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Intravascular Physiology, An Issue of Interventional Cardiology Clinics, E-Book

Intravascular Physiology, An Issue of Interventional Cardiology Clinics, E-Book

Allen Jeremias

(2016)

Additional Information

Abstract

This issue of Interventional Cardiology Clinics, edited by Allen Jeremias, is devoted to Intravascular Physiology. Dr. Jeremias assembled a group of expert contributors to review the following topics: Evolution of Coronary Physiology – Basic Concepts of FFR and CFR; Concept of "Functional PCI" – The Rational for Physiologic Lesion Assessment for PCI Guidance; Limitations and Pitfalls of FFR and Adenosine-Induced Hyperemia; Evidence for the Use of FFR to Guide Clinical Decision-Making – The Landmark FFR Clinical Trials; Evaluation of Microvascular Disease and Clinical Outcomes; Hyperemic vs. Resting Indices for the Assessment of CAD; FFR for the Evaluation of Tandem and Bifurcations Lesions, Left Main, and Acute Coronary Syndromes; and CT-FFR: Basic Concept and Clinical Implementation.

Table of Contents

Section Title Page Action Price
Front Cover Cover
INTERVENTIONAL CARDIOLOGY CLINICS i
Copyright ii
CONTRIBUTORS iii
EDITOR-IN-CHIEF iii
EDITOR iii
AUTHORS iii
CONTENTS v
Prefaceix v
History and Development of Coronary Flow Reserve and Fractional Flow Reserve for Clinical Applications397 v
The Concept of Functional Percutaneous Coronary Intervention: Why Physiologic Lesion Assessment Is Integral to Coronary Ang ... v
Limitations and Pitfalls of Fractional Flow Reserve Measurements and Adenosine-Induced Hyperemia419 v
Landmark Fractional Flow Reserve Trials435 vi
Evaluation of Microvascular Disease and Clinical Outcomes443 vi
Can Resting Indices Obviate the Need for Hyperemia and Promote the Routine Use of Physiologically Guided Revascularization?459 vi
Fractional Flow Reserve for the Evaluation of Tandem and Bifurcation Lesions, Left Main, and Acute Coronary Syndromes471 vi
Noninvasive Fractional Flow Reserve Derived from Coronary Computed Tomography Angiography for the Diagnosis of Lesion-speci ... vii
Association of Wall Shear Stress with Coronary Plaque Progression and Transformation491 vii
INTRAVASCULAR PHYSIOLOGY viii
FORTHCOMING ISSUES viii
RECENT ISSUES viii
Coronary Physiology: Basic Concepts and Clinical Applications ix
History and Development of Coronary Flow Reserve and Fractional Flow Reserve for Clinical Applications 397
KEY POINTS 397
INTRODUCTION 397
CLINICAL MOTIVATIONS 398
TECHNICAL DEVELOPMENTS 400
CORONARY FLOW RESERVE 401
FRACTIONAL FLOW RESERVE 403
SUMMARY 405
FINANCIAL SUPPORT AND RELATIONSHIPS WITH INDUSTRY 406
REFERENCES 407
The Concept of Functional Percutaneous Coronary Intervention 411
KEY POINTS 411
INTRODUCTION 411
APPROPRIATE USE CRITERIA FOR CORONARY REVASCULARIZATION 412
NONINVASIVE ISCHEMIC EVALUATION 412
ANATOMIC LESION SEVERITY AND CORONARY HEMODYNAMICS 413
INVASIVE EVALUATION OF ISCHEMIA 414
FRACTIONAL FLOW RESERVE AS AN INTEGRAL PART OF CORONARY ANGIOGRAPHY 414
A NEW APPROACH OF FUNCTIONAL ANGIOGRAPHY 415
SUMMARY 416
REFERENCES 416
Limitations and Pitfalls of Fractional Flow Reserve Measurements and Adenosine-Induced Hyperemia 419
KEY POINTS 419
INTRODUCTION 419
BASIC PRINCIPLES AND PREREQUISITES 419
PITFALLS OF FRACTIONAL FLOW RESERVE MEASUREMENTS 420
Mechanical Issues: Transducers, Zeros, Connections 420
Beat-to-Beat Variation 421
Damping of Pressure by Guiding Catheter 421
Catheters with Side Holes 421
Guide Wire Whipping Phenomenon 423
Wire Signal Drift 423
Wire Spasm and Pseudostenosis 424
Effect of Hydrostatic Pressure 426
Pressure Recovery 426
Effects of Central Venous Pressure 426
LIMITATIONS OF METHODS FOR INDUCTION OF HYPEREMIA 427
Methylxanthines and Adenosine Maximal Hyperemia 427
Intracoronary Versus Intravenous Adenosine-Induced Hyperemia 428
Peripheral Versus Central Intravenous Adenosine Infusion 428
Variable Responses to Intravenous Adenosine Infusion 429
LIMITATIONS OF A SINGLE CUTOFF VALUE 431
Fractional Flow Reserve in Difficult Anatomic Subsets 432
SUMMARY 433
REFERENCES 433
Landmark Fractional Flow Reserve Trials 435
KEY POINTS 435
INTRODUCTION 435
VALIDATION IN COMPARISON TO NONINVASIVE ISCHEMIA ASSESSMENT 436
SAFETY OF REVASCULARIZATION DEFERRAL WITH NORMAL FRACTIONAL FLOW RESERVE IN SINGLE-VESSEL CORONARY DISEASE 436
FRACTIONAL-FLOW-RESERVE-GUIDED REVASCULARIZATION IN MULTIVESSEL DISEASE 437
FRACTIONAL-FLOW-RESERVE-GUIDED REVASCULARIZATION AMONG PATIENTS WITH STABLE CORONARY DISEASE 439
SUMMARY/DISCUSSION 440
REFERENCES 441
Evaluation of Microvascular Disease and Clinical Outcomes 443
KEY POINTS 443
INTRODUCTION 443
DIRECT ANGIOGRAPHIC ASSESSMENT 444
CORONARY FLOW RESERVE 446
RESTING CORONARY FLOW PATTERNS 448
INDEX OF MICROCIRCULATORY RESISTANCE 448
INSTANTANEOUS HYPEREMIC DIASTOLIC VELOCITY-PRESSURE SLOPE 450
WAVE INTENSITY ANALYSIS 451
SUMMARY 452
REFERENCES 453
Can Resting Indices Obviate the Need for Hyperemia and Promote the Routine Use of Physiologically Guided Revascularization? 459
KEY POINTS 459
INTRODUCTION 459
IS HYPEREMIA PHYSIOLOGICALLY ESSENTIAL FOR THE PRESSURE-ONLY ASSESSMENT OF A STENOSIS? 460
IS HYPEREMIA ESSENTIAL TO UNMASK TRUE STENOSIS SEVERITY? 462
IS HYPEREMIA USEFUL IN VESSELS WITH TANDEM STENOSES? 463
FUTURE AREAS FOR DEVELOPMENT 465
SUMMARY 467
ACKNOWLEDGMENTS 467
REFERENCES 467
Fractional Flow Reserve for the Evaluation of Tandem and Bifurcation Lesions, Left Main, and Acute Coronary Syndromes 471
KEY POINTS 471
INTRODUCTION 471
FRACTIONAL FLOW RESERVE IN TANDEM LESIONS 471
FRACTIONAL FLOW RESERVE IN OSTIAL OR BIFURCATION LESIONS 473
Difficulty in Angiographic or Anatomic Evaluation 473
Outcomes of Percutaneous Coronary Intervention of Ostial or Bifurcation Lesions Are Poor 474
FRACTIONAL FLOW RESERVE IN LEFT MAIN CORONARY ARTERY DISEASE 475
FRACTIONAL FLOW RESERVE IN ACUTE CORONARY SYNDROMES 475
Fractional Flow Reserve in Chronic Myocardial Infarction 477
Fractional Flow Reserve of Nonculprit Vessel in ST Elevation Myocardial Infarction 477
Fractional Flow Reserve in Non–ST Elevation Myocardial Infarction 477
SUMMARY 478
REFERENCES 478
Noninvasive Fractional Flow Reserve Derived from Coronary Computed Tomography Angiography for the Diagnosis of Lesion-speci ... 481
KEY POINTS 481
INTRODUCTION 481
FRACTIONAL FLOW RESERVE FOR THE ASSESSMENT OF LESION-SPECIFIC ISCHEMIA 482
NONINVASIVE FRACTIONAL FLOW RESERVE COMPUTED FROM STANDARD CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY IMAGES 483
EVIDENCE IN THE LITERATURE ON THE DIAGNOSTIC VALUE OF FFRCT 484
COST-EFFECTIVENESS OF FFRCT 486
FUTURE PERSPECTIVES 486
SUMMARY 488
REFERENCES 488
Association of Wall Shear Stress with Coronary Plaque Progression and Transformation 491
KEY POINTS 491
INTRODUCTION 491
ROLE OF WALL SHEAR STRESS IN ENDOTHELIAL FUNCTION 492
MECHANOTRANSDUCTION OF WALL SHEAR STRESS IN ENDOTHELIAL CELLS 492
EFFECTS OF WALL SHEAR STRESS ON THE ENDOTHELIUM 493
Endothelial Cell Phenotype 493
Low-density Lipoprotein Uptake 493
Nitric Oxide Production and Endothelial Nitric Oxide Synthase Expression 493
Oxidative Stress 495
Proinflammatory Pathways 495
ROLE OF WALL SHEAR STRESS IN CORONARY PLAQUE PROGRESSION 495
CORONARY PLAQUE TRANSFORMATION 500
SUMMARY 500
REFERENCES 500
ICCL_4_4_bmii - Copy (2) 504
ICCL_4_4_bmii - Copy 505
ICCL_4_4_bmii 506