84 results on '"Intracoronary doppler"'
Search Results
2. Does Coronary Microvascular Spasm Exist? Objective Evidence from Intracoronary Doppler Flow Measurements During Acetylcholine Testing
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Valeria Martínez Pereyra, Fabian Guenther, Peter Ong, Andreas Seitz, Raffi Bekeredjian, and Udo Sechtem
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medicine.medical_specialty ,Intracoronary doppler ,lcsh:Diseases of the circulatory (Cardiovascular) system ,business.industry ,Atypical Angina ,coronary flow reserve ,Provocation test ,Coronary flow reserve ,General Medicine ,Blood flow ,Pathophysiology ,acetylcholine ,coronary spasm ,coronary microcirculation ,lcsh:RC666-701 ,Internal medicine ,medicine ,Cardiology ,cardiovascular diseases ,Angina symptoms ,business ,Acetylcholine ,medicine.drug - Abstract
A 43-year-old woman with recurrent atypical angina underwent invasive coronary angiography including intracoronary Doppler blood flow assessment and coronary spasm provocation testing. While obstructive epicardial disease could be ruled-out angiographically, the patient experienced reproduction of her angina symptoms after intracoronary administration of acetylcholine (100 µg) during spasm provocation testing. Simultaneously, the ECG showed new-onset ST-segment depression in the absence of epicardial spasm. In addition, coronary flow velocity was significantly reduced after acetylcholine compared to the baseline condition. Following intracoronary administration of nitroglycerine (200 µg), the patient’s symptoms as well as the ECG changes and coronary flow reduction were reversed. Considering the ongoing challenges in appropriate evaluation of the pathophysiological mechanisms of coronary microvascular dysfunction, simultaneous intracoronary Doppler flow measurement during spasm testing – as shown in this case – may provide objective evidence for microvascular spasm in addition to the standardized diagnostic criteria, especially if they are ambiguous.
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- 2020
3. The functional reserve of collaterals supplying long-term chronic total coronary occlusions in patients without prior myocardial infarction.
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Werner, Gerald S., Surber, Ralf, Ferrari, Markus, Fritzenwanger, Michael, and Figulla, Hans R.
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REVASCULARIZATION (Surgery) , *DONOR blood supply , *PATIENTS , *MYOCARDIAL infarction , *PERCUTANEOUS coronary intervention - Abstract
Aims Chronic total coronary occlusions (CTOs) with angiographically well-developed collaterals may be considered to provide sufficient blood supply to the occluded segment, and the indication for revascularization may be questioned. Therefore, the collateral function and functional reserve in patients with a CTO without a prior Q-wave myocardial infarction (MI) were assessed. Methods and results Invasive assessment of collateral function was done during successful percutaneous coronary intervention in 107 patients with a CTO and no prior Q-wave MI. Intracoronary Doppler flow velocity and pressure recordings were obtained distal to the occlusion before the first balloon inflation and collateral function indexes calculated. In 62 patients, additional pharmacological stress testing was done by intravenous adenosine (140 mg/kg/min) to assess the collateral flow reserve. Patients with normal and impaired regional dysfunction were compared. Collateral function was similar in patients with and without regional left ventricular (LV) dysfunction. In both groups, 78% collaterals provided a collateral pressure index at baseline .0.3, sufficient to prevent ischaemia during a balloon occlusion, with a minimum of 0.2 in those with preserved LV function. A Doppler-derived function index showed a wider variation due to the high prevalence of microvascular dysfunction in CTOs. Only 7% of patients had an increase in collateral flow reserve .2.0 during pharmacological stress, whereas coronary steal occurred in one-third independent of regional LV function. Conclusion A limited increase in collateral flow and the high prevalence of coronary steal during stress underscore the functional limitation of collaterals in CTOs without prior Q-wave MI. Even presumably 'well-collateralized' CTOs may benefit from a revascularization. [ABSTRACT FROM AUTHOR]
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- 2015
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4. Myocardial Bridging in Absence of Coronary Artery Disease: Proposal of a New Classification Based on Clinical-Angiographic Data and Long-Term Follow-Up.
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Schwarz, Ernst R., Gupta, Rajiv, Haager, Philipp K., vom Dahl, Juergen, Klues, Heinrich G., Minartz, Juergen, and Uretsky, Barry F.
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CARDIOMYOPATHIES , *CORONARY disease , *ISCHEMIA , *HEMODYNAMICS , *ANGIOGRAPHY - Abstract
Background: There is no widely accepted classification to guide therapy in patients with symptomatic myocardial bridging (MB). Methods: A retrospective analysis of 157 patients with chest pain, angiographic MB of the left anterior descending artery without obstructive coronary artery disease (CAD) was performed. Patients were evaluated for clinical symptoms, objective signs of ischemia by stress test, intracoronary Doppler flow measurement and coronary flow reserve. 100 patients without CAD or MB served as controls. Results: There was no difference in clinical symptoms and objective signs of ischemia between controls and patients with MB. The length of MB was 22.6 ± 7.8 mm, maximal systolic luminal diameter reduction 71 ± 16%, and maximal mid-diastolic luminal reduction 34.7 ± 13% as demonstrated by quantitative coronary angiography (QCA). Intracoronary Doppler showed significantly increased average peak flow velocity (APV), average systolic peak velocity (ASPV), average diastolic peak flow velocity (ADPV), and maximal peak velocity (MPV) in MB versus proximal and distal segments at rest and after maximal vasodilatation (p < 0.001 for all parameters). Coronary flow reserve was significantly higher proximally (2.9 ± 0.9) compared with segments distal to the MB (2.0 ± 0.6, p < 0.01). We propose a new MB classification for symptomatic patients with MB:Type A:incidental finding on angiography, no objective signs of ischemia; Type B: objective signs of ischemia, and Type C: with or without objective signs of ischemia and altered intracoronary hemodynamics (by QCA/CFR/intracoronary Doppler). 5-Year follow-up data based on this classification showed that types B and C responded well to β-blockers or calcium channel antagonists. Patients with type C refractory to medical therapy were treated with stenting of the MB. Conclusion: Patients with MB without CAD did not have a higher prevalence of chest pain or abnormal non-invasive stress tests compared to patients without CAD or MB. Intracoronary hemodynamic measurement is a novel approach that may be valuable in defining the functional significance of MB. We propose a classification of symptomatic patients with MB without CAD using non-invasive and invasive parameters to guide therapeutic choices. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
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- 2008
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5. The functional reserve of collaterals supplying long-term chronic total coronary occlusions in patients without prior myocardial infarction.
- Author
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Werner, Gerald S., Surber, Ralf, Ferrari, Markus, Fritzenwanger, Michael, and Figulla, Hans R.
- Abstract
Aims Chronic total coronary occlusions (CTOs) with angiographically well-developed collaterals may be considered to provide sufficient blood supply to the occluded segment, and the indication for revascularization may be questioned. Therefore, the collateral function and functional reserve in patients with a CTO without a prior Q-wave myocardial infarction (MI) were assessed. [ABSTRACT FROM PUBLISHER]
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- 2006
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6. Assessment of coronary flow velocity reserve by noninvasive transthoracic doppler echocardiography in patients with angiographically normal coronary arteries.
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Ya, Yang, Bartel, Thomas, Zhian, Li, and Erbel, Raimund
- Abstract
The measurement of coronary flow velocity reserve (CFVR) by transthoracic Doppler echocardiography (TTDE) with invasive intracoronary Doppler flow wire technique (ICD) was validated and the pathological factors which influence CFVR in patients with angiographically normal coronary arteries were analyzed. CFVR was determined successfully in left anterior descending artery (LAD) in 37 of 40 patients with angiographically normal coronary arteries (men 22, women 15, age 20–75 years, mean age 54±12 years). Coronary flow velocity was measured in the distal LAD by TTDE with contrast enhancement at baseline and during intravenous adenosine infusion of 140 μg/kg per min within 48 h after ICD technique. Average peak velocity at baseline (APVb), average peak velocity during hyperemia (APVh) and CFVR determined from TTDE were correlated closely with those from ICD measurements (APVb: y=0.64x+5.04, r=0.86, P<0.001; APVh: y=0.63x+14.36, r=0.82, P<0.001; CFVR: y=0.65x+0.92, r=0.88, P<0.001). For CFVR measurements, the mean differences between TTDE and ICD methods were 0.12±0.39. CFVR in patients with history of hypertension was significantly lower than that in patients without history of hypertension ( P<0.05). Intravascular ultrasound (IVUS) was performed in 34 patients. Plaque formation was found in LAD by IVUS in 17 (50%) patients. No significant difference in CFVR was found between the patients without plaque formation (3.11±0.49) and those with plaque formation (2.76±0.53, P=0.056). It is suggested that TTDE with contrast enhancement provides reliable measurement of APV and CFVR in the distal LAD. The early stage of atherosclerosis could be detected by IVUS, which may be normal in angiography. CFVR is impaired in patients with history of hypertension compared with that in patients without history of hypertension. [ABSTRACT FROM AUTHOR]
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- 2005
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7. Normal Coronary Physiology Assessed by Intracoronary Doppler Ultrasound.
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Webb, Carolyn, Collins, Peter, and Mario, Carlo
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- 2005
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8. Impaired acute collateral recruitment as a possible mechanism for increased cardiac adverse events in patients with diabetes mellitus.
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Werner, Gerald S., Richartz, Barbara M., Heinke, Stephan, Ferrari, Markus, and Figulla, Hans R.
- Abstract
Background The mortality of coronary artery disease is increased in diabetic patients. An impaired collateral function is considered a possible explanation. This study should assess the influence of diabetes on collaterals by direct invasive assessment of collateral function.Methods In 90 consecutive patients with a chronic coronary occlusion (TCO) of >2 weeks duration a recanalization was done. Thirty patients with diabetes (33%) were compared with 60 (67%) without diabetes. Blood flow velocity and pressure were measured distal to the occlusion by intracoronary Doppler and pressure wires before PTCA, and again after PTCA during a final balloon reocclusion to assess acute recruitment of collaterals. Resistance indexes for collaterals (RColl) and peripheral microcirculation (RP) were calculated.Results The RColl(diabetics: 8.1±6.8 vs nondiabetics: 8.7±6.7mmHgcm−1s−1; p=0.68) and RP(5.6±4.2 vs 6.6±3.8mmHgcm−1s−1; p=0.30) were similar in diabetic and nondiabetic patients before recanalization. During balloon reocclusion both RColland RPincreased. This increase was significantly more pronounced in diabetic than in nondiabetic patients in TCOs <3 months duration. In TCOs of longer duration (⩾3 months) these differences were no longer detectable between both patient groups.Conclusions Diabetic patients with TCOs have similarly developed collaterals as nondiabetic patients. However, in TCOs <3 months duration the acute recruitment of collaterals in case of reocclusion is impaired. This could explain some of the higher complication rate and mortality after coronary interventions in diabetic patients. [ABSTRACT FROM PUBLISHER]
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- 2003
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9. Noninvasive assessment of microvascular function in arterial hypertension by transthoracic doppler harmonic echocardiography
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Bartel, Thomas, Yang, Y.a, Müller, Silvana, Wenzel, René R., Baumgart, Dietrich, Philipp, Thomas, Erbel, Raimund, Yang, Ya, Müller, Silvana, and Wenzel, René R
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ECHOCARDIOGRAPHY , *CORONARY artery stenosis - Abstract
: ObjectivesThe present study sought to investigate the use of transthoracic Doppler harmonic echocardiography (TTDHE) to evaluate changes in coronary flow dynamics due to microvascular dysfunction.: BackgroundCoronary flow velocity reserve (CFVR) measurements by TTDHE are useful for assessing epicardial coronary artery stenoses. It remains unclear, however, if microvascular disease can be detected.: MethodsIn 54 patients with chest pain, intracoronary Doppler (ICD) and TTDHE were used to measure average peak velocity at baseline and hyperemia. Significant coronary lesions had been ruled out by both angiography and intravascular ultrasound. Comparative measurements were performed in the distal left anterior descending coronary artery after intracoronary and intravenous administration of adenosine, and CFVR was calculated. Hypertensive patients (n = 25) were studied and compared to a control group (26 normotensive individuals).: ResultsThree patients (5%) had to be excluded because of insufficient image quality or side effects. In both groups, TTDHE-derived CFVR data correlated closely with ICD measurements (group 1: y = 0.67x + 0.076, standard error of estimate [SEE] = 0.25, r = 0.87, p < 0.001; group 2: y = 0.64x + 1.11, SEE = 0.26, r = 0.87, p < 0.001). CFVR was lower in hypertensives than in normotensive controls (2.44 ± 0.49 vs. 3.33 ± 0.40, p < 0.001, cut point = 2.84).: ConclusionsThe newly described echocardiographic method is suitable for assessing microvascular dysfunction noninvasively and corresponds well to invasive measurements. [Copyright &y& Elsevier]
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- 2002
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10. Non-invasive assessment of coronary flow velocity reserve: A new method using transthoracic Doppler echocardiography.
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Ya, Yang, Bartel, Thomas, Eggebrecht, Holger, Latina, Loredana, Birgelen, Clemems, Caspari, Guido, Xinfang, Wang, and Erbel, Raimund
- Abstract
Transthoracic Doppler echocardiography (TTDE) allows noninvasive flow measurement in the distal left anterior descending artery (LAD). The feasibility of detecting coronary flow by contrast-enhanced TTDE with second harmonic technique was assessed, the coronary flow velocity reserve (CFVR) was evaluated in comparison to intracoronary Doppler flow (ICD) analysis and the CFVR after PTCA in LAD was investigated. In 77 (96%) of 80 patients, CFVR was successfully determined with intravenous adenosine infusion. Doppler signal quality was evaluated in the first 46 patients by use of intravenous Levovist infusion and second harmonic technique. The Doppler flow was not visible in 1 patient only. CFVR determined from TTDE (2.77±0.65) was correlated closely with those from ICD (2.88±0.78) measurements (y=0.73x+0.67, r=0.87, P<0.001). In conclusion, TTDE is a feasible method and provides reliable data on CFVR which can be used for followup after PTCA. [ABSTRACT FROM AUTHOR]
- Published
- 2002
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11. Uncomplicated moderate coronary artery dissections after balloon angioplasty: good outcome without stenting.
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Albertal, M., van Langenhove, G., Regar, E., Kay, I. P., Foley, D., Sianos, G., Kozuma, K., Beijsterveldt, T., Carlier, S. G., Belardi, J. A., Boersma, E., Sousa, J. E., de Bruyne, B., and Serruys, P. W.
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CORONARY arteries , *CORONARY disease , *ANGIOPLASTY , *SURGICAL stents , *TRANSLUMINAL angioplasty , *CARDIOLOGY - Abstract
Objective-To study the relation between moderate coronary dissections, coronary flow velocity reserve (CFVR), and long term outcome. Methods-523 patients undergoing balloon angioplasty and sequential intracoronary Doppler measurements were examined as part of the DEBATE II trial (Doppler endpoints balloon angioplasty trial Europe). After successful balloon angioplasty, patients were randomised to stenting or no further treatment. Dissections were graded at the core laboratory by two observers and divided into four categories: none, mild (type A-B), moderate (type C), severe (types D to F). Patients with severe dissections (n = 128) or without available reference vessel CFVR (n = 139) were excluded. The remaining 256 patients were divided into two groups according to the presence (group A, n = 45) or absence (group B, n = 211) of moderate dissection. Results-Following balloon angioplasty, there was no difference in CFVR between the two groups. At 12 months follow up, a higher rate of major adverse cardiac events was observed over- all in group A than in group B (10 (22%) v 23 (11%), p = 0.041). However, the risk of major adverse events was similar in the subgroups receiving balloon angioplasty (group A, 6 (19%) v group B, 16 (16%), NS). Among group A patients, the adverse events risk was greater in those randomised to stenting (odds ratios 6.603 v 1.197, p = 0.046), whereas there was no difference in risk if the group was analysed according to whether the CFVR was < 2.5 or ? 2.5 after balloon angioplasty. Conclusions-Moderate dissections left untreated result in no increased risk of major adverse cardiac events. Additional stenting does not improve the long term outcome. [ABSTRACT FROM AUTHOR]
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- 2001
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12. An introduction to provisional stenting.
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Di Mario, Carlo and Pijls, Nico HJ
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SURGICAL stents , *TRANSLUMINAL angioplasty - Abstract
Provisional or conditional stenting should be defined as the use of stents limited to those conditions and cases in which the operator, despite an aggressive balloon angioplasty technique with large balloons and high pressure, has been unable to obtain a result that ensures optimal chances of early and late patency. The paramount issue is how to discriminate the patients with optimal results after balloon angioplasty for whom additional stent implantation is unlikely to improve or may even worsen long-term outcome. The better results of elective stent implantation in the OPUS study suggest that visual assessment of the PTCA result is not sufficient to detect lesions with suboptimal lumen gain after PTCA. The addition of physiologic parameters (Doppler flow velocity measurements, fractional flow reserve) has improved the results of the provisional stent group, with the best outcome observed when complex lesions and multivessel treatment were included in these studies (FROST, DESTINI). Intravascular ultrasound, although more expensive and time-consuming, has the additional advantage to guide the dilatation strategy. [ABSTRACT FROM AUTHOR]
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- 2001
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13. Provisional stenting in small vessels.
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Airoldi, Flavio, Di Mario, Carlo, Takagi, Takuro, Stankovic, Goran, Albiero, Remo, and Colombo, Antonio
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SURGICAL stents , *ANGIOGRAPHY - Abstract
Based on the currently available data, the strategy of routine stent placement in unselected lesions located in small coronary arteries provides good immediate results but is still associated with a high incidence of in-stent restenosis. Randomized trials comparing elective stenting with balloon angioplasty have not provided the demonstration that routine stenting is the best strategy for percutaneous intervention in coronary arteries with a reference diameter smaller than 2.75-3.0 mm. This paper describes the rationale for provisional stenting in this clinical setting and reviews the role of quantitative coronary angiography, intracoronary ultrasound and intracoronary Doppler measurements in the identification of lesions that would benefit from adjunctive stent placement after balloon angioplasty and in guiding stent implantation. [ABSTRACT FROM AUTHOR]
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- 2001
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14. Non-invasive characterization of cardiac microvascular disease by nuclear medicine using single-photon emission tomography.
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Wieneke, Heinrich, Zander, Christina, Eising, Ernst, Haude, Michael, Bockisch, Andreas, and Erbel, Raimund
- Abstract
Copyright of Herz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 1999
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15. Functional assessment of coronary artery stenosis by Doppler derived absolute and relative coronary blood flow velocity reserve in comparison with 99mTc MIBI SPECT.
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Verberne, H. J., Piek, J. J., van Liebergen, R. A. M., Koch, K. T., Schroeder-Tanka, J. M., and van Royen, E. A.
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- 1999
16. Value of intracoronary ultrasound and Doppler in the differentiation of angiographically normal coronary arteries: a prospective study in patients with angina pectoris.
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Erbel, A., Ge, J., Bockischt, A., Kearney, P., GÖrge, G., Haude, M., Schümann, D., Zamorano, J., Rupprecht, H. J., and Meyer, J.
- Abstract
Background A substantial proportion of patients undergoing heart catheterization for suspected coronary artery disease have normal angiograms. Coronary morphology and blood flow velocity can be assessed very accurately with intracoronary ultrasound and Doppler. The purpose of this study was to use both methods to classify further patients with suspected coronary artery disease but with coronary angiograms adjudged normal at the time. Methods and results In forty-four patients with suspected coronary artery disease and normal coronary angiograms, intracoronary ultrasound and intracoronary Doppler were performed in the left anterior descending and left main coronary arteries. Coronary flow reserve was obtained by calculating the ratio of the maximal coronary flow mean velocity after the intracoronary administration of 10 mg papaverine to the coronary flow mean velocity at rest. Of 44 patients, 16 (36%) (group I) were found to have normal coronary morphology by intracoronary ultrasound and normal (>3·0) coronary flow reserve (5·3±1·8) In seven patients (16%) (group II) there were normal intracoronary ultrasonic findings but a reduced coronary flow reserve (2·1±0·4). Plaque formation was found in a total of 21 (48%) of the 44 patients; mean plaque sizes were 3·6±1·6 mm2 for those in group III (normal coronary flow reserve) and 5·0±2·3 mm2 for those in group IV (reduced coronary flow reserve). Vessel area in both of these groups.(16·3±8·0 mm2 and 19·2±6·1 mm2) was significantly larger than that of group I (14·6 ± 5·7 mm2, P<0·01). Plaque calcification was found in 25% of those in group III and 44% of those in group IV. Thus, only 36% of the patients with normal angiograms were true normal, 48% exhibited early stage of coronary atherosclerosis, and the other 16% might be considered as syndrome X. Conclusion Intracoronary ultrasound and Doppler can be used to differentiate further heart disease in patients with normal coronary angiograms. Only a minority were true normal. Early signs of atherosclerosis cannot be de tected by coronary angiography. This may have important therapeutic and prognostic implications. [ABSTRACT FROM PUBLISHER]
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- 1996
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17. Principles of interpretation of coronary velocity and pressure tracings.
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Di Mario, C. and Serruys, P. W.
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The development of quantitative angiography and the introduction of new techniques of intracoronary imaging cannot replace the functional methods for the assessment of stenosis severity. The measurement of the trans-stenotic pressure gradient and of the post-stenotic flow velocity using miniaturized sensors with guidewire technology offers an alternative to the conventional non-invasive methods which is applicable in the catheterization laboratory at the time of the interventional procedure The complexity of the coronary circulation, however, limits the possibility of establishing simple cut-off criteria to identify the presence of a flow-limiting stenosis. For intermediate lesions, or in the presence of variable haemodynamic conditions the accuracy of the assessment can be improved by the application of more complex indices, proposed and validated in the animal laboratory and based on the instantaneous relationship between pressure or pressure gradient and flow velocity. [ABSTRACT FROM PUBLISHER]
- Published
- 1995
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18. Torsades de pointes after intracoronary papaverine.
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VROLIX, M., PIESSENS, J., and GEEST, H. DE
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Coronary blood flow velocity and coronary flow reserve can be assessed in humans using a coronary Doppler catheter and the vasodilator papaverine. Although it is a safe, elegant and reproducible technique, serious complications can occur. Coronary flow reserve assessment in a 49-year-old man with a critical stenosis in the proximal part of the circumflex artery was complicated by a papaverine-induced ventricular arrhythmia. Several features of the present case report support papaverine-induced disturbances of the repolarization phase as the pathophysiotogical mechanism: a ‘torsade de pointes ’ pattern of the tachycardia, the lengthening of the QT-interval, the appearance of a new U-wave and the presence of additional risk factors (hypokalaemia and alcalosis). Patients presenting additional risk factors for this complication should be excluded from coronary flow reserve assessment. [ABSTRACT FROM PUBLISHER]
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- 1991
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19. Assessment of coronary flow velocity reserve by noninvasive transthoracic doppler echocardiography in patients with angiographically normal coronary arteries
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Li Zhian, Yang Ya, Thomas Bartel, and Raimund Erbel
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Adult ,Male ,medicine.medical_specialty ,Intracoronary doppler ,Adenosine ,Biomedical Engineering ,Contrast Media ,Doppler echocardiography ,Biochemistry ,Biomaterials ,Young Adult ,Coronary Circulation ,Internal medicine ,Intravascular ultrasound ,Genetics ,medicine ,Humans ,In patient ,Normal coronary arteries ,Aged ,Earth-Surface Processes ,Coronary flow ,medicine.diagnostic_test ,business.industry ,Middle Aged ,Atherosclerosis ,Coronary Vessels ,Echocardiography, Doppler, Color ,medicine.anatomical_structure ,Angiography ,Cardiology ,Female ,business ,Blood Flow Velocity ,Artery - Abstract
The measurement of coronary flow velocity reserve (CFVR) by transthoracic Doppler echocardiography (TTDE) with invasive intracoronary Doppler flow wire technique (ICD) was validated and the pathological factors which influence CFVR in patients with angiographically normal coronary arteries were analyzed. CFVR was determined successfully in left anterior descending artery (LAD) in 37 of 40 patients with angiographically normal coronary arteries (men 22, women 15, age 20-75 years, mean age 54 +/- 12 years). Coronary flow velocity was measured in the distal LAD by TTDE with contrast enhancement at baseline and during intravenous adenosine infusion of 140 microg/kg per min within 48 h after ICD technique. Average peak velocity at baseline (APVb), average peak velocity during hyperemia (APVh) and CFVR determined from TTDE were correlated closely with those from ICD measurements (APVb: y = 0.64x + 5.04, r = 0.86, P0.001; APVh: y = 0.63x + 14.36, r = 0.82, P0.001; CFVR: y = 0.65x + 0.92, r = 0.88, P0.001). For CFVR measurements, the mean differences between TTDE and ICD methods were 0.12 +/- 0.39. CFVR in patients with history of hypertension was significantly lower than that in patients without history of hypertension (P0.05). Intravascular ultrasound (IVUS) was performed in 34 patients. Plaque formation was found in LAD by IVUS in 17 (50%) patients. No significant difference in CFVR was found between the patients without plaque formation (3.11 +/- 0.49) and those with plaque formation (2.76 +/- 0.53, P = 0.056). It is suggested that TTDE with contrast enhancement provides reliable measurement of APV and CFVR in the distal LAD. The early stage of atherosclerosis could be detected by IVUS, which may be normal in angiography. CFVR is impaired in patients with history of hypertension compared with that in patients without history of hypertension.
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- 2005
20. Non-invasive assessment of coronary flow velocity reserve: A new method using transthoracic Doppler echocardiography
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Wang Xin-fang, Clemems von Birgelen, Yang Ya, Raimund Erbel, Holger Eggebrecht, Guido Caspari, Thomas Bartel, and Loredana Latina
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Adult ,Male ,medicine.medical_specialty ,Intracoronary doppler ,Adenosine ,Vasodilator Agents ,Biomedical Engineering ,Contrast Media ,Coronary Artery Disease ,Doppler echocardiography ,Biochemistry ,Flow measurement ,Biomaterials ,symbols.namesake ,Doppler flow ,Polysaccharides ,Predictive Value of Tests ,Coronary Circulation ,Internal medicine ,Genetics ,Humans ,Medicine ,Distal left anterior descending artery ,Aged ,Earth-Surface Processes ,Coronary flow ,medicine.diagnostic_test ,business.industry ,Non invasive ,Middle Aged ,Coronary Vessels ,Echocardiography, Doppler ,symbols ,Cardiology ,Female ,business ,Doppler effect ,Blood Flow Velocity - Abstract
Transthoracic Doppler echocardiography (TTDE) allows noninvasive flow measurement in the distal left anterior descending artery (LAD). The feasibility of detecting coronary flow by contrast-enhanced TTDE with second harmonic technique was assessed, the coronary flow velocity reserve (CFVR) was evaluated in comparison to intracoronary Doppler flow (ICD) analysis and the CFVR after PTCA in LAD was investigated. In 77 (96%) of 80 patients, CFVR was successfully determined with intravenous adenosine infusion. Doppler signal quality was evaluated in the first 46 patients by use of intravenous Levovist infusion and second harmonic technique. The Doppler flow was not visible in 1. patient only. CFVR determined from TTDE (2.77 +/- 0.65) was correlated closely with those from ICD (2.88 +/- 0.78) measurements (y = 0.73x + 0.67, r = 0.87, P0.001). In conclusion, TTDE is a feasible method and provides reliable data on CFVR which can be used for follow-up after PTCA.
- Published
- 2002
21. TCT-774 Coronary Microembolization during Transfemoral Transcatheter Aortic Valve Implantation: An Intracoronary Doppler Study
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Matthias Thielmann, Jürgen Peters, Eva Kottenberg, Gerd Heusch, Daniel Wendt, Heike A. Hildebrandt, Philipp Kahlert, Kai Nassenstein, Theodor Baars, Felix Nensa, Fadi Al-Rashid, Heinz Jakob, Raimund Erbel, and Till Neumann
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medicine.medical_specialty ,Intracoronary doppler ,animal structures ,Transcatheter aortic ,business.industry ,EuroSCORE ,Perioperative ,medicine.disease ,medicine.anatomical_structure ,Embolism ,Aortic valve stenosis ,Internal medicine ,Troponin I ,medicine ,Cardiology ,cardiovascular system ,Radiology ,business ,Cardiology and Cardiovascular Medicine ,Artery - Abstract
Background: A postprocedural increase of the serum troponin I concentration (TnI) reflects myocardial injury and occurs frequently during transcatheter aortic valve implantation (TAVI). Periprocedural coronary microembolization is a potential cause of such injury. We therefore evaluated each step of the transfemoral TAVI procedure for coronary embolization using intracoronary Doppler (ICD) in the left anterior descending (LAD) artery. Methods: 15 high-risk patients with severe, symptomatic aortic valve stenosis (age 79 ± 45 yrs; EuroScore 17 ± 4%) who underwent transfemoral TAVI using the balloon-expandable Edwards bioprosthesis were included. ICD examinations were recorded and evaluated off-line for high-intensity transient signals (HITS). Perioperative concentrations of TnI were serially measured within the first 72 h after TAVI, and a cardiac MRI with late gadolinium-enhancement (LGE) was performed within 7 days. Results: HITS were detected in all patients (figure 1), mostly during the initial crossing...
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- 2014
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22. Provisional stenting in small vessels
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Carlo Di Mario, Flavio Airoldi, Takuro Takagi, Remo Albiero, Goran Stankovic, and Antonio Colombo
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medicine.medical_specialty ,Intracoronary doppler ,Percutaneous ,business.industry ,medicine.medical_treatment ,equipment and supplies ,Balloon ,medicine.disease ,law.invention ,Surgery ,Coronary arteries ,surgical procedures, operative ,medicine.anatomical_structure ,Randomized controlled trial ,Restenosis ,law ,Angioplasty ,medicine ,Radiology, Nuclear Medicine and imaging ,Intracoronary ultrasound ,cardiovascular diseases ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Based on the currently available data, the strategy of routine stent placement in unselected lesions located in small coronary arteries provides good immediate results but is still associated with a high incidence of in-stent restenosis. Randomized trials comparing elective stenting with balloon angioplasty have not provided the demonstration that routine stenting is the best strategy for percutaneous intervention in coronary arteries with a reference diameter smaller than 2.75-3.0 mm. This paper describes the rationale for provisional stenting in this clinical setting and reviews the role of quantitative coronary angiography, intracoronary ultrasound and intracoronary Doppler measurements in the identification of lesions that would benefit from adjunctive stent placement after balloon angioplasty and in guiding stent implantation.
- Published
- 2001
23. Angiographical and Doppler flow-derived parameters for assessment of coronary lesion severity and its relation to the result of exercise electrocardiography
- Subjects
coronary stenosis ,BALLOON ANGIOPLASTY ,MYOCARDIAL BLOOD-FLOW ,ARTERY STENOSES ,HUMANS ,PRESSURE ,VELOCITY RESERVE ,GUIDE-WIRE ,VALIDATION ,DISEASE ,exercise electrocardiography ,intracoronary Doppler ,DISTAL ,angiography - Abstract
Aims Evaluation of angiographical and intracoronary Doppler-derived parameters of coronary stenosis severity. Methods and Results A total of 225 patients with one-vessel disease were studied before PTCA and at 6 months follow-up. Exercise electrocardiography was performed to document presence (n=157) or absence (n=138) of an ST segment shift (greater than or equal to 0.1 mV). Intracoronary blood flow velocity analysis was performed to determine the proximal/distal flow velocity ratio, the distal diastolic/systolic flow velocity ratio and coronary flow velocity reserve. Receiver operator characteristic curves were calculated to assess the predictive value of these variables compared with the exercise test. The distal coronary flow velocity reserve demonstrated the best linear correlation for both percentage diameter stenosis and minimum lumen diameter (r=0.67 and r=0.66; P Conclusions The distal coronary flow velocity reserve is the best intracoronary Doppler parameter for evaluation of coronary narrowings. Angiographical estimates of coronary lesion severity and distal coronary flow velocity reserve are good and independent predictors for the assessment of functional severity of coronary stenosis, emphasizing the complementary role of these parameters for clinical decision making. (C) 2000 The European Society of Cardiology.
- Published
- 2000
24. Functional assessment of internal mammary artery bypass grafts: Case reports and review of the literature
- Author
-
Vincent J.B. Robinson, Reed W. Seligman, and David Marks
- Subjects
medicine.medical_specialty ,Intracoronary doppler ,Diagnostic information ,business.industry ,Bypass grafts ,General Medicine ,Surgery ,surgical procedures, operative ,Doppler flow ,Text mining ,medicine ,Mammary artery ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business - Abstract
The utility of intra-arterial Doppler flow in assessing internal mammary artery (IMA) bypass grafts has infrequently been reported. Two patients are described in which Doppler evaluation of the IMA graft provided valuable diagnostic information prior to intervention. Also provided is a review of the available literature concerning evaluation of pathology in IMA grafts.
- Published
- 1999
25. TCT-304 Intracoronary Doppler Flow Velocity And Pressure Derived Hyperemic Microvascular Resistance Is Independent Of Epicardial Obstruction In Stable Coronary Artery Disease
- Author
-
Paul F. Teunissen, Sukhjinder Nijjer, Peter M. van de Ven, Paul Knaapen, Niels van Royen, Justin E. Davies, Koen M. Marques, and Guus A. de Waard
- Subjects
Intracoronary doppler ,medicine.medical_specialty ,Interventional cardiology ,business.industry ,food and beverages ,medicine.disease ,Coronary pressure ,Coronary artery disease ,Microvascular resistance ,Flow velocity ,Internal medicine ,Cardiology ,Medicine ,business ,Cardiology and Cardiovascular Medicine - Abstract
Introduction: Coronary microvascular function can be assessed invasively by combining measurements of coronary pressure and flow. The index of microcirculator resistance (IMR), obtained using therm...
- Published
- 2015
- Full Text
- View/download PDF
26. Protected Left Main Angioplasty: Alterations of Intracoronary Doppler Flow Velocity
- Author
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Morton J. Kern, William R. Craig, and Eugene A. Caracciolo
- Subjects
medicine.medical_specialty ,Intracoronary doppler ,business.industry ,medicine.medical_treatment ,Blood flow ,medicine.disease ,Stenosis ,medicine.anatomical_structure ,Flow velocity ,Internal medicine ,Angioplasty ,Occlusion ,medicine ,Cardiology ,Radiology, Nuclear Medicine and imaging ,Circumflex ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Coronary blood flow velocity measurements during protected left main coronary angioplasty have not been previously reported. In a patient undergoing angioplasty of left main and circumflex vessels with prior coronary artery bypass grafting, distal coronary flow velocity was measured before, during, and after angioplasty, and again after stenting of the circumflex stenosis. The data demonstrated preserved coronary flow during left main occlusion in this individual and provided new observations that highlight the limitations of our understanding of myocardial blood flow in complex circumstances of high risk angioplasty and interventions following bypass graft surgery.
- Published
- 1998
27. Use and Limitations of Immediate Postprocedural Intracoronary Doppler Blood Flow Measurements for Predicting Late Result after Coronary Balloon Angioplasty
- Author
-
Basil S. Lewis, D. Kattan, and David Laughrun
- Subjects
Intracoronary doppler ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Coronary flow reserve ,Coronary balloon angioplasty ,Blood flow ,medicine.disease ,Physiologic measurement ,Restenosis ,Internal medicine ,Angiography ,medicine ,Cardiology ,Pharmacology (medical) ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Perfusion - Abstract
Background and Aims: Physiologic measurement of myocardial perfusion in the immediate postangioplasty period may complement the angiographic assessment of the outcome of the procedure and improve our
- Published
- 1997
28. Methods to Assess Coronary Microvascular Function
- Author
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Filippo Crea, Paolo G. Camici, and Gaetano Antonio Lanza
- Subjects
Myocardial contrast echocardiography ,medicine.medical_specialty ,Intracoronary doppler ,business.industry ,Internal medicine ,Contrast echocardiography ,medicine ,Cardiology ,Coronary microcirculation ,business ,humanities - Abstract
This chapter reviews the main noninvasive (TTDE, myocardial contrast echocardiography, PET, and CMR) and invasive (thermodilution, gas wash-out method, intracoronary Doppler recording) methods and techniques proposed to assess coronary microvascular function in the clinical setting and to identify the various mechanisms of CMD. Pros and cons of each method are discussed and compared.
- Published
- 2013
29. Intracoronary doppler flow to monitor the results of selective saphenous vein graft thrombolytic therapy
- Author
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Gary Gershony, Mary Beth Cishek, and Michael T. Galloway
- Subjects
Male ,medicine.medical_specialty ,Intracoronary doppler ,Thrombolytic treatment ,medicine.medical_treatment ,Saphenous vein graft ,Coronary Disease ,Coronary Circulation ,Angioplasty ,Internal medicine ,Fibrinolysis ,medicine ,Humans ,Saphenous Vein ,Thrombolytic Therapy ,Derivation ,Coronary Artery Bypass ,Ultrasonography, Interventional ,business.industry ,fungi ,Graft Occlusion, Vascular ,Ultrasonography, Doppler ,Middle Aged ,medicine.disease ,Coronary Vessels ,Thrombosis ,medicine.anatomical_structure ,Cardiology ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Blood Flow Velocity ,Artery - Abstract
Selective intracoronary thrombolytic therapy has recently been advocated as a technique to recanalize occluded coronary bypass grafts. We report a novel approach for monitoring the results of this treatment utilizing a coronary artery doppler flow guidewire. This approach may optimize the duration of thrombolytic treatment in these patients. © 1995 Wiley-Liss, Inc.
- Published
- 1995
30. Improvement of coronary morphology and blood flow after stenting: Assessment by intravascular ultrasound and intracoronary Doppler
- Author
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Ge, Junbo, Erbel, Raimund, Zamorano, Jose, Haude, Michael, Kearney, Peter, Görge, Günter, and Meyer, Jürgen
- Published
- 1995
- Full Text
- View/download PDF
31. TCT-717 Coronary Microcirculation during Transfemoral Transcatheter Aortic Valve Implantation
- Author
-
Eva Kottenberg, Heike A. Hildebrandt, Theodor Baars, Heinz Jakob, Philipp Kahlert, Karim El Chilali, Fadi Al-Rashid, Jürgen Peters, Daniel Wendt, Raimund Erbel, Matthias Thielmann, and Gerd Heusch
- Subjects
medicine.medical_specialty ,Intracoronary doppler ,Transcatheter aortic ,business.industry ,Coronary microcirculation ,Blood flow ,medicine.anatomical_structure ,Internal medicine ,cardiovascular system ,medicine ,Cardiology ,In patient ,Cardiology and Cardiovascular Medicine ,Symptomatic aortic stenosis ,business ,Artery ,Coronary flow - Abstract
Coronary flow velocity reserve (CVR) is reduced in patients with severe symptomatic aortic stenosis, contributing to ischemic clinical symptoms. We evaluated coronary flow dynamics assessed by intracoronary Doppler surveillance of the blood flow in the left anterior descending (LAD) artery during
- Published
- 2014
32. Management and prevention of complications during specific interventions
- Author
-
Manel Sabaté, Eulogio García, and Carlos Macaya
- Subjects
medicine.medical_specialty ,Intracoronary doppler ,medicine.diagnostic_test ,business.industry ,Internal medicine ,Intravascular ultrasound ,medicine ,Psychological intervention ,Cardiology ,Radiology ,business - Published
- 2006
33. Lack of evidence for improvement in internal mammary graft flow by occlusion of side branch
- Author
-
Atul D. Abhyankar, A. Stewert Mitchell, and Louis Bernstein
- Subjects
medicine.medical_specialty ,Intracoronary doppler ,business.industry ,medicine.medical_treatment ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Coronary steal ,Side branch ,Occlusion ,medicine ,Derivation ,Embolization ,Cardiology and Cardiovascular Medicine ,business ,Complication ,Artery - Abstract
Coronary steal due to unligated side branches of an internal mammary artery graft has been reported previously. Embolization of these side branches has been shown to result in symptomatic improvement, but objective evidence of improved flow to the coronary artery has been lacking. We studied intracoronary Doppler flow in a patient presenting with symptoms thought to be due to a large unligated side branch of mammary graft. There was no significant change in the mammary flow after balloon occlusion of the side branch. More objective data may be required to routinely prescribe side branch embolization for symptomatic patients with unligated side branches of a mammary graft.
- Published
- 1997
34. Coronary flow reserve in HOCM-patients – An intracoronary Doppler-catheter investigation
- Author
-
D Stosch, Udo Boeken, HG Klues, Emmeran Gams, Peter Feindt, Jens Litmathe, and Bernhard Korbmacher
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Catheter ,Intracoronary doppler ,business.industry ,Internal medicine ,Cardiology ,Medicine ,Coronary flow reserve ,Surgery ,Cardiology and Cardiovascular Medicine ,business - Published
- 2004
35. Frame count reserve
- Author
-
Stoel, Maaike, Zijlstra, F., de Visser, C.A., and Stoel, MG
- Subjects
Male ,Adenosine ,BALLOON ANGIOPLASTY ,ARTERY DISEASE ,Vasodilator Agents ,Hemodynamics ,Infarction ,Contrast Media ,Blood Pressure ,Coronary Angiography ,coronary disease ,GUIDE-WIRE ,blood flow ,angiography ,STENT IMPLANTATION ,CORONARY FLOW RESERVE ,medicine.diagnostic_test ,Middle Aged ,Coronary Vessels ,Diagnostic catheterization ,REGIONAL MYOCARDIAL PERFUSION ,Cardiology ,Female ,INTRACORONARY DOPPLER ,Cardiology and Cardiovascular Medicine ,INFARCTION ,TIMI ,Blood Flow Velocity ,Adult ,medicine.medical_specialty ,VELOCITY RESERVE ,Angina Pectoris ,Physiology (medical) ,Internal medicine ,Coronary Circulation ,medicine ,Humans ,cardiovascular diseases ,Ultrasonography, Interventional ,Vascular Patency ,Aged ,BLOOD-FLOW ,business.industry ,Coronary Stenosis ,Coronary flow reserve ,Reproducibility of Results ,Blood flow ,medicine.disease ,Flow velocity ,Angiography ,business - Abstract
Background— The Doppler wire–derived (relative) coronary flow velocity reserve (CVR) that is used to evaluate functional significance of a coronary stenosis is a method performed only by interventional cardiologists. An angiographic method would be useful in the diagnostic catheterization laboratory. For this purpose, we investigated the relation between TIMI frame count reserve (FCR) and CVR. Methods and Results— In 38 patients, (relative) FCR of left anterior descending (LAD) and left circumflex coronary artery (LCx) was calculated by using manual, synchronized contrast agent injections and compared with (relative) CVR. In addition, vessel length was measured with an intracoronary guidewire and frame count flow velocity was calculated and compared with average peak velocity. There was a strong correlation between FCR and CVR ( r =0.62, P r =0.84, P P P Conclusion— The (relative) frame count reserve can be used to estimate (relative) coronary flow velocity reserve.
- Published
- 2003
36. Intracoronary Doppler versus new method of the assessment of coronary flow using computer analysis of conventional coronary angiograms
- Author
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Dabrowski M, Witold Rużyłło, Z. Dzielinska, Jodkowski J, P. Szmaus, and B Górecka
- Subjects
medicine.medical_specialty ,Intracoronary doppler ,medicine.diagnostic_test ,Cardiac cycle ,business.industry ,Blood flow ,medicine.disease ,Stenosis ,medicine.anatomical_structure ,Computer analysis ,Internal medicine ,medicine ,Cardiology ,Angiocardiography ,business ,Coronary flow ,Artery - Abstract
The aim of the study was validation of a mean brightness method and new coronary flow index CFI for the assessment of coronary flow by means of intracoronary Doppler measurements. This method utilizes the dynamics of coronary angiograms and is based on the computer analysis of conventional coronary angiograms. The contractual measure of blood flow is percent change of mean brightness of coronary artery in unit of time: cardiac cycle (%/cycle) or time in seconds (%/sec). Coronary flow was investigated in 10 patients with angiographically normal coronary artery (NCA group) and in 17 patients with single vessel stenosis (SVS group). In the SVS group, measurements were repeated twice: before and after PTCA procedure. In both groups statistically significant, positive correlations were found between both methods. In conclusion, the new CFI is very reliable, simple and easy to obtain parameters able to assess coronary flow and can be very useful in the case of comparative studies.
- Published
- 2002
37. Value of coronary stenotic flow velocity acceleration in prediction of angiographic restenosis following balloon angioplasty
- Author
-
Albertal, M., Regar, E., Van Langenhove, G., Carlier, Stephane, and Cardio-vascular diseases
- Subjects
intracoronary Doppler ,RESTENOSIS ,ANGIOPLASTY - Abstract
Introduction Quantitative angiographic assessment after balloon angioplasty is a poor predictor of immediate and long-term outcome. However, the measurement of blood flow velocity during angioplasty has been proved clinically useful. Aims To analyse the value of the maximal stenotic flow velocity and the presence of stenotic flow velocity acceleration (aSV) for the long-term outcome after balloon angioplasty. Methods and Results Patients undergoing single lesion angioplasty within the DEBATE trial were included. aSV was defined as acceleration in the stenotic coronary flow velocity >50% baseline velocity assessed at a reference site of the target vessel. After balloon angioplasty diameter stenosis, minimal lumen diameter (MLD) and coronary flow velocity reserve were similar between the aSV (n=54) and non-aSV group (n = 125). At follow-up, the aSV group had a higher restenosis rate (52% vs 30%, P=0.006). The presence of aSV was the strongest independent predictor of restenosis (OR 3.08, 95% CI 1.35 to 7.05, P=0.008). The best predictive cut-off value of SV was 101 cm.s (-1) (sensitivity of 46%, specificity of 81%, positive predictive value of 85% and a negative predictive value of 58%). Conclusion Following angioplasty, SV appears to be exquisitely sensitive to the changes experienced at the treated area without depending on the status of the microcirculation. (C) 2002 The European Society of Cardiology.
- Published
- 2002
38. Noninvasive assessment of coronary flow velocity and coronary flow velocity reserve in the right coronary artery by transthoracic Doppler echocardiography: comparison with intracoronary Doppler guidewire
- Author
-
Yasuyuki Nakamura, Yoshiki Ueno, Hiroyuki Takashima, Masahiko Kinoshita, and Akira Soma
- Subjects
Male ,medicine.medical_specialty ,Intracoronary doppler ,Diastole ,Doppler echocardiography ,symbols.namesake ,medicine.artery ,Internal medicine ,Coronary Circulation ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Coronary flow ,Aged ,Observer Variation ,medicine.diagnostic_test ,business.industry ,Middle Aged ,Coronary Vessels ,Echocardiography, Doppler ,Peak velocity ,Echocardiography ,Right coronary artery ,Cardiology ,symbols ,Linear Models ,Female ,Cardiology and Cardiovascular Medicine ,Observer variation ,business ,Doppler effect ,Blood Flow Velocity - Abstract
The aim of this study was to evaluate whether coronary flow velocity (CFV) and coronary flow velocity reserve (CFVR) in the posterior descending right coronary artery can be reliably measured by transthoracic Doppler echocardiography (TTDE). In 17 patients, CFV in the posterior descending right coronary artery was measured with TTDE at the time of Doppler guidewire examination. CFV was measured by both methods at baseline and under hyperemic conditions. TTDE data were obtained for 12 patients. CFV and CFVR by TTDE show a good correlation with those obtained by the Doppler guidewire method (average diastolic peak velocity: r = 0.98, y = 0.85x + 5.26; diastolic peak velocity: r = 0.97, y = 0.94x + 3.39; CFVR: r = 0.97, y = 0.87x + 0.56). CFV and CFVR in the posterior descending right coronary artery obtained noninvasively by TTDE accurately reflect these values obtained by the invasive Doppler guidewire method.
- Published
- 2002
39. Coronary Doppler measurements do not predict progression of cardiac allograft vasculopathy: analysis by serial intracoronary Doppler, dobutamine stress echocardiography, and intracoronary ultrasound
- Author
-
Johannes Rieber, Christoph H. Spes, Hans Ulrich Stempfle, Andreas König, Volker Klauss, Harald Mudra, Bruno Meiser, Karl Theisen, Thomas M. Schiele, and Bruno Reichart
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Intracoronary doppler ,medicine.medical_specialty ,Duplex ultrasonography ,Dobutamine stress echocardiography ,Coronary Artery Disease ,Cardiac allograft vasculopathy ,Asymptomatic ,Postoperative Complications ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,Ultrasonography, Interventional ,Transplantation ,business.industry ,Ultrasound ,Middle Aged ,Echocardiography, Doppler ,cardiovascular system ,Cardiology ,Disease Progression ,Heart Transplantation ,Surgery ,Intracoronary ultrasound ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Blood Flow Velocity ,Echocardiography, Stress - Abstract
Coronary flow velocity reserve (CFVR) (maximum/baseline flow velocity, 16 microg adenosine) was compared with dobutamine stress echocardiography (DSE) (5 to 40 microg/kg/min) to assess the progression of angiographically silent cardiac allograft vasculopathy (CAV). As a reference for the morphologic assessment of CAV, serial intracoronary ultrasound (ICUS) measurements were performed. An increase in CFVR could be observed in all transplant patients despite morphologic or functional progression of CAV or non-progressive CAV as assessed by ICUS or DSE. Thus, serial intracoronary Doppler flow analysis is not useful to predict morphologic or functional progression of CAV.
- Published
- 2002
40. Flow velocity and predictors of a suboptimal coronary flow velocity reserve after coronary balloon angioplasty
- Author
-
Albertal, M., Regar, E., Van Langenhove, G., Carlier, Stephane, and Cardio-vascular diseases
- Subjects
intracoronary Doppler ,blood flow ,ANGIOPLASTY - Abstract
Aims This study was conducted to analyse flow velocity parameters and predictors of a suboptimal coronary flow reserve ( Methods Two hundred and twenty-five patients underwent sequential intracoronary Doppler as part of the DEBATE I study. Of these, 183, with complete angiography and Doppler at the 6-month follow-up, were included. Univariate and multivariate logistic analysis was performed to identify independent predictors of post-procedural suboptimal coronary flow reserve, defined as coronary flow reserve Results Forty-eight per cent (n=88) of the patients achieved a suboptimal coronary flow reserve. These patients had higher baseline velocities (cm.s(-1)) before balloon angioplasty (18 +/- 9 vs 14 +/- 6, P=0.004), after balloon angioplasty (22 +/- 11 vs 14 +/- 5, P Conclusion A suboptimal coronary flow reserve was associated with (1) a chronically elevated baseline average peak velocity (2) a transient deficit in the hyperaemic average peak velocity (3) the elderly, and female gender.
- Published
- 2002
41. Collateral Flow Index to Assess Myocardial Viability: Chugh’s Hypothesis Revisited
- Author
-
Sanjay Kumar Chugh
- Subjects
medicine.medical_specialty ,Intracoronary doppler ,Index (economics) ,Collateral flow ,business.industry ,Physiology (medical) ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
To the Editor: The article by Werner et al1 in the December 12, 2000, issue of Circulation provides further evidence that the collateral flow index can be used to quantify collaterals and correlates with the presence of preserved myocardial contractile function. This supports Chugh’s hypothesis, which was first put forward in 1997 and was published in the British Journal of Cardiology in 2000.2 Chugh’s hypothesis refers to the use of intracoronary Doppler and pressure …
- Published
- 2001
42. Assessing coronary blood flow dynamics with the TIMI frame count method: comparison with simultaneous intracoronary Doppler and ultrasound
- Author
-
Maria Rosa Costanzo, Lloyd W. Klein, Misael Marquez, Steven M. Hollenberg, Joel S. Tanedo, Joseph E. Parrillo, Durand E. Burns, and Russell F. Kelly
- Subjects
Adult ,Male ,Duplex ultrasonography ,medicine.medical_specialty ,Intracoronary doppler ,Myocardial Infarction ,Blood Pressure ,Cohort Studies ,symbols.namesake ,Heart Rate ,Internal medicine ,Coronary Circulation ,medicine ,Methods ,Humans ,Radiology, Nuclear Medicine and imaging ,Ultrasonography, Interventional ,medicine.diagnostic_test ,business.industry ,Ultrasound ,Hemodynamics ,Coronary flow reserve ,Ultrasonography, Doppler ,General Medicine ,Blood flow ,Middle Aged ,Coronary Vessels ,Angiography ,symbols ,Cardiology ,Heart Transplantation ,Female ,Vascular Resistance ,Cardiology and Cardiovascular Medicine ,business ,Doppler effect ,TIMI ,Blood Flow Velocity - Abstract
This study compared the TIMI frame count (TFC), which has been proposed as a method for quantifying coronary blood flow, with coronary flow and microvascular function measured with intracoronary Doppler and intracoronary ultrasound. Coronary blood flow volume was calculated from coronary blood velocity (by intracoronary Doppler) and lumen area (by intracoronary ultrasound) in the LAD in 46 post-heart transplant patients at baseline and after intracoronary adenosine. TFC correlated significantly with average peak coronary blood velocity (r = -0.42; P = 0.004) and coronary lumen area (r = 0.39; P = 0.008), but not with coronary blood flow volume (r = -0.01; P = 0.96) or the coronary flow reserve response to adenosine (r = 0.09; P = 0.58). In conclusion, TFC is a simple method of assessing coronary blood velocity but not volumetric flow. While TFC does not predict coronary flow reserve, as a measure of velocity it does provide an assessment of basal microvascular tone, information that is complementary to that afforded by flow reserve measurements.
- Published
- 2001
43. Angiographical and Doppler flow-derived parameters for assessment of coronary lesion severity and its relation to the result of exercise electrocardiography
- Author
-
Piek, JJ, Boersma, E, di Mario, C, Schroeder, E, Vrints, C, Probst, P, de Bruyne, B, Hanet, C, Fleck, E, Haude, M, Verna, E, Voudris, [No Value], Geschwind, H, Emanuelsson, H, Muhlberger, [No Value], Serruys, PW, and Faculteit Medische Wetenschappen/UMCG
- Subjects
coronary stenosis ,BALLOON ANGIOPLASTY ,MYOCARDIAL BLOOD-FLOW ,ARTERY STENOSES ,HUMANS ,PRESSURE ,VELOCITY RESERVE ,GUIDE-WIRE ,VALIDATION ,DISEASE ,exercise electrocardiography ,intracoronary Doppler ,DISTAL ,angiography - Abstract
Aims Evaluation of angiographical and intracoronary Doppler-derived parameters of coronary stenosis severity. Methods and Results A total of 225 patients with one-vessel disease were studied before PTCA and at 6 months follow-up. Exercise electrocardiography was performed to document presence (n=157) or absence (n=138) of an ST segment shift (greater than or equal to 0.1 mV). Intracoronary blood flow velocity analysis was performed to determine the proximal/distal flow velocity ratio, the distal diastolic/systolic flow velocity ratio and coronary flow velocity reserve. Receiver operator characteristic curves were calculated to assess the predictive value of these variables compared with the exercise test. The distal coronary flow velocity reserve demonstrated the best linear correlation for both percentage diameter stenosis and minimum lumen diameter (r=0.67 and r=0.66; P Conclusions The distal coronary flow velocity reserve is the best intracoronary Doppler parameter for evaluation of coronary narrowings. Angiographical estimates of coronary lesion severity and distal coronary flow velocity reserve are good and independent predictors for the assessment of functional severity of coronary stenosis, emphasizing the complementary role of these parameters for clinical decision making. (C) 2000 The European Society of Cardiology.
- Published
- 2000
44. Measuring maximal percent area stenosis poststent placement with intracoronary Doppler and the continuity equation and correlation with intracoronary ultrasound and angiography
- Author
-
David R. Holmes, Stuart T. Higano, Amir Lerman, Jassim Al Suwaidi, and Charanjit S. Rihal
- Subjects
Male ,Intracoronary doppler ,medicine.medical_specialty ,Duplex ultrasonography ,Adenosine ,Coronary Disease ,Coronary stenosis ,Coronary Angiography ,Sensitivity and Specificity ,Endosonography ,symbols.namesake ,Internal medicine ,Coronary Circulation ,medicine ,Image Processing, Computer-Assisted ,Humans ,Angioplasty, Balloon, Coronary ,Aged ,medicine.diagnostic_test ,business.industry ,Coronary flow reserve ,Middle Aged ,medicine.disease ,Echocardiography, Doppler ,Stenosis ,Treatment Outcome ,Angiography ,symbols ,Cardiology ,Intracoronary ultrasound ,Female ,Stents ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Doppler effect ,Blood Flow Velocity - Abstract
Quantitative coronary angiography (QCA) and intracoronary ultrasound (ICUS) are methods for anatomic assessment of stent deployment. Intracoronary Doppler is primarily a method for the physiologic assessment of coronary stenoses. It correlates well with traditional noninvasive measurements of lesion significance. Intracoronary Doppler was used for the anatomic assessment of de novo coronary artery stenosis with variable success; however, its use for anatomic assessment of adequate stent deployment is unavailable. A rapid, automated software program was developed based on a modified continuity equation to calculate the maximal in-stent percent area stenosis by comparing the maximal in-stent velocity to an average reference velocity (proximal and distal). This study was designed to compare the Doppler method of an anatomic assessment with QCA and ICUS in 15 patients. Physiologic success of stent deployment was determined by the distal coronary flow reserve to 24 to 36 microg of intracoronary adenosine. Following successful stent deployment, distal coronary flow reserve increased significantly from a baseline of 1.6 +/- 0.5 to 2.9 +/- 1.1. There was a significant correlation between the maximal in-stent percent area stenosis as measured by Doppler and both QCA (r = 0.78, p0.01) and ICUS (r = 0.84, p0.01). This study demonstrates that maximal in-stent percent area stenosis can be measured by intracoronary Doppler and a novel software program. The intracoronary Doppler guidewire method can assess the adequacy of stent deployment using both anatomic and physiologic principles and may supplement other quantitative methodologies.
- Published
- 1999
45. Angiographical and Doppler flow-derived parameters for assessment of coronary lesion severity and its relation to the result of exercise electrocardiography
- Author
-
UCL - Cliniques universitaires Saint-Luc, UCL - MD/MINT - Département de médecine interne, Piek, JJ, Hanet, Claude, Boersma, E., di Mario, C, Schroeder, Erwin, Vrints, C, Probst, P., de Bruyne, B, Fleck, E., Haude, M, Verna, E, Voudris, V, Geschwind, H, Emanuelsson, H, Muhlberger, V, Peels, HO, Serruys, PW., UCL - Cliniques universitaires Saint-Luc, UCL - MD/MINT - Département de médecine interne, Piek, JJ, Hanet, Claude, Boersma, E., di Mario, C, Schroeder, Erwin, Vrints, C, Probst, P., de Bruyne, B, Fleck, E., Haude, M, Verna, E, Voudris, V, Geschwind, H, Emanuelsson, H, Muhlberger, V, Peels, HO, and Serruys, PW.
- Abstract
Aims Evaluation of angiographical and intracoronary Doppler-derived parameters of coronary stenosis severity. Methods and Results A total of 225 patients with one-vessel disease were studied before PTCA and at 6 months follow-up. Exercise electrocardiography was performed to document presence (n=157) or absence (n=138) of an ST segment shift (greater than or equal to 0.1 mV). Intracoronary blood flow velocity analysis was performed to determine the proximal/distal flow velocity ratio, the distal diastolic/systolic flow velocity ratio and coronary flow velocity reserve. Receiver operator characteristic curves were calculated to assess the predictive value of these variables compared with the exercise test. The distal coronary flow velocity reserve demonstrated the best linear correlation for both percentage diameter stenosis and minimum lumen diameter (r=0.67 and r=0.66; P<0.01), compared to the diastolic/systolic flow velocity ratio (r=0.19 and r=0.14; P<0.01) and the proximal/distal flow velocity ratio (r=0.03 and r=0.07; not significant). The areas under the curve were 0.84 +/- 0.02; 0.82 +/- 0.03 and 0.83 +/- 0.03 for diameter stenosis, minimum lumen diameter and coronary flow velocity reserve, respectively. Logistic regression analysis revealed that the percentage diameter stenosis or minimum lumen diameter and coronary flow velocity reserve were independent predictors for the result of stress testing. Conclusions The distal coronary flow velocity reserve is the best intracoronary Doppler parameter for evaluation of coronary narrowings. Angiographical estimates of coronary lesion severity and distal coronary flow velocity reserve are good and independent predictors for the assessment of functional severity of coronary stenosis, emphasizing the complementary role of these parameters for clinical decision making. (C) 2000 The European Society of Cardiology.
- Published
- 2000
46. Intracoronary Doppler and collateral resistance
- Author
-
Christian Seiler
- Subjects
medicine.medical_specialty ,Intracoronary doppler ,business.industry ,Collateral ,Diastole ,Hemodynamics ,Collateral Circulation ,Coronary Disease ,medicine.disease ,Collateral circulation ,Adenosine ,Coronary Vessels ,Coronary artery disease ,medicine.anatomical_structure ,Physiology (medical) ,Internal medicine ,medicine ,Cardiology ,Humans ,Vascular Resistance ,Cardiology and Cardiovascular Medicine ,business ,Ultrasonography, Interventional ,Artery ,medicine.drug - Abstract
To the Editor: In the July 1, 1997, issue of Circulation , Piek and coworkers1 provided very interesting intracoronary data on the pharmacological responsiveness of the human coronary collateral circulation. In 38 patients with 1-vessel coronary artery disease and visible (n=24) or recruitable (n=14) collaterals, a collateral flow index, indices for collateral resistance, and index for the resistance in the vascular bed downstream of the collateral receiving artery were investigated regarding their response to intracoronary adenosine or nitroglycerin injected into the collateral donor artery. The authors found that spontaneously visible and recruitable collaterals substantially differed in their response to intracoronary adenosine or nitroglycerin in that the former were able to decrease their resistance and thus increase the flow through it, whereas the latter were unable to do so. Although the direct study of collateral hemodynamics in humans is very important because almost no data exist in this area of research, the mentioned results of the present study have to be taken cautiously for some methodological reasons. 1. The authors’ assertion is incorrect that they obtained collateral flow by measuring diastolic occlusive time velocity …
- Published
- 1998
47. Biphasic flow reaction after nitroglycerine provocation in patients with myocardial bridging demostrated by intracoronary doppler flow measurement
- Author
-
R. Hammentgen, G. Caspan, G. Görge, Michael Haude, Dietrich Baumgart, F. Liu, Raimund Erbel, and J. Go
- Subjects
Intracoronary doppler ,medicine.medical_specialty ,Myocardial bridging ,Flow (mathematics) ,business.industry ,Internal medicine ,Provocation test ,Cardiology ,Medicine ,In patient ,business ,Cardiology and Cardiovascular Medicine ,Flow measurement - Published
- 1998
- Full Text
- View/download PDF
48. Eventfree survival following deferral of coronary interventions based on relative flow velocity reserve derived from intracoronary doppler measurements
- Author
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S. Vetter, G. Görge, Michael Haude, Dirk Welge, J. Ge, F. Liu, Raimund Erbel, and D. Baumgan
- Subjects
Intracoronary doppler ,medicine.medical_specialty ,Flow velocity ,business.industry ,Internal medicine ,Cardiology ,Medicine ,business ,Deferral ,Cardiology and Cardiovascular Medicine - Published
- 1998
- Full Text
- View/download PDF
49. Dobutamine stress echocardiography results correlate with intracoronary doppler measures of coronary flow reserve
- Author
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Christopher M. Kramer, James Joye, Sinda Dianzumba, Peter A Soukas, David Lasorda, Tony Farah, Nathaniel Reichek, and Kenneth W. House
- Subjects
medicine.medical_specialty ,Intracoronary doppler ,Dobutamine stress echocardiography ,business.industry ,Internal medicine ,medicine ,Cardiology ,Coronary flow reserve ,business ,Cardiology and Cardiovascular Medicine - Published
- 1996
- Full Text
- View/download PDF
50. Immediate evaluation of percutaneous transluminal coronary balloon angioplasty success by intracoronary Doppler ultrasound
- Author
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Michael Haude, Dietrich Baumgart, Junbo Ge, Raimund Erbel, and Guido Caspari
- Subjects
medicine.medical_specialty ,Intracoronary doppler ,Percutaneous ,business.industry ,medicine.medical_treatment ,Ultrasound ,Coronary flow reserve ,Coronary balloon angioplasty ,medicine.disease ,Coronary artery bypass graft operations ,Coronary artery disease ,Internal medicine ,Angioplasty ,Cardiology ,medicine ,business - Abstract
Percutaneous transluminal coronary angioplasty has achieved a dominant role for the treatment of patients with coronary artery disease. In several European countries and the US the number of angioplasty procedures has exceeded the number of coronary artery bypass graft operations[1, 2].
- Published
- 1996
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