Letter by Michiels et al Regarding Article, “Diagnostic Accuracy of Combined Intracoronary Pressure and Flow Velocity Information During Baseline Conditions: Adenosine-Free Assessment of Functional Coronary Lesion Severity”

Hoef, Tim P. van de; Nolte, Froukje; Siebes, Maria; Spaan, Jos A. E.; Damman, Peter; Delewi, Ronak; Tijssen, Jan G.P.; Piek, Jan J.; Bax, Matthijs; Chamuleau, Steven A. J.; Voskuil, Michiel; Meuwissen, Martijn

doi:10.1161/circinterventions.112.973255

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…At present, f ractional ow reserve (FFR) is considered to be the "gold standard" for the clinical diagnosis of functional myocardial ischemia [6][7][8] . It is de ned as the ratio of the maximum blood ow of the myocardium in the area dominated by the stenotic coronary artery to the maximum blood ow of the myocardium when the same coronary artery has no stenosis.…”

Section: Introductionmentioning

confidence: 99%

On Intlet Pressure Boundary Conditions for CT-Based Computation of FFRSS: Clinical Measurement of Aortic Pressure

Liu¹,

Wang²,

Ma³

et al. 2021

Preprint

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Background and Objectives: With the development of medical imaging and computational fluid dynamics (CFD), a fast calculation method of steady-state fractional flow reserve (FFRss) based on CTA images has been applied to predict myocardial ischemia. Whilst this is a reliable non-invasive method of calculating FFR, assumptions involved in the analysis still need to be investigated for further improvement in predictive accuracy. In this study, we analyzed the influence of inlet and outlet boundary conditions on FFRSS.Methods: A clinical trial was carried out in Peking University People's Hospital. We enrolled 15 patients with coronary heart disease. All patients underwent coronary CTA examination, aortic pressure measurement and FFR catheter surgery. In order to better reflect the relationship between different entrance boundary conditions and FFRss, we used the invasive measurement of FFR as the standard, and calculated FFRss for 15 patients with coronary heart disease with different degrees of stenosis. The boundary conditions are divided into two groups: (1) pressure calculated based on physiological formula; (2) clinically measured aortic pressure. Based on the boundary conditions calculated by the physiological formula, we further studied the changes of FFRss under different coronary vasodilation responses (12%-48% baseline).Results: The research results show that although the pressure difference between the two pressure boundary conditions is 15mmHg, the FFRss calculation result does not change significantly. With the change of the vasodilation state, the microcirculation resistance of the exit boundary condition gradually increased, and the calculated FFR value increased.Conclusions: We found that changes in the microcirculation resistance of coronary stenoses have a huge impact on FFRss. The changes in FFRss values caused by boundary conditions are due to the overestimation of the vasodilation response. Therefore, individualizing the hyperemia state of the stenotic vessel microcirculation resistance value is an effective method to improve the calculation of FFR.

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Section: Introductionmentioning

confidence: 99%

On Intlet Pressure Boundary Conditions for CT-Based Computation of FFRSS: Clinical Measurement of Aortic Pressure

Liu¹,

Wang²,

Ma³

et al. 2021

Preprint

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Comparison of Ticagrelor Versus Prasugrel for Inflammation, Vascular Function, and Circulating Endothelial Progenitor Cells in Diabetic Patients With Non–ST-Segment Elevation Acute Coronary Syndrome Requiring Coronary Stenting

Jeong

Hong

Cho

et al. 2017

JACC: Cardiovascular Interventions

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Compared with prasugrel, ticagrelor significantly decreased inflammatory cytokines such as interleukin 6 and tumor necrosis factor alpha and increased circulating EPCs, contributing to improved arterial endothelial function in diabetic non-ST-segment elevation acute coronary syndrome patients. Thus, data support that pleiotropic effects of ticagrelor beyond its potent antiplatelet effects could contribute to additional clinical benefits. (Comparison of Ticagrelor vs. Prasugrel on Inflammation, Arterial Stiffness, Endothelial Function, and Circulating Endothelial Progenitor Cells in Diabetic Patients With Non-ST Elevation Acute Coronary Syndrome [NSTE-ACS] Requiring Coronary Stenting; NCT02487732).

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Letter by Michiels et al Regarding Article, “Diagnostic Accuracy of Combined Intracoronary Pressure and Flow Velocity Information During Baseline Conditions: Adenosine-Free Assessment of Functional Coronary Lesion Severity”

Cited by 2 publications

References 6 publications

On Intlet Pressure Boundary Conditions for CT-Based Computation of FFRSS: Clinical Measurement of Aortic Pressure

On Intlet Pressure Boundary Conditions for CT-Based Computation of FFRSS: Clinical Measurement of Aortic Pressure

Comparison of Ticagrelor Versus Prasugrel for Inflammation, Vascular Function, and Circulating Endothelial Progenitor Cells in Diabetic Patients With Non–ST-Segment Elevation Acute Coronary Syndrome Requiring Coronary Stenting

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