Background: Recently, resting pressure–derived indexes such as resting full-cycle ratio (RFR) and diastolic pressure ratio (dPR) have been introduced to assess the functional significance of epicardial coronary stenosis. The present study sought to investigate the agreement of RFR or dPR with other pressure-derived indexes (instantaneous wave-free ratio [iFR] or fractional flow reserve), the sensitivity of RFR or dPR for anatomic or hemodynamic stenosis severity, and the prognostic implications of RFR or dPR compared with iFR Methods: RFR and dPR were calculated from resting pressure tracings by an independent core laboratory in 1024 vessels (435 patients). The changes in resting physiological indexes according to diameter stenosis were compared among iFR, RFR, and dPR. Among 115 patients who underwent 13 N-ammonia positron emission tomography, the changes in those indexes according to basal and hyperemic stenosis resistance and absolute hyperemic myocardial blood flow were compared. The association between resting physiological indexes and the risk of 2-year vessel-oriented composite outcomes (a composite of cardiac death, vessel-related myocardial infarction, and vessel-related ischemia-driven revascularization) was analyzed among 864 deferred vessels. Results: Both RFR and dPR showed a significant correlation with iFR ( R =0.979, P <0.001 for RFR; and R =0.985, P <0.001 for dPR), which was higher than that with fractional flow reserve ( R =0.822, P <0.001; and R =0.819, P <0.001, respectively). RFR and dPR showed a very high agreement with iFR (C index, 0.987 and 0.993). Percent difference of iFR, RFR, and dPR according to the increase in anatomic and hemodynamic severity was almost identical. The diagnostic performance of iFR, RFR, and dPR was not different in the prediction of myocardial ischemia defined by both low hyperemic myocardial blood flow and low coronary flow reserve by 13 N-ammonia positron emission tomography. All resting physiological indexes showed significant association with the risk of 2-year vessel-oriented composite outcomes (iFR per 0.1 increase: hazard ratio, 0.514 [95% CI, 0.370–0.715], P <0.001; RFR per 0.1 increase: hazard ratio, 0.524 [95% CI, 0.378–0.725], P <0.001; dPR per 0.1 increase: hazard ratio, 0.587 [95% CI, 0.436–0.791], P <0.001) in deferred vessels. Conclusions: All resting pressure–derived physiological indexes (iFR, RFR, and dPR) can be used as invasive tools to guide treatment strategy in patients with coronary artery disease. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT01621438.
Myocardial infarction results in scar tissue and irreversible loss of ventricular function. Unlike humans, zebrafish has the capacity to remove scar tissue after injury. To assess ventricular function during repair, we synchronized microelectrocardiogram (μECG) signals with a high-frequency ultrasound pulsed-wave (PW) Doppler to interrogate cardiac hemodynamics. μECG signals allowed for identification of PW Doppler signals for passive (early [E]-wave velocity) and active ventricular filling (atrial [A]-wave velocity) during diastole. The A wave (9.0±1.2 cm·s(-1)) is greater than the E wave (1.1±0.4 cm·s(-1)), resulting in an E/A ratio <1 (0.12±0.05, n=6). In response to cryocauterization to the ventricular epicardium, the E-wave velocity increased, accompanied by a rise in the E/A ratio at 3 days postcryocauterization (dpc) (0.55±0.13, n=6, p<0.001 vs. sham). The E waves normalize toward the baseline, along with a reduction in the E/A ratio at 35 dpc (0.36±0.06, n=6, p<0.001 vs. sham) and 65 dpc (0.2±0.16, n=6, p<0.001 vs. sham). In zebrafish, E/A<1 at baseline is observed, suggesting the distinct two-chamber system in which the pressure gradient across the atrioventricular valve is higher compared with the ventriculobulbar valve. The initial rise and subsequent normalization of E/A ratios support recovery in the ventricular diastolic function.
In recent times, polymer-based flexible pressure sensors have been attracting a lot of attention because of their various applications. A highly sensitive and flexible sensor is suggested, capable of being attached to the human body, based on a three-dimensional dielectric elastomeric structure of polydimethylsiloxane (PDMS) and microsphere composite. This sensor has maximal porosity due to macropores created by sacrificial layer grains and micropores generated by microspheres pre-mixed with PDMS, allowing it to operate at a wider pressure range (~150 kPa) while maintaining a sensitivity (of 0.124 kPa−1 in a range of 0~15 kPa) better than in previous studies. The maximized pores can cause deformation in the structure, allowing for the detection of small changes in pressure. In addition to exhibiting a fast rise time (~167 ms) and fall time (~117 ms), as well as excellent reproducibility, the fabricated pressure sensor exhibits reliability in its response to repeated mechanical stimuli (2.5 kPa, 1000 cycles). As an application, we develop a wearable device for monitoring repeated tiny motions, such as the pulse on the human neck and swallowing at the Adam’s apple. This sensory device is also used to detect movements in the index finger and to monitor an insole system in real-time.
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