Publications by authors named "Everaars H"
Background: Continuous intracoronary thermodilution with saline allows for the accurate measurement of volumetric blood flow (Q) and absolute microvascular resistance (R). However, this requires repositioning of the temperature sensor by the operator to measure the entry temperature of the saline infusate, denoted as T.
Aims: We evaluated whether Ti could be predicted based on known parameters without compromising the accuracy of calculated Q.
Article Synopsis
- The study explored how the timing of treatment (symptom-to-reperfusion time) affects heart damage in patients with ST-segment elevation myocardial infarction (STEMI) after undergoing primary percutaneous coronary intervention (PPCI).
- Researchers divided 108 STEMI patients into two groups based on their reperfusion time and found that shorter reperfusion times were linked to less heart damage (smaller infarct size) and better heart function measured by cardiovascular magnetic resonance (CMR).
- The findings suggest that a quicker treatment response correlates with better recovery of heart muscle function, particularly in circumferential and radial strain measurements, which are important for assessing heart health after an infarction.
Aims: In chronic coronary syndrome (CCS) patients with documented coronary artery disease (CAD), ischaemia detection by myocardial perfusion imaging (MPI) and an invasive approach are viable diagnostic strategies. We compared the diagnostic performance of quantitative flow ratio (QFR) with single-photon emission computed tomography (SPECT), positron emission tomography (PET), and cardiac magnetic resonance imaging (CMR) in patients with prior CAD [previous percutaneous coronary intervention (PCI) and/or myocardial infarction (MI)].
Methods And Results: This PACIFIC-2 sub-study evaluated 189 CCS patients with prior CAD for inclusion.
Purpose: Acute myocardial ischaemia triggers a non-specific inflammatory response of remote myocardium through the increase of plasma concentrations of acute-phase proteins, which causes myocardial oedema. As ticagrelor has been shown to significantly decrease circulating levels of several pro-inflammatory cytokines in patients after acute myocardial infarction with ST-elevation (STEMI), we sought to investigate a potential suppressive effect of ticagrelor over prasugrel on cardiac magnetic resonance (CMR) T1 and T2 values in remote myocardium.
Methods: Ninety STEMI patients were prospectively included and randomised to receive either ticagrelor or prasugrel maintenance treatment after successful primary percutaneous coronary intervention.
Background: The invasive microvascular function indices, coronary flow reserve (CFR) and the index of microcirculatory resistance (IMR), exhibit a dynamic pattern after ST-segment-elevation myocardial infarction. The effects of microvascular injury on the evolution of the microvascular function and the prognostic significance of the evolution of microvascular function are unknown. We investigated the relationship between the temporal changes of CFR and IMR, and cardiovascular magnetic resonance-derived microvascular injury characteristics in reperfused ST-segment-elevation myocardial infarction patients, and their association with 1-month left ventricular ejection fraction and infarct size (IS).
View Article and Find Full Text PDFObjectives: The aim of this study was to compare Doppler flow velocity and thermodilution-derived indexes and to determine the optimal thermodilution-based diagnostic thresholds for coronary flow reserve (CFR).
Background: The majority of clinical data and diagnostic thresholds for flow-based indexes are derived from Doppler measurements, and correspondence with thermodilution-derived indices remain unclear.
Methods: An international multicenter registry was conducted among patients who had coronary flow measurements using both Doppler and thermodilution techniques in the same vessel and during the same procedure.
Article Synopsis
- The study aimed to assess how revascularization impacts coronary flow capacity (CFC) in patients with coronary artery disease (CAD) using PET imaging.
- Researchers found that CFC significantly improved after revascularization, especially in vessels that initially had lower CFC.
- An increase in CFC post-revascularization was linked to reduced rates of death and non-fatal heart attacks, suggesting that better CFC correlates with better long-term health outcomes.
Article Synopsis
- This study investigates how treating chronic total coronary occlusions (CTOs) affects blood flow in heart regions not directly targeted during the procedure.
- A total of 164 patients were analyzed using PET imaging before and after they underwent successful CTO percutaneous coronary intervention (PCI), revealing significant increases in myocardial blood flow (hMBF) and coronary flow reserve (CFR) in remote myocardium.
- The findings suggest that CTO PCI not only improves blood flow in the occluded area but also positively impacts distant heart regions, indicating a broader benefit of this treatment method.
Article Synopsis
- The study investigates the relationship between residual quantitative flow ratio (QFR) and post-percutaneous coronary intervention (PCI) fractional flow reserve (FFR) using data from invasive coronary angiography (ICA).
- Out of 159 vessels analyzed, residual QFR was successfully calculated in 128 (81%), showing that its median value was significantly higher than that of post-PCI FFR.
- Results indicated that while a high residual QFR (≥0.90) does not guarantee a satisfactory PCI outcome (post-PCI FFR ≥ 0.90), it had a high specificity for identifying suboptimal PCI results.
Cardiac MRI is a noninvasive diagnostic tool using nonionizing radiation that is widely used in patients with ST-segment elevation myocardial infarction (STEMI). Cardiac MRI depicts different prognosticating components of myocardial damage such as edema, intramyocardial hemorrhage (IMH), microvascular obstruction (MVO), and fibrosis. But how do cardiac MRI findings correlate to histologic findings? Shortly after STEMI, T2-weighted imaging and T2* mapping cardiac MRI depict, respectively, edema and IMH.
View Article and Find Full Text PDFTo evaluate the effect of percutaneous coronary intervention (PCI) of coronary chronic total occlusions (CTOs) on left ventricular (LV) strain assessed using cardiac magnetic resonance (CMR) tissue tracking. In 150 patients with a CTO, longitudinal (LS), radial (RS) and circumferential shortening (CS) were determined using CMR tissue tracking before and 3 months after successful PCI. In patients with impaired LV strain at baseline, global LS (10.
View Article and Find Full Text PDFObjectives: This study evaluated myocardial viability as well as global and regional functional recovery after successful chronic coronary total occlusion (CTO) percutaneous coronary intervention (PCI) using sequential quantitative cardiac magnetic resonance (CMR) imaging.
Background: The patient benefits of CTO PCI are being questioned.
Methods: In a single high-volume CTO PCI center patients were prospectively scheduled for CMR at baseline and 3 months after successful CTO PCI between 2013 and 2018.
Objectives: The authors sought to evaluate the impact of ischemic burden reduction after chronic total occlusion (CTO) percutaneous coronary intervention (PCI) on long-term prognosis and cardiac symptom relief.
Background: The clinical benefit of CTO PCI is questioned.
Methods: In a high-volume CTO PCI center, 212 patients prospectively underwent quantitative [O]HO positron emission tomography perfusion imaging before and three months after successful CTO PCI between 2013-2019.
Aims: This study aims to explore cardiovascular magnetic resonance (CMR)-derived left ventricular (LV) function, strain, and infarct size characteristics in patients with transient ST-segment elevation myocardial infarction (TSTEMI) compared to patients with ST-segment and non-ST-segment elevation myocardial infarctions (STEMI and NSTEMI, respectively).
Methods And Results: In total, 407 patients were enrolled in this multicentre observational prospective cohort study. All patients underwent CMR examination 2-8 days after the index event.
Article Synopsis
- Up to 24% of patients with ST-elevation myocardial infarction (STEMI) experience spontaneous resolution of symptoms before treatment, but the reasons for this are not well understood.
- In a study comparing 251 patients with transient STEMI and persistent STEMI, those with transient STEMI had fewer thrombus issues and a smaller infarct size, indicating less heart damage.
- The findings suggest that effective fibrinolysis (clot breakdown) in transient STEMI patients leads to lower myocardial injury and could inform better treatment strategies for STEMI in the future.
Aims: To compare cardiac magnetic resonance (CMR) measurement of T1 reactivity (ΔT1) with [15O]H2O positron emission tomography (PET) measurements of quantitative myocardial perfusion.
Methods And Results: Forty-three patients with suspected obstructed coronary artery disease underwent [15O]H2O PET and CMR at 1.5-T, including rest and adenosine stress T1 mapping (ShMOLLI) and late gadolinium enhancement to rule out presence of scar tissue.
Objectives: This study was designed to assess the prognostic value of pericoronary adipose tissue computed tomography attenuation (PCATa) beyond quantitative coronary computed tomography angiography (CCTA)-derived plaque volume and positron emission tomography (PET) determined ischemia.
Background: Inflammation plays a crucial role in atherosclerosis. PCATa has been shown to assess coronary-specific inflammation and is of prognostic value in patients with suspected coronary artery disease (CAD).
Background And Aims: The value of serial coronary artery calcium (CAC) scores to predict changes in absolute myocardial perfusion and epicardial vasomotor function is poorly documented. This study explored the association between progression of CAC score and changes in absolute myocardial perfusion.
Methods: Fifty-three patients (26% female) with de novo single-vessel coronary artery disease underwent [O]HO positron emission tomography/computed tomography at 1 month (baseline), 1 year, and 3 years after complete revascularization with percutaneous coronary intervention (PCI) to assess CAC scores, hyperemic myocardial blood flow (hMBF), coronary flow reserve (CFR) and cold pressor test MBF (CPT-MBF), within the context of the VANISH trial.
Aims: Myocardial ischaemic burden (IB) is used for the risk stratification of patients with coronary artery disease (CAD). This study sought to define a prognostic threshold for quantitative [15O]H2O positron emission tomography (PET)-derived IB.
Methods And Results: A total of 623 patients with suspected or known CAD who underwent [15O]H2O PET perfusion imaging were included.
Aims: This study sought to determine the prognostic value of combined functional testing using positron emission tomography (PET) perfusion imaging and anatomical testing using coronary computed tomography angiography (CCTA)-derived stenosis severity and plaque morphology in patients with suspected coronary artery disease (CAD).
Methods And Results: In this retrospective study, 539 patients referred for hybrid [15O]H2O PET-CT imaging because of suspected CAD were investigated. PET was used to determine myocardial blood flow (MBF), whereas CCTA images were evaluated for obstructive stenoses and high-risk plaque (HRP) morphology.
Article Synopsis
- The study examined the impact of using coronary computed tomography angiography (CTA) guidance during percutaneous coronary intervention (PCI) compared to traditional angiography guidance.
- Sixty patients were split into two groups: one received CTA-guided PCI and the other angiography-guided PCI, with an innovative augmented-reality system aiding the procedure.
- Results showed that CTA guidance led to more frequent use of postdilation and shorter balloons but did not significantly change stent size selection or safety outcomes, indicating it may be as effective as traditional methods.
Article Synopsis
- This study evaluated the effectiveness of a new tool, called the FFR planner, which uses CT scans to predict the benefits of a heart procedure called percutaneous coronary intervention (PCI) compared to traditional invasive measurements.
- It was conducted on 56 patients, analyzing FFR readings (a measure of blood flow) before and after PCI, showing that the FFR planner has some correlation with post-PCI FFR outcomes, although it was not perfectly accurate.
- The findings suggest that while the FFR planner is useful for planning PCI, further advancements in the technology are necessary for it to be fully reliable in clinical settings.
Determining the anatomic severity and extent of coronary artery disease (CAD) by means of coronary computed tomography angiography (CCTA) and its effect on perfusion using myocardial perfusion imaging (MPI) form the pillars of the non-invasive imaging assessment of CAD. This review will 1) focus on CCTA and [O]HO positron emission tomography MPI as stand-alone imaging modalities and their combined use for detecting CAD, 2) highlight some of the lessons learned from the PACIFIC trial (Comparison of Coronary CT Angiography, SPECT, PET, and Hybrid Imaging for Diagnosis of Ischemic Heart Disease Determined by Fractional Flow Reserve (FFR) (NCT01521468)), and 3) discuss the use of [O]HO PET MPI in the clinical work-up of patients with a chronic coronary total occlusion (CTO).
View Article and Find Full Text PDFBackground: This study aimed to investigate the diagnostic value of comprehensive on-site coronary computed tomography angiography (CCTA) using stenosis and plaque measures and subtended myocardial mass (V) for fractional flow reserve (FFR) defined hemodynamically obstructive coronary artery disease (CAD). Additionally, the incremental diagnostic value of off-site CT-derived FFR (FFR) was assessed.
Methods: Prospectively enrolled patients underwent CCTA followed by invasive FFR interrogation of all major coronary arteries.