The authors developed and tested a dual stress magnetic resonance (MR) imaging protocol to evaluate myocardial perfusion, function, and hibernation. The technique was well tolerated, and high-quality images were achieved. The comprehensive information obtained can be used to guide clinical management decisions regarding coronary artery revascularization procedures. This protocol offers a one-stop assessment of patients with coronary artery disease with use of a clinical MR imager.
In the majority of cases the area ratios are in close agreement with the theoretically predicted values for forward matched junctions. Minimal pulse wave reflections are therefore expected to arise from the junctions of a healthy arterial system. We therefore consider that, contrary to the established view, the presence of reflected waves in the central arterial system is a potential pathological phenomenon and not a characteristic of the healthy system. This may have important theoretical implications for the way hemodynamic findings are interpreted. Finally we suggest that arterial area ratio can be considered as another criterion of normality of arterial junctions in the interpretation of angiograms.
The aim of this study was to assess the quality of angiograms obtained using 4 Fr catheters compared with 6 Fr catheters, the ease of use of the 4 Fr catheters, and the safety of patient mobilization 1 hr following 4 Fr angiography. Details of catheter performance and procedural details were recorded at the time of the angiogram. The angiographic images were scored on the quality and completeness of vessel opacification throughout systole and diastole. A total of 410 patients were recruited. There was no difference between 4 and 6 Fr for procedural variables. All angiograms were considered to be of diagnostic quality. The angiographic scores for the right coronary artery and left ventricular injections were no different between 4 and 6 Fr. However, the angiographic scores for the left anterior descending and circumflex arteries were lower with 4 than with 6 Fr (both P < 0.05). Patients who had 4 Fr angiography mobilized safely at 1 hr and reported significantly less discomfort and bruising than 6 Fr patients. Good-quality diagnostic coronary angiograms can be achieved using 4 Fr catheters with the advantage of earlier postprocedural mobilization and reduced discomfort and bruising for the patient.
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