TCT 2002 Abstracts

• Cardiovascular Imaging and Physiologic Lesion Assessment

TCT 2002 Presentations

• Physiologic Lesion Assessment: Basic and Advanced Concepts, by B. De Bruyne

Full text journal article July 2002
Correlates of Coronary Blood Flow Before and After Percutaneous Coronary Intervention and Their Relationship to Angiographic and Clinical Outcomes in the RESTORE Trial
The presence of thrombus is associated with slower flow and after PCI is associated with an increased risk of mortality.

Full text journal article Oct 2002
The Constant Search for Indices of Coronary Flow and Perfusion
Assessment of coronary flow is an important task for diagnosis and assessment of interventions in ischemic heart disease.

Effects of Selective {alpha}1- and {alpha}2-Adrenergic Blockade on Coronary Flow Reserve After Coronary Stenting    
Luisa Gregorini et al
Circulation 2002;106 2901-2907
http://circ.ahajournals.org/cgi/content/abstract/106/23/2901?etoc
Urapidil and yohimbine attenuated the CFR impairment occurring after revascularization by increasing both the epicardial vasodilator effect of adenosine and the blood flow velocity, thus suggesting that the adrenergic system plays an important role in limiting the capacity of the coronary circulation to dilate.

Flow velocity and predictors of a suboptimal coronary flow velocity reserve after coronary balloon angioplasty
Albertal M, et al.
Eur Heart J 2002;23:133-8.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11785995  
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.

Coronary Flow Velocity Pattern Immediately After Percutaneous Coronary Intervention as a Predictor of Complications and In-Hospital Survival After Acute Myocardial Infarction    
Atsushi Yamamuro et l
Circulation 2002;106 3051-3056
http://circ.ahajournals.org/cgi/content/abstract/106/24/3051?etoc
The results of this study suggest that the CFV pattern is an accurate predictor of the presence or absence of complications and of in-hospital survival after AMI

I have an acute myocardial infarction: open my coronary artery, stent it and keep full flow!
Aschermann M, et al.
Eur Heart J 2002;23:913-6.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12069440

How good are experienced cardiologists at predicting the hemodynamic severity of coronary stenoses when taking fractional flow reserve as the gold standard
Brueren BR, et al.
Int J Cardiovasc Imaging 2002;18:73-6.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12108911  
The assessment of the hemodynamic severity of intermediate coronary stenosis should not be based on eyeball assessment even by experienced interventional cardiologists

Prognostic value of coronary blood flow velocity and myocardial perfusion in intermediate coronary narrowings and multivessel disease
Chamuleau SA, et al.
J Am Coll Cardiol 2002;39:852-8.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11869852  
Deferral of PTCA of intermediate lesions in multivessel disease is safe when CFVR greater-than-or-equal 2.0 (event rate 6%). This selective evaluation of coronary lesion severity during cardiac catheterization allows a more accurate risk stratification than does SPECT, which is important for clinical decision making in this patient cohort.

Assessment of coronary flow reserve: comparison between contrast- enhanced magnetic resonance imaging and positron emission tomography
Ibrahim T, et al.
J Am Coll Cardiol 2002;39:864-70.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11869854
Magnetic resonance imaging first-pass perfusion measurements underestimate flow reserve values, but may represent a promising semi- quantitative technique for detection and severity assessment of regional CAD.

The meaning of suboptimal coronary flow reserve after coronary balloon angioplasty
Kern MJ.
Eur Heart J 2002;23:99-100.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11785988

Validation of collateral fractional flow reserve by myocardial perfusion imaging
Matsuo H, et al.
Circulation 2002;105:1060-5.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11877355
http://www.circulationaha.org/cgi/content/full/105/9/1060
http://www.circulationaha.org/cgi/content/abstract/105/9/1060
FFR(coll), calculated from coronary pressure during balloon occlusion, is highly correlated with the extent and severity of the defect at myocardial perfusion of the territory of the occluded artery and can be used for quantitative assessment of collateral blood flow in conscious humans.

Impact of final coronary flow velocity reserve on late outcome following stent implantation
Nishida T, et al.
Eur Heart J 2002;23:331-40.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11812070
The presence of a final coronary flow velocity reserve of < 2.0 is an independent predictor of the need for target lesion revascularization after stent implantation in native coronary artery lesions.

Usefulness of an echo-contrast agent for assessment of coronary flow velocity and coronary flow velocity reserve in the left anterior descending coronary artery with transthoracic doppler scan echocardiography
Okayama H, et al.
Am Heart J 2002;143:668-75.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11923804
http://www.mosby.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=abs&id=a120968&target=
The data of this study suggest that administration of echo-contrast agent improves pulse wave Doppler scan quality and thus the feasibility of measuring CFVR

Coronary thermodilution to assess flow reserve: validation in humans
Pijls NH, et al.
Circulation 2002;105:2482-6.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12034653
http://www.circulationaha.org/cgi/content/full/105/21/2482
http://www.circulationaha.org/cgi/content/abstract/105/21/2482
This study shows the feasibility of simultaneous measurement of FFR (by coronary pressure) and CFR (by coronary thermodilution) in humans by one single guide wire in a practical and straightforward way and will facilitate assessment of microvascular disease.

Coronary flow reserve and brachial artery reactivity in patients with chest pain and "false positive" exercise-induced ST-segment depression
Rigo F, et al.
Am J Cardiol 2002;89:1141-4.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11988213

Coronary flow reserve or brachial artery flow to assess endothelial dysfunction: is it time to look at the heart again?
Shizukuda Y, et al.
Am J Cardiol 2002;89:113.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11779545