2012
DOI: 10.1016/j.yjmcc.2011.07.025
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Coronary pressure-flow relations as basis for the understanding of coronary physiology

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Cited by 98 publications
(66 citation statements)
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“…However, FFR and hyperemic flow velocity, as an important factor in CFVR, are intrinsically related by a curvilinear pressure drop-flow velocity relationship resulting from the combined effect of Poiseuille's and Bernouilli's Law on stenosis hemodynamics. 4,14 As a result, the pressure drop across a stenosis increases with increasing flow through the stenosis. Consequently, for a given stenosis, FFR and CFVR per definition move in opposite directions with changing hyperemic flow through the stenosis.…”
Section: Discordance Between Ffr and Cfvr: Is Only One Of Them Correct?mentioning
confidence: 99%
See 1 more Smart Citation
“…However, FFR and hyperemic flow velocity, as an important factor in CFVR, are intrinsically related by a curvilinear pressure drop-flow velocity relationship resulting from the combined effect of Poiseuille's and Bernouilli's Law on stenosis hemodynamics. 4,14 As a result, the pressure drop across a stenosis increases with increasing flow through the stenosis. Consequently, for a given stenosis, FFR and CFVR per definition move in opposite directions with changing hyperemic flow through the stenosis.…”
Section: Discordance Between Ffr and Cfvr: Is Only One Of Them Correct?mentioning
confidence: 99%
“…2,3 Nonetheless, the impact of a coronary stenosis on myocardial perfusion may alternatively be quantified by the coronary blood flow-derived coronary flow velocity reserve (CFVR). 4 Despite the fact that the diagnostic accuracy of FFR and CFVR is known to be equivalent, 5 FFR and CFVR results are discordant in 30% to 40% of coronary stenoses 6,7 : a phenomenon proposed to originate from divergent distribution of epicardial and microvascular involvement in coronary artery disease ( Figure 1). 8,9 Daily practice is likely governed by a combination of epicardial and microvascular involvement, where the extent of microvascular involvement remains elusive to the interventionalist when only coronary pressure is assessed.…”
mentioning
confidence: 99%
“…20 Of note, FFR and CFVR are complementary parameters, and may be discordant in the evaluation of the same coronary lesion, because of the relative contribution of epicardial stenoses and coronary microvascular dysfunction. 21 Landmark studies have introduced FFR in the clinical practice. 22 The FAME study has convincingly shown a clinical benefit of FFR-guided vs. CAG-guided myocardial revascularization in patients presenting with multivessel disease, using a cutoff of 0.80, 23,24 and the FAME 2 study has recently demonstrated that, in patients with stable CAD, FFR-guided PCI as compared with medical therapy alone, improves the outcome principally by a lower rate of urgent revascularization in the PCI group (4.0% vs. 16.3%; hazard ratio (HR): 0.23; 95% confidence interval (CI): 0.14 to 0.38; P<0.001).…”
Section: Functional Tests For the Assessment Of Endothelial Dysfunctimentioning
confidence: 99%
“…6 Consequently, in order to supply the four-to fivefold increase in oxygen delivery that the myocardium requires under conditions of exercise or stress, blood flow must increase by a similar amount. Normally this is achieved by a beautifully coordinated vascular response involving neural, chemical and physical factors such as shear stress acting on several different regions of the coronary circulation.…”
Section: Ischaemic Heart Diseasementioning
confidence: 99%