Measuring pressure-derived fractional flow reserve through four french diagnostic catheters

Legalery, Pierre; Seronde, Marie‐France; Méneveau, Nicolas; Schiele, François; Bassand, Jean‐Pierre

doi:10.1016/s0002-9149(03)00151-6

Cited by 17 publications

(6 citation statements)

References 16 publications

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“…The reliability of FFR measurements made with 4 Fr diagnostic catheters has been demonstrated previously. 16) In our study, 5 Fr diagnostic catheters were required to measure accurate transit time by saline injection. Measurement of IMR has been used in various clinical settings.…”

Section: Discussionmentioning

confidence: 99%

“…Coronary physiology measurements: Coronary physiology measurements were performed for all intermediate stenoses, as described previously. 8,[14][15][16][17][18][19] All patients received an intravenous bolus injection of 5,000 IU of heparin and intracoronary isosorbide dinitrate (1-2 mg) before angiography. A coronary 0.014-inch pressure-temperature sensor guidewire (Certus, St. Jude Medical, St. Paul, MN, USA) threaded through 5 Fr diagnostic catheters was used for measurements after a diagnostic coronary angiogram (CAG) (Figure 1).…”

Section: Methodsmentioning

confidence: 99%

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Impact of Smoking on Coronary Microcirculatory Resistance in Patients With Coronary Artery Disease

et al. 2015

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SummaryThe aim of this study was to investigate the relationship between coronary microvascular function and smoking using the 3 parameters fractional flow reserve (FFR), coronary flow reserve (CFR thermo ), and index of microcirculatory resistance (IMR) in patients with coronary artery disease (CAD). A total of 97 CAD patients with 148 intermediate stenotic lesions were divided into two groups: current and former smokers (Smokers: n = 54), and those who had never smoked (Non-smokers: n = 43). Coronary physiology measurements were made following coronary angiography at rest and during hyperemia induced with intravenous adenosine triphosphate. If a patient had several intermediate lesions, the lesion producing the largest IMR value and minimum FFR myo and CFR thermo value was selected. Averaged over all patients, the FFR myo , CFR thermo , and IMR values were 0.86 ± 0.10, 2.66 ± 1.50, and 20.8 ± 10.7, respectively. There was no significant correlation between FFR myo and IMR. There were no significant differences between smokers and non-smokers in FFR myo value ( perfusion is dependent on both epicardial and microvascular resistance. 1) An increased microcirculatory resistance indicates the presence of coronary microvascular dysfunction (CMVD), a term introduced to describe abnormalities in the regulation of microvascular blood flow. CMVD has been found to play an important role in determining ischemic threshold 2) and to be independent of epicardial stenosis severity.3) Smoking is known to be associated with the development of epicardial atherosclerosis and impairment of coronary endothelial function. [4][5][6] However, the effects of smoking on coronary microvascular function are unknown.Recently, a parameter called the index of microcirculatory resistance (IMR) was proposed for evaluating coronary microvascular function. The advantage of this parameter is that it could be calculated from values obtained using a coronary temperature and pressure sensing guidewire. 7) IMR has been found to be a reproducible index and to be independent of epicardial stenosis severity.7-10) The aim of this study was to investigate the relationship between microvascular function and smoking in patients with CAD by comparing 3 coronary physiology parameters, fractional flow reserve (FFR), coronary flow reserve (CFR), and IMR, between patients with and without a smoking history. MethodsStudy population: A total of 97 patients with CAD who had 148 discrete intermediate grade stenotic lesions (40-70% diameter stenosis on visual assessment) and visited the Department of Cardiovascular Medicine, Kashiwa Municipal Hospital (Chiba, Japan) from August 2010 to August 2013 were retrospectively enrolled. To examine the relationship between coronary physiology and smoking, patients were divided into two groups based on smoking status; current and former smokers (smokers), and those who had never smoked (non-smokers). The exclusion criteria were 1) history of coronary artery bypass surgery; 2) history of myocardial infarction (MI); 3) recent MI,...

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Impact of Smoking on Coronary Microcirculatory Resistance in Patients With Coronary Artery Disease

et al. 2015

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“…FFR measurement was strongly encouraged in all patients with intermediate coronary lesions (defined as an angiographic diameter of stenosis between 40 and 70% on visual estimation), and without demonstrable ischemia. Initial FFR was measured using a wire fitted with a pressure sensor at the tip of the catheter (Volcano, San Diego, CA, USA), and analysed according to the recommended technique 14 , with 4-6 French diameter catheters 15 during maximal hyperemia induced by injection of an intracoronary bolus of adenosine (effect similar to 140 µg intravenous 16 ). The average of three consecutive FFR measures was recorded, and the decision to proceed to revascularization was made…”

Section: Methodsmentioning

confidence: 99%

Effect of Fractional Flow Reserve (≤0.90 vs >0.90) on Long-Term Outcome (>10 Years) in Patients With Nonsignificant Coronary Arterial Narrowings

Badoz

Chatot

Hechema

et al. 2016

The American Journal of Cardiology

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“…However, a recent study by Legalery et al . [ 19 ] has demonstrated that FFR measurement can also be safely performed through a conventional 4F diagnostic catheter. The use of diagnostic catheters is technically feasible.…”

Section: F Ractional F Low R mentioning

confidence: 99%

Clinical Relevance of Coronary Fractional Flow Reserve

Adiputra

Chen

2015

Chinese Medical Journal

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Objective:The objective was to delineate the current knowledge of fractional flow reserve (FFR) in terms of definition, features, clinical applications, and pitfalls of measurement of FFR.Data Sources:We searched database for primary studies published in English. The database of National Library of Medicine (NLM), MEDLINE, and PubMed up to July 2014 was used to conduct a search using the keyword term “FFR”.Study Selection:The articles about the definition, features, clinical application, and pitfalls of measurement of FFR were identified, retrieved, and reviewed.Results:Coronary pressure-derived FFR rapidly assesses the hemodynamic significance of individual coronary artery lesions and can readily be performed in the catheterization laboratory. The use of FFR has been shown to effectively guide coronary revascularization procedures leading to improved patient outcomes.Conclusions:FFR is a valuable tool to determine the functional significance of coronary stenosis. It combines physiological and anatomical information, and can be followed immediately by percutaneous coronary intervention (PCI) if necessary. The technique of FFR measurement can be performed easily, rapidly, and safely in the catheterization laboratory. By systematic use of FFR in dubious stenosis and multi-vessel disease, PCI can be made an even more effective and better treatment than it is currently. The current clinical evidence for FFR should encourage cardiologists to use this tool in the catheterization laboratory.

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Measuring pressure-derived fractional flow reserve through four french diagnostic catheters

Cited by 17 publications

References 16 publications

Impact of Smoking on Coronary Microcirculatory Resistance in Patients With Coronary Artery Disease

Impact of Smoking on Coronary Microcirculatory Resistance in Patients With Coronary Artery Disease

Effect of Fractional Flow Reserve (≤0.90 vs >0.90) on Long-Term Outcome (>10 Years) in Patients With Nonsignificant Coronary Arterial Narrowings

Clinical Relevance of Coronary Fractional Flow Reserve

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