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001-es BibID:	BIBFORM123877
035-os BibID:	(WOS)001248398300001 (Scopus)85196196047
Első szerző:	Ágoston András
Cím:	The pressure-derived microvascular resistance reserve and its correlation to Doppler MRR measurement - a proof of concept study / András Ágoston, Azzaya Dorj, Áron Üveges, Balázs Tar, Gábor Tamás Szabó, Judit Barta, Tibor Szűk, Michael Kest, Réka Méhész, András Komócsi, Dániel Czuriga, Benjámin Csippa, Zsolt Piróth, Emanuele Barbato, Zsolt Kőszegi
Dátum:	2024
ISSN:	2297-055X
Megjegyzések:	Background: Microvascular resistance reserve (MRR) is a recently introduced specific index of coronary microcirculation. MRR calculation can utilize parameters deriving from coronary flow reserve (CFR) assessment, provided that intracoronary pressure data are also available. The previously proposed pressure-bounded CFR (CFRpb) defines the possible CFR interval on the basis of resting and hyperemic pressure gradients in the epicardial vessel, however, its correlation to the Doppler wire measurement was reported to be rather poor without the correction for hydrostatic pressure. Purpose: We aimed to determine the pressure-bounded coronary MRR interval with hydrostatic pressure correction according to the previously established equations of CFRpb adapted for the MRR concept. Furthermore, we also aimed to design a prediction model using the actual MRR value within the pressure-bounded interval and validate the results against the gold-standard Doppler wire technique. Methods: Hydrostatic pressure between the tip of the catheter and the sensor of the pressure wire was calculated by height difference measurement from a lateral angiographic view. In the derivation cohort the pressure-bounded MRR interval (between MRRpbmin and MRRpbmax) was determined solely from hydrostatic pressure-corrected intracoronary pressure data. The actual MRR was calculated by simple hemodynamic equations incorporating the anatomical data of the three-dimensionally reconstructed coronary artery (MRRp?3D). These results were analyzed by regression analyses to find relations between the MRRpb bounds and the actual MRRp?3D. Results: In the derivation cohort of 23 measurements, linear regression analysis showed a tight relation between MRRpbmax and MRRp?3D (r2= 0.74, p < 0.0001). Using this relation (MRRp?3D = 1.04 + 0.51 ? MRRpbmax), the linear prediction of the MRR was tested in the validation cohort of 19 measurements against the gold standard Doppler wire technique. A significant correlation was found between the linearly predicted and the measured values (r = 0.54, p = 0.01). If the area stenosis (AS%) was included to a quadratic prediction model, the correlation was improved (r = 0.63, p = 0.004). Conclusions: The MRR can be predicted reliably to assess microvascular function by our simple model. After the correction for hydrostatic pressure error, the pressure data during routine FFR measurement provides a simultaneous physiological assessment of the macro- and microvasculature. 2024 Ágoston, Dorj, Üveges, Tar, Szabó, Barta, Szűk, Kest, Méhész, Komócsi, Czuriga, Csippa, Piróth, Barbato and Kőszegi.
Tárgyszavak:	Orvostudományok Elméleti orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk coronary flow reserve (CFR) coronary microvascular dysfunction (CMD) fractional flow reserve (FFR) hydrostatic pressure (HP) microvascular resistance reserve (MRR)
Megjelenés:	Frontiers in Cardiovascular Medicine. - 11 (2024), p. 1-11. -
További szerzők:	Dorj, Azzaya Üveges Áron (1993-) (orvos) Tar Balázs (1970-) (orvos) Szabó Gábor Tamás (1982-) (kardiológus) Barta Judit (1975-) (kardiológus) Szűk Tibor (1967-) (kardiológus) Kest, Michael Méhész Réka Komócsi András Czuriga Dániel (1982-) (kardiológus) Csippa Benjamin Piroth Zsolt Barbato, Emanuele Kőszegi Zsolt (1962-) (kardiológus, belgyógyász)
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001-es BibID:	BIBFORM091240
Első szerző:	Tu, Shengxian
Cím:	Fractional flow reserve calculation from 3-dimensional quantitative coronary angiography and TIMI frame count : a fast computer model to quantify the functional significance of moderately obstructed coronary arteries / Tu S., Barbato E., Köszegi Z., Yang J., Sun Z., Holm N. R., Tar B., Li Y., Rusinaru D., Wijns W., Reiber J. H. C.
Dátum:	2014
ISSN:	1936-8798
Megjegyzések:	Objectives This study sought to present a novel computer model for fast computation of myocardial fractional flow reserve (FFR) and to evaluate it in patients with intermediate coronary stenoses. Background FFR is an indispensable tool to identify individual coronary stenoses causing ischemia. Calculation of FFR from x-ray angiographic data may increase the utility of FFR assessment. Methods Consecutive patients with intermediate coronary stenoses undergoing pressure wire-based FFR measurements were analyzed by a core laboratory. Three-dimensional quantitative coronary angiography (QCA) was performed and the mean volumetric flow rate at hyperemia was calculated using TIMI (Thrombolysis In Myocardial Infarction) frame count combined with 3-dimensional QCA. Computational fluid dynamics was applied subsequently with a novel strategy for the computation of FFR. Diagnostic performance of the computed FFR (FFRQCA) was assessed using wire-based FFR as reference standard. Results Computation of FFRQCA was performed on 77 vessels in 68 patients. Average diameter stenosis was 46.6 ? 7.3%. FFRQCA correlated well with FFR (r = 0.81, p < 0.001), with a mean difference of 0.00 ? 0.06 (p = 0.541). Applying the FFR cutoff value of ?0.8 to FFRQCA resulted in 18 true positives, 50 true negatives, 4 false positives, and 5 false negatives. The area under the receiver-operating characteristic curve was 0.93 for FFRQCA, 0.73 for minimum lumen area, and 0.65 for percent diameter stenosis. Conclusions Computation of FFRQCA is a novel method that allows the assessment of the functional significance of intermediate stenosis. It may emerge as a safe, efficient, and cost-reducing tool for evaluation of coronary stenosis severity during diagnostic angiography.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk fractional flow reserve
Megjelenés:	JACC-Cardiovascular Interventions. - 7 : 7 (2014), p. 768-777. -
További szerzők:	Barbato, Emanuele Kőszegi Zsolt (1962-) (kardiológus, belgyógyász) Yang, Junqing Sun, Zhonghua Holm, Niels R. Tar Balázs (1970-) (orvos) Li, Yingguang Rusinaru, Dan Wijns, William Reiber, Johan H. C.
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