Comparison of Diagnostic Values of Instantaneous Wave-Free R atio and Fractional Flow R eserve With Noninvasive Methods for Evaluating Myocardial Ischemia in Assessment of the Functional Significance of Intermediate Coronary Stenoses in Patients With Chronic Ischemic Heart Disease

Kardiologiia ◽  
2017 ◽  
Vol 17 (8) ◽  
pp. 11-19
Author(s):  
D. I. Darenskiy ◽  
◽  
V. V. Gramovich ◽  
E. A. Zharova ◽  
A. A. Ansheles ◽  
...  
Keyword(s):  
Heart Disease ◽  
Myocardial Ischemia ◽  
Ischemic Heart Disease ◽  
Functional Significance ◽  
Ischemic Heart ◽  
Chronic Ischemic Heart Disease ◽  
Fractional Flow ◽  
Noninvasive Methods ◽  
Diagnostic Values ◽  
Coronary Stenoses

scholarly journals Objective Identification of Intermediate Lesions Inducing Myocardial Ischemia Using Sequential Intracoronary Pressure and Flow Measurements

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
Valérie E. Stegehuis ◽  
Gilbert W. M. Wijntjens ◽  
Sukhjinder S. Nijjer ◽  
Guus A. de Waard ◽  
Tim P. van de Hoef ◽  
...  
Keyword(s):  
Heart Disease ◽  
Myocardial Ischemia ◽  
Ischemic Heart Disease ◽  
Flow Velocity ◽  
Coronary Flow ◽  
Ischemic Heart ◽  
Fractional Flow ◽  
Sequential Approach ◽  
Flow Measurements ◽  
Flow Reserve

Background Although ischemic heart disease has a complex and multilevel origin, the diagnostic approach is mainly focused on focal obstructive disease as assessed by pressure‐derived indexes. The prognostic relevance of coronary flow over coronary pressure has been suggested and implies that identification of relevant perfusion abnormalities by invasive physiology techniques is critical for the correct identification of patients who benefit from coronary revascularization. The purpose of this study was to evaluate the diagnostic potential of a sequential approach using pressure‐derived indexes instantaneous wave‐free ratio ( iFR ), fractional flow reserve ( FFR ), and coronary flow reserve ( CFR ) measurements to determine the number of intermediate lesions associated with flow abnormalities after initial pressure measurements. Methods and Results A total of 366 intermediate lesions were assessed with simultaneous intracoronary pressure and flow velocity measurements. Contemporary clinical iFR , FFR, and CFR cut points for myocardial ischemia were applied. A total of 118 (32%) lesions were FFR + and 136 (37%) lesions were iFR +. Subsequent CFR assessment resulted for FFR in a total of 91 (25%) FFR +/ CFR + and for iFR a total of 111 (30%) iFR +/ CFR + lesions. An iFR , FFR , and invasive flow velocity assessment approach would have yielded 20% of lesions (74 of 366) as ischemic. Conclusions Ultimately, 20% of intermediate lesions are associated with flow abnormalities after applying a pressure and flow velocity sequential approach. If iFR is borderline, FFR has limited additional value, in contrast with CFR . These results emphasize the use of coronary physiology in assessing stenosis severity but may also further question the contemporary reputation of a pressure‐based approach as a gold standard for the detection of myocardial ischemia in ischemic heart disease.

scholarly journals Profoundly Reduced Neovascularization Capacity of Bone Marrow Mononuclear Cells Derived From Patients With Chronic Ischemic Heart Disease

Circulation ◽  
2004 ◽  
Vol 109 (13) ◽  
pp. 1615-1622 ◽  
Author(s):  
Christopher Heeschen ◽  
Ralf Lehmann ◽  
Jörg Honold ◽  
Birgit Assmus ◽  
Alexandra Aicher ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Mononuclear Cells ◽  
Ischemic Heart ◽  
Bone Marrow Mononuclear Cells ◽  
Chronic Ischemic Heart Disease

scholarly journals Correlations of Serum Magnesium and Potassium in Acute Myocardial Infarction, Chronic Ischemic Heart Disease and Normal Healthy Volunteers of Bangladesh

2013 ◽  
Vol 3 (2) ◽  
pp. 50-56
Author(s):  
MBK Choudhury ◽  
MM Hossain ◽  
M Akhtaruzzaman ◽  
MM Jamal Uddin ◽  
MS Rahman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Healthy Volunteers ◽  
Serum Magnesium ◽  
Ischemic Heart ◽  
Diagnostic Tools ◽  
Strong Positive Correlation ◽  
Chronic Ischemic Heart Disease

Magnesium (Mg) and potassium (K) are the major intracellular cations whose presence in the serum are low, but minor changes of those may show a remarkable change in the various body functions specially in the heart. The study was designed to find out the correlation between serum Mg and K in acute myocardial infarction (AMI), chronic ischemic heart disease (CIHD) and normal healthy volunteers. It was carried out over a period of 18 months in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration with Department of Cardiology, Sir Salimullah Medical College & Mitford Hospital (SSMC & MH) and Atomic Energy Center, Dhaka. A total of 101 subjects were included in which 32 subjects were AMI, 34 CIHD and 35 normal healthy volunteers. Serum glucose and serum creatinine were estimated to exclude diabetes and renal dystrophies. Estimation of serum CK-MB and ECG tracing were done as diagnostic tools of AMI and to categories the subjects into various groups. Serum Mg was estimated by Atomic absorption spectrophotometer and serum K by Ion sensitive electrode. The present study shows that there is a strong positive correlation of serum Mg and K in AMI, CIHD and healthy control subjects (r = 0.566, p<0.01 level). So it is suggested to estimate and supplement both Mg and K in IHD patients for their better management. DOI: http://dx.doi.org/10.3329/bjmb.v3i2.13812 Bangladesh J Med Biochem 2010; 3(2): 50-56

Abstract 10958: Identification of Right Ventricular Myocardial Infarction With Late Gadolinium Enhancement in Chronic Ischemic Heart Disease: Comparison With Pathological Findings

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yan Chaowu ◽  
Li Li ◽  
Fang Wei ◽  
Li Hua ◽  
Wang Yang
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Late Gadolinium Enhancement ◽  
Ischemic Heart Disease ◽  
Ischemic Heart ◽  
Pathological Findings ◽  
Chronic Ischemic Heart Disease ◽  
Gadolinium Enhancement ◽  
Right Ventricular Myocardial Infarction ◽  
Replacement Fibrosis

Introduction: Late gadolinium enhancement (LGE) has the potential to become an excellent technique in the diagnosis of right ventricular myocardial infarction (RVMI). However, the gold standard, pathological findings from patients, is still unavailable to validate the true value of LGE. Hypothesis: We hypothesized that LGE might correspond with histological infarction in RVMI. Methods: 36 transplant candidates (35 M /1F) with chronic ischemic heart disease were studied prospectively with LGE. According to the 12-segment-model, the pathological findings of RV were compared with the previous in vivo LGE after heart transplantation. Results: Histological RVMI was detected in 7 patients, and corresponded with all LGE segments (n=23) and 2 non-LGE segments. A generalize linear mix effect model showed non-significant difference (P=0.152) between the results of LGE and histological infraction. In identifying the RV segments with histological infarction, sensitivity and specificity of LGE was 92.0% (95%CI 74.0% to 99.0%) and 100% (95%CI 99.9% to 100.0%), respectively. Furthermore, RV segments without LGE mainly included two pathological patterns: histologically normal myocardium (n=372) or the admixture of viable myocardium and scattered replacement fibrosis (n=35). In the non-LGE RV segments, wall motion abnormality was associated with volume fraction of collagen (11.4±6.5% vs 4.3±2.2%, P<0.001) and the presence of ischemia (96.4% vs 1.7%, P<0.001). Conclusions: The RV segments with LGE corresponded closely with histological infarction in ischemic heart disease. However, RV segments without LGE might be histologically normal myocardium or intermixed with scattered replacement fibrosis. Further studies are required to evaluate the significance of scattered replacement fibrosis in the non-LGE segments.

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