Background: Coronary computed tomography angiography-derived fractional flow reserve (FFR) is a per-vessel index reflecting cumulative hemodynamic burden while coronary events occur in focal lesions.
Objectives: The authors sought to evaluate the additive prognostic value of the local gradient of FFR (FFR gradient) in addition to FFR to predict future coronary events.
Methods: The current study included 245 patients (634 vessels) who underwent coronary computed tomography angiography within 6 to 36 months before the index angiography, of which 209 vessels had future coronary events and 425 vessels did not.
Introduction: Epicardial adipose tissue (EAT) is known for its pro-inflammatory properties and association with Coronavirus Disease 2019 (COVID-19) severity. However, existing detection methods for COVID-19 severity assessment often lack consideration of organs and tissues other than the lungs, which limits the accuracy and reliability of these predictive models.
Material And Methods: The retrospective study included data from 515 COVID-19 patients (Cohort 1, n=415; Cohort 2, n=100) from two centers (Shanghai Public Health Center and Brazil Niteroi Hospital) between January 2020 and July 2020.
Objectives: The study aimed to investigate the prognostic value of pre-transcatheter aortic valve replacement (TAVR) computed tomography angiography (CTA) in assessing physiological stenosis severity (CTA-derived fractional flow reserve (CT-FFR)) and high-risk plaque characteristics (HRPC).
Materials And Methods: Among TAVR patients who underwent pre-procedure CTA, the presence and number of HRPCs (minimum lumen area of < 4 mm, plaque burden ≥ 70%, low-attenuating plaques, positive remodeling, napkin-ring sign, or spotty calcification) as well as CT-FFR were assessed. The risk of vessel-oriented composite outcome (VOCO, a composite of vessel-related ischemia-driven revascularization, vessel-related myocardial infarction, or cardiac death) was compared according to the number of HRPC and CT-FFR categories.
Circ Cardiovasc Imaging
September 2023
Innovation (Camb)
September 2023
It is essential to create a sustainable and all-encompassing panvascular ecosystem that integrates medical care, industry-academia research, prevention, and management, necessitating the in-depth participation of every cardiovascular doctor on their journey of unwavering excellence. "From doctors, by researchers/engineers, for patients" is the foundation of sustainable development in the "panvascular medicine +" ecosystem. Medical education can make knowledge tangible and serve as a conduit for inheritance and innovation.
View Article and Find Full Text PDFObjective: To investigate the association of baseline nocturnal sleep duration and sleep changes with functional disability in middle-aged and elderly Chinese.
Methods: Data for this study were collected from the China Health and Retirement Longitudinal Study (CHARLS) from baseline (2011) to the Wave 3 follow-up (2018). 8361 participants free of IADL disability in 2011 and aged ≥ 45 years old were recruited and prospectively followed till 2018 to analyze the association between baseline nocturnal sleep duration and IADL disability.
Background: Stress-related neural activity (SNA) assessed by amygdalar activity can predict cardiovascular events. However, its mechanistic linkage with plaque vulnerability is not fully elucidated.
Objectives: The authors aimed to investigate the association of SNA with coronary plaque morphologic and inflammatory features as well as their ability in predicting major adverse cardiovascular events (MACE).
Introduction: The cohort study aimed to assess the association of nighttime sleep duration and the change in nighttime sleep duration with chronic kidney disease (CKD) and whether the association between nighttime sleep duration and CKD differed by daytime napping.
Methods: This study included 11,677 individuals from the China Health and Retirement Longitudinal Study (CHARLS) and used data from the 2011 baseline survey and four follow-up waves. Nighttime sleep duration was divided into three groups: short (<7 h per night), optimal (7-9 h), and long nighttime sleep duration (>9 h).
Background: Whether physiological coronary diffuseness assessed by quantitative flow reserve (QFR) pullback pressure gradient (PPG) correlates with longitudinal myocardial blood flow (MBF) gradient and improves diagnostic performances for myocardial ischemia remains unknown.
Methods And Results: MBF was measured in mL g min with Tc-MIBI CZT-SPECT at rest and stress, corresponding myocardial flow reserve (MFR = MBF stress/MBF rest) and relative flow reserve (RFR = MBF stenotic area/MBF reference) were calculated. Longitudinal MBF gradient was defined as apical and basal left ventricle MBF gradient.
Aims: Peri-procedural myocardial infarction (PMI) after percutaneous coronary intervention (PCI) has been shown to be associated with worse clinical outcomes. We aimed to investigate the value of coronary plaque characteristics and physiologic disease patterns (focal vs. diffuse) assessed by coronary computed tomography angiography (CTA) in predicting PMI and adverse events.
View Article and Find Full Text PDFBackground: Lipoprotein(a) [Lp(a)] is a risk factor for cardiovascular events. This study evaluated the relationship between Lp(a) and high-risk attributes by coronary computed tomography angiography as well as their prognostic value.
Methods: Lp(a) and coronary computed tomography angiography from 377 consecutive patients at Zhongshan Hospital (Shanghai, China) were evaluated.
Background: Post-percutaneous coronary intervention (PCI) residual disease is associated with clinical outcomes. Nevertheless, the prognostic value of residual disease patterns remains unknown.
Objectives: This study aimed to evaluate clinical implications of 2-dimensional residual disease patterns after PCI.
Background: A significant proportion of ischemia with non-obstructive coronary artery disease (INOCA) demonstrate coronary microvascular dysfunction (CMD), a condition associated with abnormal myocardial perfusion imaging (MPI) and adverse outcomes. Coronary angiography-derived index of microvascular resistance (caIMR) is a novel non-invasive technique to assess CMD. We aimed to investigate the prognostic value of combined caIMR and MPI by CZT SPECT in INOCA patients.
View Article and Find Full Text PDFIntravascular ultrasound (IVUS) imaging allows direct visualization of the coronary vessel wall and is suitable for assessing atherosclerosis and the degree of stenosis. Accurate segmentation and lumen and median-adventitia (MA) measurements from IVUS are essential for such a successful clinical evaluation. However, current automated segmentation by commercial software relies on manual corrections, which is time-consuming and user-dependent.
View Article and Find Full Text PDFFront Cardiovasc Med
May 2022
Background Coronary diffuse disease associates with poor outcomes, but little is known about its role after percutaneous coronary intervention (PCI). We aimed to investigate the prognostic implication of pre-PCI focal or diffuse disease patterns combined with post-PCI quantitative flow ratio (QFR). Methods and Results Pre-PCI QFR derived pullback pressure gradient (PPG) (QFR-PPG) was measured to assess physiological disease patterns for 1685 included vessels; the vessels were classified according to dichotomous pre-PCI QFR-PPG and post-PCI QFR.
View Article and Find Full Text PDFIntroduction And Objectives: The index of microcirculatory resistance (IMR) measured after primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) is associated with microvascular obstruction (MVO) and adverse clinical events. To evaluate MVO after successful primary PCI for STEMI without pressure wires or hyperemic agents, we investigated the feasibility and usefulness of functional angiography-derived IMR (angio-IMR).
Methods: The current study included a total of 285 STEMI patients who underwent primary PCI and cardiac magnetic resonance (CMR).
Angiography-derived index of microcirculatory resistance (angio-IMR) is an emerging pressure-wire-free index to assess coronary microvascular function, but its diagnostic and prognostic value remains to be elucidated. The study population consisted of three independent cohorts. The internal diagnostic cohort enrolled 53 patients with available hyperemic microcirculatory resistance (HMR) calculated from myocardial blood flow and pressure.
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