The relationship between the basal coronary translesional pressure ratio and fractional flow reserve

2017 ◽  
Vol 90 (5) ◽  
pp. 745-753 ◽  
Author(s):  
William M. Wilson ◽  
Anoop S. V. Shah ◽  
Duncan Birse ◽  
Emma Harley ◽  
David B. Northridge ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Pressure Ratio ◽  
Fractional Flow ◽  
Flow Reserve ◽  
The Relationship

scholarly journals The relationship between coronary stenosis morphology and fractional flow reserve: a computational fluid dynamics modelling study

2021 ◽  
Author(s):  
Roberto T F Newcombe ◽  
Rebecca C Gosling ◽  
Vignesh Rammohan ◽  
Patricia V Lawford ◽  
D Rodney Hose ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Coronary Artery ◽  
Fractional Flow Reserve ◽  
Computational Modelling ◽  
Fractional Flow ◽  
Cfd Modelling ◽  
Flow Reserve ◽  
The Relationship ◽  
Lesion Severity

Abstract Background International guidelines mandate the use of fractional flow reserve (FFR) and/or non-hyperaemic pressure ratios to assess the physiological significance of moderate coronary artery lesions to guide revascularisation decisions. However, they remain underused such that visual estimation of lesion severity continues to be the predominant decision-making tool. It would be pragmatic to have an improved understanding of the relationship between lesion morphology and haemodynamics. Aims To compute virtual FFR (vFFR) in idealised coronary artery geometries with a variety of stenosis and vessel characteristics Methods Coronary artery geometries were modelled, based upon physiologically realistic branched arteries. Common stenosis characteristics were studied, including % narrowing, length, eccentricity, shape, number, position relative to branch, and distal (myocardial) resistance. Computational fluid dynamics (CFD) modelling was used to calculate vFFRs using the VIRTUheartTM system. Results Percentage lesion severity had the greatest effect upon FFR. Any ≥80% diameter stenosis in two views (i.e. concentric) was physiologically significant (FFR ≤ 0.80), irrespective of length, shape or vessel diameter. Almost all eccentric stenoses and all 50% concentric stenoses were physiologically non-significant, whilst 70% uniform concentric stenoses about 10mm long straddled the ischaemic threshold (FFR 0.80). A low microvascular resistance (MVR) reduced FFR on average by 0.05, and a high MVR increased it by 0.03. Conclusions Using computational modelling, we have produced an analysis of virtual FFR that relates stenosis characteristics to haemodynamic significance. The strongest predictor of a positive virtual FFR was a concentric, ≥80% diameter stenosis. The importance of MVR was quantified. Other lesion characteristics have a limited impact.

scholarly journals The Relationship between Fractional Flow Reserve, Platelet Reactivity and Platelet Leukocyte Complexes in Stable Coronary Artery Disease

PLoS ONE ◽  
2013 ◽  
Vol 8 (12) ◽  
pp. e83198 ◽  
Author(s):  
Jan-Willem E. M. Sels ◽  
Bert Rutten ◽  
Thijs C. van Holten ◽  
Marieke A. K. Hillaert ◽  
Johannes Waltenberger ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Fractional Flow Reserve ◽  
Platelet Reactivity ◽  
Stable Coronary Artery Disease ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Artery Disease ◽  
The Relationship

Combining Baseline Distal-to-Aortic Pressure Ratio and Fractional Flow Reserve in the Assessment of Coronary Stenosis Severity

2015 ◽  
Vol 8 (13) ◽  
pp. 1681-1691 ◽  
Author(s):  
Mauro Echavarría-Pinto ◽  
Tim P. van de Hoef ◽  
Martijn A. van Lavieren ◽  
Sukhjinder Nijjer ◽  
Borja Ibañez ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Coronary Stenosis ◽  
Pressure Ratio ◽  
Aortic Pressure ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Stenosis Severity

scholarly journals TCT-300 Combining baseline distal-to-aortic pressure ratio and fractional flow reserve in the assessment of coronary stenosis severity

2015 ◽  
Vol 66 (15) ◽  
pp. B119
Author(s):  
Mauro Echavarria-Pinto ◽  
Tim P. van de Hoef ◽  
Martijn A. van Lavieren ◽  
Sukhjinder S. Nijjer ◽  
Borja Ibañez ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Coronary Stenosis ◽  
Pressure Ratio ◽  
Aortic Pressure ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Stenosis Severity

Prognostic value of pre-revascularization fractional flow reserve mediated by the post-revascularization level: a causal mediation analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Hamaya ◽  
M Mittleman ◽  
M Hoshino ◽  
Y Kanaji ◽  
J Lee ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Mediation Analysis ◽  
Prognostic Value ◽  
Coronary Intervention ◽  
Fractional Flow ◽  
Prognostic Information ◽  
Causal Mediation ◽  
Flow Reserve ◽  
Causal Mediation Analysis ◽  
The Relationship

Abstract Background The prognostic value of pre-percutaneous coronary intervention (PCI) fractional flow reserve (FFR) can depend on that of the post-PCI FFR and their interaction. To correctly interpret the prognostic value of pre-PCI FFR, it is essential to understand to what extent the relationship between pre-PCI FFR and clinical outcome is explained by pre-PCI FFR-related post-PCI FFR. Purpose The aim of this study is to investigate the extent to which post-PCI FFR mediates the relationship between pre-PCI FFR and vessel-related outcomes using a global, multicenter collaboration registry. Methods Patient data from 4 global FFR registries were pooled and 1488 patients with pre-PCI FFR ≤0.80 were analyzed. The primary outcome was target vessel failure (TVF) during 2-years of follow-up. We evaluated the extent to which post-PCI FFR <0.90 mediated the association between pre-PCI FFR <0.75 and TVF employing a causal mediation analysis in a counterfactual framework. Results Among 1488 patients, the mean (standard deviation) age was 63.5 (9.9) years and 78% (1161 patients) were male. The median (IQR) pre-PCI and post-PCI FFR were 0.71 (0.62–0.76) and 0.88 (0.83–0.92), respectively. The direct effect of low pre-PCI FFR (<0.75) on TVF was significantly elevated (OR: 1.81, 95% CI: 1.03–3.18, p=0.038), and was not mediated by post-PCI FFR<0.90 (indirect effect, OR: 1.01, 95% CI: 0.98–1.05, p=0.39). In the model, post-PCI FFR explained only 2.2% of the association between pre-PCI FFR and TVF. The subgroup analysis implicated that the prognostic information of pre-PCI FFR was mainly for diffuse lesions. Conclusions The prognostic information of pre-PCI FFR did not greatly depend on the results of PCI assessed by post-PCI FFR. Pre-PCI FFR, as a prognostic marker, may mainly reflect the global atherosclerotic burden of the artery, not the extent of the modifiable epicardial stenosis, thus providing independent information from post-PCI FFR. Interpretation Funding Acknowledgement Type of funding source: None

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