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001-es BibID:BIBFORM097169
035-os BibID:(WoS)001083297700001 (Scopus)85170582604
Első szerző:Csippa Benjamin
Cím:Simplified coronary flow reserve calculations based on three-dimensional coronary reconstruction and intracoronary pressure data / Csippa Benjamin, Üveges Áron, Gyürki Dániel, Jenei Csaba, Tar Balázs, Bugarin-Horváth Balázs, Szabó Gábor Tamás, Komócsi András, Paál György, Kőszegi Zsolt
Dátum:2023
ISSN:1897-5593
Megjegyzések:Background: Measurements of fractional flow reserve (FFR) and/or coronary flow reserve (CFR) are widely used for hemodynamic characterization of coronary lesions. The frequent combination of the epicardial and microvascular disease may indicate a need for complex hemodynamic evaluation of coronary lesions. This study aims at validating the calculation of CFR based on a simple hemodynamic model to detailed computational fluid dynamics (CFD) analysis. Methods: Three-dimensional (3D) morphological data and pressure values from FFR measurements were used to calculate the target vessel. Nine patients with one intermediate stenosis each, measured by pressure wire, were included in this study. Results: A correlation was found between the determined CFR from simple equations and from a steady flow simulation (r = 0.984, p < 10-5). There was a significant correlation between the CFR values calculated by transient and steady flow simulations (r = 0.94, p < 10(-3)). Conclusions: Feasibility was demonstrated of a simple hemodynamic calculation of CFR based on 3D-angiography and intracoronary pressure measurements. A simultaneous determination of both the FFR and CFR values provides the capability to diagnose microvascular dysfunction: the CFR/FFR ratio characterizes the microvascular reserve.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Cardiology Journal. - 30 : 4 (2023), p. 516-525. -
További szerzők:Üveges Áron Gyürki Dániel Jenei Csaba (1976-) (kardiológus) Tar Balázs (1970-) (orvos) Bugarin-Horváth Balázs Szabó Gábor Tamás (1982-) (kardiológus) Komócsi András Paál György Kőszegi Zsolt (1962-) (kardiológus, belgyógyász)
Pályázati támogatás:ÚNKP-20-03
Egyéb
BME NC TKP2020
NKFIH
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Intézményi repozitóriumban (DEA) tárolt változat
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2.

001-es BibID:BIBFORM116641
035-os BibID:(Scopus)85177188045 (WoS)001105097500001
Első szerző:Kest, Michael
Cím:Angiography-based coronary microvascular assessment with and without intracoronary pressure measurements : a systematic review / Kest Michael, Ágoston András, Szabó Gábor Tamás, Kiss Attila, Üveges Áron, Czuriga Dániel, Komócsi András, Hizoh István, Kőszegi Zsolt
Dátum:2023
ISSN:1861-0684
Megjegyzések:Background: In recent years, several indices have been proposed for quantifying coronary microvascular resistance. We intended to conduct a comprehensive review that systematically evaluates indices of microvascular resistance derived from angiography. Objective: The objective of this study was to identify and analyze angiography-derived indices of microvascular resistance that have been validated against an invasive reference method. We aimed to compare their limits of agreement with their reference methods and explore their advantages and inherent limitations. Methods and results: We searched PubMed from inception until 2022 for studies on different techniques for quantifying microvascular resistance. Seven studies met the inclusion criteria. Five studies included techniques that applied calculations based solely on invasive angiography, and were validated against invasively measured thermodilution-derived index of microvascular resistance. The remaining two studies combined angiography with invasively measured intracoronary pressure data, and were validated against invasive Doppler measurements. We converted the ? 1.96 standard deviation limits of agreement with the reference method from the seven studies into percentages relative to the cut-off value of the reference method. The lower limits of agreement for angiography-based methods ranged from ? 122 to ? 60%, while the upper limits ranged from 74 to 135%. The range of the limits of agreement was considerably lower for the two combined angiography- and pressure-based methods, standing at ? 52 to 60% and ? 25 to 27%. Conclusion: Our findings suggest that combined angiography- and pressure-based methods provide a more reliable assessment of microvascular resistance compared to methods relying solely on angiography. Graphical Abstract: [Figure not available: see fulltext.] Central illustration. Comparative assessment of image-based methods quantifying microvascular resistance with and without intracoronary pressure measurements. Angiography-based methods rely on angiography alone to calculate the microvascular resistance by utilizing angiographic frame counting to extrapolate coronary flow (Q) and subsequently deriving distal coronary pressure using fluid dynamic equations. Combined angiography- and pressure-based methods utilize invasive intracoronary pressure gradients measured during rest and maximal vasodilation to determine coronary flow in their calculation of microvascular resistance. The combined methods showed more acceptable levels of agreement with their reference methods compared to angiography-based methods alone.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Angiographic microvascular assessment
Coronary blood flow
Coronary microvascular assessment
Coronary microvascular dysfunction
Index of microvascular resistance
Megjelenés:Clinical Research In Cardiology. - [Epub ahead of print] (2023). -
További szerzők:Ágoston András Szabó Gábor Tamás (1982-) (kardiológus) Kiss Attila Üveges Áron Czuriga Dániel (1982-) (kardiológus) Komócsi András Hizoh István Kőszegi Zsolt (1962-) (kardiológus, belgyógyász)
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Intézményi repozitóriumban (DEA) tárolt változat
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3.

001-es BibID:BIBFORM084581
035-os BibID:(WoS)000383869501601
Első szerző:Komócsi András
Cím:Platelet function guided antiplatelet therapy after coronary intervention for myocardial infarction, a propensity score matched analysis from the Hungarian national registry of myocardial infarction / A. Komocsi, B. Merkely, T. Szuk, K. Csapo, L. Toth, Z. Ruzsa, R. G. Kiss, P. Andrassy, F. Nagy, G. Lupkovics, Z. Koszegi, A. C. Dezsi, P. Ofner, D. Aradi, A. Janosi
Dátum:2016
ISSN:0195-668X
Tárgyszavak:Orvostudományok Elméleti orvostudományok idézhető absztrakt
folyóiratcikk
Megjelenés:European Heart Journal. - 37 : Suppl. (2016), p. 382. -
További szerzők:Merkely Béla (1965-) (orvos) Szűk Tibor (1967-) (kardiológus) Csapo K. Tóth L. Ruzsa Zoltán Kiss Róbert Gábor Andrássy Péter Nagy Ferenc (orvos Szeged) Lupkovics Géza Kőszegi Zsolt (1962-) (kardiológus, belgyógyász) Dézsi Csaba András Ofner Péter Aradi Dániel Jánosi András
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4.

001-es BibID:BIBFORM084563
Első szerző:Komócsi András
Cím:Underuse of coronary intervention and its impact on mortality in the elderly with myocardial infarction : a propensity-matched analysis from the Hungarian Myocardial Infarction Registry / Komócsi András, Simon Mihály, Merkely Béla, Szűk Tibor, Kiss Róbert G., Aradi Dániel, Ruzsa Zoltán, Andrássy Péter, Nagy Lajos, Lupkovics Géza, Kőszegi Zsolt, Ofner Péter, Jánosi András
Dátum:2016
ISSN:0167-5273
Megjegyzések:Background: Data are limited on the real-life use of coronary intervention (PCI) and on its long-term efficacy and safety in elderly patients with acute myocardial infarction (AMI). Methods: Data from a nation-wide registry of patients treated due to an AMI event in centers of invasive cardiology were analyzed for the potential interaction of age on the utilization of invasive therapy and outcome. Followup data of consecutive patients between March 1, 2013, and March 1, 2014 were analyzed. Differences in the risk of all-cause death at 1 year between patients undergoing PCI versus others receiving conservative treatment were determined from vital records and were compared with propensity score matching. Results: A total of 8485 consecutive patients were enrolled at 19 centers. Sixty-three percent of the patients were male; the mean age was 65.1 ? 12.4 years. The proportion of STEMI cases was 51%. STEMI cases were treated with primary PCI in 91.0% while patients with NSTEACS underwent PCI in 71.0%. The age of patients was a significant determinant of deferring coronary angiography (Hazard ratio (HR): 0.524 95% confidence interval (CI) 0.47?0.59, p b 0.001) and PCI (HR: 0.76 95% CI 0.73?0.80, p b 0.001). One-year survival after PCI was significantly better both in the overall and in the propensity matched cohort (HR: 0.44 [95% CI: 0.39?0.49] and HR: 0.59 [95% CI: 0.50?0.69], p b 0.001, both). This benefit remained consistent in age-dependent subgroup analyses. Conclusion: Coronary intervention is underused among the elderly despite the mortality benefit of interventional therapy in myocardial infarction that is consistent in all age groups.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Acute coronary syndromes
Percutaneous coronary intervention
Mortality
Elderly
Megjelenés:International Journal Of Cardiology. - 214 (2016), p. 485-490. -
További szerzők:Simon Mihály Merkely Béla (1965-) (orvos) Szűk Tibor (1967-) (kardiológus) Kiss Róbert Gábor Aradi Dániel Ruzsa Zoltán Andrássy Péter Nagy Lajos (Szombathely) Lupkovics Géza Kőszegi Zsolt (1962-) (kardiológus, belgyógyász) Ofner Péter Jánosi András
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Intézményi repozitóriumban (DEA) tárolt változat
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5.

001-es BibID:BIBFORM079024
Első szerző:Komócsi András
Cím:Comparison of Platelet Function Guided Versus Unguided Treatment With P2Y12 Inhibitors in Patients With Acute Myocardial Infarction (from the Hungarian Myocardial Infarction Registry) / Komócsi András, Aradi Dániel, Szűk Tibor, Nagy Gergely György, Ebrahim Noori, Ruzsa Zoltán, Kiss Róbert G., Andrássy Péter, Nagy Lajos, Nagy Ferenc Tamás, Lupkovics Géza, Kőszegi Zsolt, Dézsi Csaba András, Papp Előd, Molnár Zsolt, Kupó Péter, Ofner Péter, Merkely Béla, Jánosi András
Dátum:2018
ISSN:0002-9149
Megjegyzések:Evidence is conflicting regarding the clinical benefits of selecting P2Y12 inhibitors based on platelet function testing (PFT). Between March 1, 2013 and March 1, 2014, we collected clinical characteristics and platelet function data in a nationwide acute myocardial infarction (AMI) registry from 15 interventional cardiology centers in Hungary. The risk of allcause mortality at 1 year were compared after propensity score (PS) matching between patients receiving PFT-guided and unguided P2Y12-inhibitor therapies. High platelet reactivity on clopidogrel (HPRoC) was uniformly defined with the Multiplate assay. A total of 5,583 patients with AMI and coronary intervention were registered. After exclusion of cases with contraindication to prasugrel, propensity matching resulted in a sample of 2,104 patients with well-adjusted characteristics. Clopidogrel was the dominant P2Y12 inhibitor in both groups (unguided: 96% vs PFT guided: 85%, p <0.001). In the PFT-guided group, 19% of patients had HPRoC and 77% of them were switched to prasugrel. According to the adjusted analysis, all-cause mortality at 1 year was significantly lowerin the PFT-guided compared with the unguided group (hazard ratio 0.57 [95% confidence interval 0.43 to 0.77], p <0.001). Although prasugrel treatment was not associated with lower all-cause mortality in the overall cohort, patients with HPRoC who switched to prasugrel had significantly lower mortality when compared with those continuing clopidogrel (hazard ratio 0.33 [95% confidence interval 0.12 to 0.92], p <0.05). In conclusion, in patients with AMI, PFT-guided treatment with a high rate of switchover to prasugrel was associated with a lower risk of mortality. Prasugrel was a predictor of lower mortality in patients with HPRoC but not in the overall cohort of AMI.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:American Journal Of Cardiology. - 121 : 10 (2018), p. 1129-1137. -
További szerzők:Aradi Dániel Szűk Tibor (1967-) (kardiológus) Nagy Gergely György (1976-) (orvos) Ebrahim, Noori Ruzsa Zoltán Kiss Róbert Gábor Andrássy Péter Nagy Lajos Nagy Ferenc (orvos Szeged) Lupkovics Géza Kőszegi Zsolt (1962-) (kardiológus, belgyógyász) Dézsi Csaba András Papp Előd Molnár Zsolt Kupó Péter Ofner Péter Merkely Béla (1965-) (orvos) Jánosi András
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Intézményi repozitóriumban (DEA) tárolt változat
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6.

001-es BibID:BIBFORM100404
035-os BibID:(cikkazonosító)784220
Első szerző:Kőszegi Zsolt (kardiológus, belgyógyász)
Cím:Anatomical Assessment vs. Pullback REsting full-cycle rAtio (RFR) Measurement for Evaluation of Focal and Diffuse CoronarY Disease : rationale and Design of the "READY Register" / Kőszegi Zsolt, Berta Balázs, Tóth Gábor G., Tar Balázs, Üveges Áron, Ágoston András, Szücs Attila, Szabó Gábor Tamás, Barta Judit, Szük Tibor, Czuriga Dániel, Komócsi András, Ruzsa Zoltán
Dátum:2021
ISSN:2297-055X 2297-055X
Megjegyzések:Background: The morphology and functional severity of coronary stenosis show poor correlation. However, in clinical practice, the visual assessment of the invasive coronary angiography is still the most common means for evaluating coronary disease. The fractional flow reserve (FFR), the coronary flow reserve (CFR), and the resting full-cycle ratio (RFR) are established indices to determine the hemodynamic significance of a coronary stenosis. Design/Methods: The READY register (NCT04857762) is a prospective, multicentre register of patients who underwent invasive intracoronary FFR and RFR measurement. The main aim of the registry is to compare the visual estimate of coronary lesions and the functional severity of the stenosis assessed by FFR, as well as the RFR pullback. Characterizations of the coronary vessel for predominantly focal, diffuse, or mixed type disease according to visual vs. RFR pullback determination will be compared. The secondary endpoint of the study is a composite of major adverse cardiac events, including death, myocardial infarction, and repeat coronary revascularization at 1 year. These endpoints will be compared in patients with non-ischemic FFR in the subgroup of cases where the local pressure drop indicates a focal lesion according to the definition of ?RFR > 0.05 (for <25 mm segment length) and in the subgroup without significant ?RFR. In case of an FFR value above 0.80, an extended physiological analysis is planned to diagnose or exclude microvascular disease using the CFR/FFR index. This includes novel flow dynamic modeling for CFR calculation (CFRp-3D). Conclusion: The READY register will define the effect of RFR measurement on visual estimation-based clinical decision-making. It can identify a prognostic value of ?RFR during RFR pullback, and it would also explore the frequency of microvascular disease in the patient population with FFR > 0.80. Clinical Trial Registration: ClinicalTrials.gov (NCT04857762).
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
resting full-cycle ratio (RFR)
microvascular coronary disease
fractional flow reserve (FFR)
coronary flow reserve (CFR)
coronary artery disease
Megjelenés:Frontiers in Cardiovascular Medicine. - 8 (2021), p. 1-7. -
További szerzők:Berta Balázs Tóth Gábor G. Tar Balázs (1970-) (orvos) Üveges Áron Ágoston András Szücs Attila Szabó Gábor Tamás (1982-) (kardiológus) Barta Judit (1975-) (kardiológus) Szűk Tibor (1967-) (kardiológus) Czuriga Dániel (1982-) (kardiológus) Komócsi András Ruzsa Zoltán
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Intézményi repozitóriumban (DEA) tárolt változat
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7.

001-es BibID:BIBFORM102029
Első szerző:Tar Balázs (orvos)
Cím:Pressure- and 3D-Derived Coronary Flow Reserve with Hydrostatic Pressure Correction : comparison with Intracoronary Doppler Measurements / Balázs Tar, András Ágoston, Áron Üveges, Gábor Tamás Szabó, Tibor Szűk, András Komócsi, Dániel Czuriga, Benjamin Csippa, György Paál, Zsolt Kőszegi
Dátum:2022
ISSN:2075-4426
Megjegyzések:Purpose: To develop a method of coronary flow reserve (CFR) calculation derived from three-dimensional (3D) coronary angiographic parameters and intracoronary pressure data during fractional flow reserve (FFR) measurement. Methods: Altogether 19 coronary arteries of 16 native and 3 stented vessels were reconstructed in 3D. The measured distal intracoronary pressures were corrected to the hydrostatic pressure based on the height differences between the levels of the vessel orifice and the sensor position. Classical fluid dynamic equations were applied to calculate the flow during the resting state and vasodilatation based on morphological data and intracoronary pressure values. 3D-derived coronary flow reserve (CFRp-3D) was defined as the ratio between the calculated hyperemic and the resting flow and was compared to the CFR values simultaneously measured by the Doppler sensor (CFRDoppler). Results: Haemodynamic calculations using the distal coronary pressures corrected for hydrostatic pressures showed a strong correlation between the individual CFRp-3D values and the CFRDoppler measurements (r = 0.89, p < 0.0001). Hydrostatic pressure correction increased the specificity of the method from 46.1% to 92.3% for predicting an abnormal CFRDoppler < 2. Conclusions: CFRp-3D calculation with hydrostatic pressure correction during FFR measurement facilitates a comprehensive hemodynamic assessment, supporting the complex evaluation of macro-and microvascular coronary artery disease.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
stable angina
fractional flow reserve (FFR)
coronary flow reserve (CFR)
quantitative coronary angiography
coronary microvascular disease
microvascular resistance reserve (MRR)
Megjelenés:Journal of Personalized Medicine. - 12 : 5 (2022), p. 1-13. -
További szerzők:Ágoston András Üveges Áron Szabó Gábor Tamás (1982-) (kardiológus) Szűk Tibor (1967-) (kardiológus) Komócsi András Czuriga Dániel (1982-) (kardiológus) Csippa Benjamin Paál György Kőszegi Zsolt (1962-) (kardiológus, belgyógyász)
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Intézményi repozitóriumban (DEA) tárolt változat
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8.

001-es BibID:BIBFORM088395
Első szerző:Tar Balázs (orvos)
Cím:Hyperemic contrast velocity assessment improves accuracy of the image-based fractional flow reserve calculation / Balázs Tar, Csaba Jenei, Áron Üveges, Gábor Tamás Szabó, András Ágoston, Csaba András Dézsi, András Komócsi, Dániel Czuriga, Attila Juhász, Zsolt Kőszegi
Dátum:2021
ISSN:1897-5593
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Cardiology Journal. - 28 : 1 (2021), p. 163-165. -
További szerzők:Jenei Csaba (1976-) (kardiológus) Üveges Áron Szabó Gábor Tamás (1982-) (kardiológus) Ágoston András Dézsi Csaba András Komócsi András Czuriga Dániel (1982-) (kardiológus) Juhász Attila Kőszegi Zsolt (1962-) (kardiológus, belgyógyász)
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