Coronary physiology assessment in the catheterization laboratory

Díez-Delhoyo, Felipe; Gutiérrez‐Ibañes, Enrique; Loughlin, Gerard; Sanz‐Ruiz, Ricardo; Vázquez-Álvarez, María Eugenia; Sarnago-Cebada, Fernando; Angulo-Llanos, Rocío; Casado-Plasencia, Ana; Elı́zaga, Jaime; Díaz, Francisco Fernández Avilés

doi:10.4330/wjc.v7.i9.525

Cited by 34 publications

(20 citation statements)

References 70 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…CMD can only be indirectly assessed using invasive and noninvasive techniques that measure parameters strongly dependent on the functional and structural integrity of coronary microcirculation [18]. In the coronary catheterization laboratory, CMD is commonly diagnosed by evaluating coronary blood flow before and after administration of adenosine with a Doppler-tipped guide wire in the coronary artery [19]. However, the corrected thrombolysis in myocardial infarction (TIMI) frame count (cTFC) and myocardial blush grade (MBG) provide easy and accessible angiographic indexes of coronary blood flow that do not require additional coronary artery instrumentation [20].…”

Section: Beyond Epicardial Obstructive Coronary Artery Disease Micromentioning

confidence: 99%

Sex and Gender Differences in Ischemic Heart Disease: Endocrine Vascular Disease Approach (EVA) Study Design

Raparelli

Proietti

Lenzi

et al. 2018

J. of Cardiovasc. Trans. Res.

View full text Add to dashboard Cite

Improvements in ischemic heart disease (IHD) management have been unbalanced between sexes, with coronary microvascular dysfunction considered the likely underlying reason. The Endocrine Vascular disease Approach (EVA) is an observational study (Clinicaltrial.gov NCT02737982) aiming to assess sex and gender interactions between coronary circulation, sexual hormones, and platelet function. Consecutive patients with IHD undergoing coronary angiography will be recruited: (1) to assess sex and gender differences in angiographic reperfusion indexes; (2) to evaluate the effects of estrogen/androgen on sex-related differences in myocardial ischemia; (3) to investigate the platelet biology differences between men and women with IHD; (4) to verify sexand gender-driven interplay between response to percutaneous coronary intervention, platelets, sex hormones, and myocardial damage at baseline and its impact on 12-month outcomes. The integration of sex and gender in this translational project on IHD will contribute to the identification of new targets for further innovative clinical interventions. Keywords Sex. Gender. Coronary microvascular dysfunction. Sex steroid hormones. Platelet function. Clinical outcomes. Myocardial blush grade Abbreviations 1VD One-vessel disease 2VD Two-vessel disease 3VD Three-vessel disease ACS Acute coronary syndrome AR Androgen receptors CAD Coronary artery disease CMD Coronary microvascular dysfunction CMR Cardiac magnetic resonance CVD Cardiovascular disease E2 Estradiol eCRFs Electronic case report forms ER Estrogen receptor GP Glycoprotein IHD Ischemic heart disease INOCA Ischemia and no obstructive CAD MACE Major adverse cardiovascular events MBG Myocardial blush grade MMAS-4 Morisky Medication Adherence Scale-4 Items NOS Nitric oxide synthase NOX2 NADPH oxidase 2 NSTEMI Non-ST elevation myocardial infarction PCI Percutaneous coronary intervention STEMI ST elevation myocardial infarction (c)TFC (corrected) TIMI frame count Associate Editor Enrique Lara-Pezzi oversaw the review of this article

show abstract

Section: Beyond Epicardial Obstructive Coronary Artery Disease Micromentioning

confidence: 99%

Sex and Gender Differences in Ischemic Heart Disease: Endocrine Vascular Disease Approach (EVA) Study Design

Raparelli

Proietti

Lenzi

et al. 2018

J. of Cardiovasc. Trans. Res.

View full text Add to dashboard Cite

show abstract

“…In normal conditions, the coronary blood flow can triple when required, so a coronary flow reserve above 3.0 is considered as normal. Conversely, a coronary flow reserve < 2.0 is considered as pathological and is associated with poor outcome in patients with cardiovascular disease (Kern et al, 2006;Johnson and Gould, 2012;Díez-Delhoyo et al, 2015). In a study concerning 70 patients presenting septic shock with preserved left ventricular ejection fraction, Ikonomidis et al showed a decreased coronary flow reserve, whose intensity was correlated with the severity of the disease.…”

Section: Discussionmentioning

confidence: 99%

Early Hyperdynamic Sepsis Alters Coronary Blood Flow Regulation in Porcine Fecal Peritonitis

Boudart

Pitisci

et al. 2021

Front. Physiol.

View full text Add to dashboard Cite

Background: Sepsis is a common condition known to impair blood flow regulation and microcirculation, which can ultimately lead to organ dysfunction but such contribution of the coronary circulation remains to be clarified. We investigated coronary blood flow regulatory mechanisms, including autoregulation, metabolic regulation, and endothelial vasodilatory response, in an experimental porcine model of early hyperdynamic sepsis.Methods: Fourteen pigs were randomized to sham (n = 7) or fecal peritonitis-induced sepsis (n = 7) procedures. At baseline, 6 and 12 h after peritonitis induction, the animals underwent general and coronary hemodynamic evaluation, including determination of autoregulatory breakpoint pressure and adenosine-induced maximal coronary vasodilation for coronary flow reserve and hyperemic microvascular resistance calculation. Endothelial-derived vasodilatory response was assessed both in vivo and ex vivo using bradykinin. Coronary arteries were sampled for pathobiological evaluation.Results: Sepsis resulted in a right shift of the autoregulatory breakpoint pressure, decreased coronary blood flow reserve and increased hyperemic microvascular resistance from the 6th h after peritonitis induction. In vivo and ex vivo endothelial vasomotor function was preserved. Sepsis increased coronary arteries expressions of nitric oxide synthases, prostaglandin I2 receptor, and prostaglandin F2α receptor.Conclusion: Autoregulation and metabolic blood flow regulation were both impaired in the coronary circulation during experimental hyperdynamic sepsis, although endothelial vasodilatory response was preserved.

show abstract

“…CFR was calculated from coronary blood flow velocity measurements, which were derived from Doppler-velocity wire data recorded in real time via a dedicated console [15]. The average peak velocity (APV) at baseline (APVb), and peak hyperemia (APVp) were automatically determined by integrated software.…”

Section: Observational Endpoint 1: Coronary Flow Reservementioning

confidence: 99%

Coronary Flow Reserve Assessment of Orbital Atherectomy: An Observational Pilot Study

Dib¹,

Martinsen²,

Anose³

et al. 2019

JBiSE

View full text Add to dashboard Cite

The aim of this prospective observational pilot study was to observe the impact of orbital atherectomy (OA) on the coronary microcirculation via coronary flow reserve (CFR) measurements. Fifteen subjects who had successful OA and stent placement with no procedural complication were enrolled at 3 hospitals in the U.S. Baseline and hyperemic velocities were 16 ± 5.2 and 36 ± 14 cm/sec, respectively. The average CFR post-procedure was within the normal range at 2.23 ± 0.33. The observation of normal CFR following OA may be attributed to the orbital action of the device that allows for continuous flow during treatment, minimizing a bolus embolization effect which can impact microvascular function.

show abstract

Coronary physiology assessment in the catheterization laboratory

Cited by 34 publications

References 70 publications

Sex and Gender Differences in Ischemic Heart Disease: Endocrine Vascular Disease Approach (EVA) Study Design

Sex and Gender Differences in Ischemic Heart Disease: Endocrine Vascular Disease Approach (EVA) Study Design

Early Hyperdynamic Sepsis Alters Coronary Blood Flow Regulation in Porcine Fecal Peritonitis

Coronary Flow Reserve Assessment of Orbital Atherectomy: An Observational Pilot Study

Contact Info

Product

Resources

About