardia

2015 ◽  
Vol 61 (4) ◽  
pp. 387-390
Author(s):  
Rudzik Roxana ◽  
Şuş Ioana ◽  
Hadadi László ◽  
Şerban Răzvan Constantin ◽  
Dobreanu Dan
Keyword(s):  
Ventricular Tachycardia ◽  
Coronary Artery ◽  
Calcium Channel ◽  
Coronary Artery Stenosis ◽  
Myocardial Revascularization ◽  
Artery Stenosis ◽  
Polymorphic Ventricular Tachycardia ◽  
Vasospastic Angina ◽  
Fractional Flow ◽  
Flow Reserve

AbstractIntroduction: Coronary vasospasm is a possible cause of ventricular tachyarrhythmias and is frequently associated with atherosclerotic lesions. The revascularization of mild to moderate coronary artery stenosis which causes symptoms only due to associated vasospasm is still a matter of debate, as the standard treatment of Prinzmetal angina is represented by the long term administration of calcium-channel blockers.Case presentation: We present the case of a 46 year old woman with an intermediate severity coronary artery stenosis complicated by vasospastic angina and subsequent polymorphic ventricular tachycardia. Although the functional significance of the fixed coronary artery lesion was equivocal at invasive fractional flow reserve measurement, a combined pharmacologic and interventional treatment strategy was chosen with stent implantation and long acting calcium channel blocker administration with a symptom-free, good clinical outcome.Conclusion: Patients with vasospastic angina and intermediate severity atherosclerotic coronary artery stenoses are at risk of malignant ventricular arrhythmias, therefore myocardial revascularization should be considered in addition to the standard medical treatment.

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

Systemic immune-inflammation index is a novel marker to predict functionally significant coronary artery stenosis

2020 ◽  
Vol 14 (16) ◽  
pp. 1553-1561
Author(s):  
Mehmet Erdoğan ◽  
Mehmet A Erdöl ◽  
Selçuk Öztürk ◽  
Tahir Durmaz
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Fractional Flow ◽  
Predictive Capacity ◽  
Significant Coronary Artery Stenosis ◽  
Lymphocyte Ratio ◽  
Coronary Syndrome ◽  
Flow Reserve ◽  
Immune Inflammation

Aim: The study aimed to investigate and compare the predictive capacity of a systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to determine a hemodynamically significant coronary artery stenosis assessed by fractional flow reserve (FFR). Patients & methods: A total of 207 chronic coronary syndrome patients with FFR measurement were enrolled in the study. NLR, PLR and SII levels were calculated. Results: The cut-off value of the SII (620) was associated with 78.4% sensitivity and 64.0% specificity to predict a hemodynamically significant stenosis. SII level independently predicted FFR ≤0.80. Conclusion: SII is an independent predictor of functionally significant coronary stenosis detected by FFR in chronic coronary syndrome patients. SII levels can predict hemodynamically severe obstruction better than NLR and PLR.

P5633Diagnostic impact of resting full-cycle ratio as newly developed non-hyperemic indices for physiological lesion assessment

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Takashima ◽  
A Suzuki ◽  
S Sakurai ◽  
H Ando ◽  
Y Nakano ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Entire Range ◽  
Coronary Artery Stenosis ◽  
Stable Condition ◽  
Artery Stenosis ◽  
Lesion Length ◽  
Fractional Flow ◽  
Gold Standard Method ◽  
Flow Reserve ◽  
Lesion Severity

Abstract Background Although fractional flow reserve (FFR) is a gold standard method to evaluate functional lesion severity in the catheterization laboratory, the need of hyperemic condition limits the widespread adoption of FFR. Recently, the resting full-cycle ratio (RFR) which was newly developed resting indices was launched. It is unclear whether RFR as resting condition could assess physiological lesion severity of coronary artery stenosis. The aim of this study was to evaluate the diagnostic impact of RFR compared to FFR in entire range of coronary artery stenosis. Method A total of 53 patients with 70 lesions were enrolled in this study. The RFR was measured after adequately waiting for stable condition, while FFR was measured after intravenous administration of ATP (180mcg/kg/min). Lesions with FFR ≤0.80 were considered functionally significant coronary artery stenosis. Results In all lesions, reference diameter, diameter stenosis, lesion length, RFR, and FFR were 3.3±0.8mm, 44±12%, 14.6±7.2mm, 0.90±0.11, and 0.83±0.11, respectively. Functional significance was observed in 24 lesions (34%) of all lesions. The RFR showed a significant correlation with FFR (y = 0.800x + 0.239, R = 0.817, p<0.001). The Bland-Altman plot demonstrated a good agreement with a mean difference of 0.07 and a standard deviation of 0.06 between RFR and FFR across entire range of coronary artery stenosis. ROC curve analysis showed an excellent accuracy of RFR cut-off of ≤0.90 in predicting FFR ≤0.80 which had 78% sensitivity and 87% specificity (AUC 0.87, diagnostic accuracy 84%). Conclusion The RFR as newly resting indices is reliable to the assessment of functional lesion severity. This physiology-based approach may be a possible alternative method for FFR measurements in daily practice.

Correlation between fractional flow reserve and intravascular ultrasound lumen area in intermediate coronary artery stenosis

2011 ◽  
Vol 7 (2) ◽  
pp. 225-233 ◽  
Author(s):  
Itsik Ben-Dor ◽  
Rebecca Torguson ◽  
Michael A. Gaglia ◽  
Manuel A. Gonzalez ◽  
Gabriel Maluenda ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Intravascular Ultrasound ◽  
Fractional Flow Reserve ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Lumen Area ◽  
Fractional Flow ◽  
Flow Reserve
Sign in / Sign up

Export Citation Format

Share Document