Aggressive Up-Titration of Heart Failure Guideline-Directed Medical Therapies in Cardiogenic Shock Supported by a Percutaneous Ventricular Assist Device.

Background: Survival rates after cardiogenic shock (CS) remain dismal and largely unaltered in clinical trials, contrasting heart failure with reduced ejection fraction, where new drugs have established guideline-directed therapy, improving long-term outcomes. Unfortunately, unfavorable effects on blood pressure and glomerular perfusion limit their use in CS. A percutaneous ventricular assist device (pVAD) supports cardiac output and blood pressure, offering an option to counteract these negative drug effects.

Comparison of Diagnostic Accuracy of CT Derived Fractional Flow Reserve for Predicting Revascularization.

Purpose: CT-derived fractional-flow-reserve (FFR) is recommended for determining the indication of revascularization. Consensus on optimal fractional-flow-reserve (FFR) measurement methods and lesions is lacking. To investigate the diagnostic accuracy of FFR measurement methods for predicting revascularization and factors affecting FFR measurement methods.

A multicenter analysis of implantable monitoring device-based diagnosis of supraventricular arrhythmia post patent foramen ovale closure: the OCCL-ILR study.

Background: Recent data suggest that the true incidence of atrial fibrillation (AF) after patent foramen ovale (PFO) closure has probably been underestimated, and may differ according to the type of closing device used.

Objectives: On the basis of continuous rhythm monitoring with an implantable device, this study aims to assess the incidence of  supraventricular arrhythmia following PFO closure with the Occlutech PFO device.

Methods: This is a multicentric analysis of consecutive PFO closure patients treated with an Occlutech device between 01/01/2019 and 20/03/2024, with an implantable loop recorder (IRL) (or a pacemaker or implantable cardioverter defibrillator) implanted for at least 3 months preceding the procedure, and with available follow-up for at least 1month post procedure.

Favorable impact of FFR on myocardial revascularization outcomes: Results from an observational real-world registry.

Background: Coronary computed tomography angiography (CCTA)-derived fractional flow reserve (FFR) strategy significantly decreases unnecessary invasive coronary angiography and refines the appropriateness of revascularization decision. The present study aimed to evaluate how FFR guided - strategy impacts outcomes postrevascularization.

Methods: We included patients with suspected obstructive coronary artery disease (OCAD in a registry from 2013 to 2021.

Clinical utility of coronary CT angiography to guide PCI: a survey among P4 investigators.

Background: Coronary CT Angiography (CTA) is increasingly being used to plan percutaneous coronary intervention (PCI), offering detailed pre-procedural anatomical and physiological insights. The Precise Procedural and PCI Plan (P4) study evaluates the efficacy of CT- versus intravascular ultrasound-guided PCI. The aim of this study was to assess the utility of various CT-guided PCI tools and strategies as perceived by experienced operators within the context of the P4 study.

Residential exposome and the risk of coronary obstruction and myocardial ischemia detected by coronary computed tomography.

Background And Aims: To assess independent impacts of air and noise pollution, and residential green exposure on non-invasively derived coronary obstruction and myocardial ischemia.

Methods: Consecutive patients screened by coronary computed tomography angiography (CCTA) for stable chest pain between 01/01/2019 and 31/12/2020 were included in a registry. Exposure associations between residential PM2.

Impact of recurrent COVID-19 disease waves on acute myocardial infarction epidemics: results from a regional network.

Aims: To assess the impact of COVID-19 related public containment measures during recurrent COVID-19 waves on hospital admission rate for acute myocardial infarction (AMI).

Methods And Results: Clinical characteristics, reperfusion therapy modalities, COVID-19 status and in-hospital mortality of consecutive AMI patients who were admitted in a regional AMI network were recorded during one year starting in March 2020 and were compared with the year before. The COVID-19 study period encompassed two waves: the first in March-May 2020 and the second in October-December 2020.

Normalization of FFR after surgical unroofing of a myocardial bridge: a case report.

Background: Cardiac computed tomography angiography derived fractional flow reserve (FFR) is a diastolic measurement and has emerged as a valuable non-invasive alternative to FFR in patients with stable coronary artery disease. It has, unlike FFR during coronary angiography, not been validated for the physiological evaluation of an isolated myocardial bridge (MB) so far.

Case Summary: Our patient, previously known with a long myocardial bridge of the mid-segment of the left anterior descending artery, presented with a non-ST-segment elevation myocardial infarction that was treated by surgical unroofing of the MB.

Clinical and prognostic incremental value of FFRCT in screening of patients with obstructive coronary artery disease.

Background: Coronary computed tomography angiography (CCTA) -derived fractional flow reserve (FFR) is recommended to evaluate the functional consequences of obstructive coronary artery disease (OCAD). Real-world incremental impacts of FFR use still remains under debate.

Methods: 1601 patients with suspected OCAD on CCTA (>50 ​% stenosis), including 808 (50.

FFRct use for acute chest pain triage in the emergency department: a cost-effectiveness analysis.

Aims: To model and assess the cost-effectiveness of CT-based fractional flow reserve (FFRct) for a population of low to intermediate risk patients for coronary artery disease (CAD) presenting to the emergency department (ED) with acute chest pain.

Methods And Results: Using a decision tree model with a 1 year time horizon and from a health care perspective, two diagnostic pathways using FFRct are compared to current clinical routine combining coronary computed tomography angiography (CCTA) with an exercise test. Model data are drawn from the literature and nationally reported data.

Impact of vessel morphology on CT-derived fractional-flow-reserve in non-obstructive coronary artery disease in right coronary artery.

Objectives: Computed tomography (CT)-derived fractional flow reserve (FFR) decreases continuously from proximal to distal segments of the vessel due to the influence of various factors even in non-obstructive coronary artery disease (NOCAD). It is known that FFR is dependent on vessel-length, but the relationship with other vessel morphologies remains to be explained.

Purpose: To investigate morphological aspects of the vessels that influence FFR in NOCAD in the right coronary artery (RCA).

Depression and Malnutrition for Prediction of Mortality after Transcatheter Aortic Valve Replacement: A Registry Study of a Tertiary Referral Hospital.

Moderate to severe frailty is a predictor of a poor outcome after transcatheter aortic valve replacement (TAVR), but little is known about the prognostic importance of different geriatric frailty markers in an overall fit or pre-frail geriatric population undergoing TAVR. This retrospective study aimed to examine the incremental value of adding patient frailty markers to conventional surgical risk score to predict all-cause mortality in relatively fit elderly patients undergoing TAVR. Overall patient frailty was assessed using the comprehensive geriatric assessment frailty index (CGA-FI).

The impact of iodine contrast agent on radiation dose of heart and blood: a comparison between coronary CT angiography and cardiac calcium scoring CT.

Background: Iodine contrast agent (CA) is widely used in cardiac computed tomography (CT). The CA can increase the organ radiation doses due to the photoelectric effect.

Purpose: To investigate the impact of CA on radiation dose in cardiac CT by comparing the radiation dose between contrast coronary CT angiography (CCTA) and non-contrast calcium scoring CT (CSCT).

A chart review on surgical myocardial debridging in symptomatic patients: a safe procedure with good long-term clinical outcome and coronary computed tomographic angiography results.

Objectives: Myocardial bridging is mostly diagnosed as an incidental imaging finding but can result in severe vessel compression and significant clinical adverse complications. Since there is still an ongoing debate when to propose surgical unroofing, we studied a group of patients where this was performed as an isolated procedure.

Methods: In 16 patients (38.

Evaluation of coronary artery disease in patients undergoing atrial fibrillation ablation: a non-invasive FFR computed tomography study.

To evaluate coronary artery disease (CAD) with computed tomography coronary angiography (CTCA)-derived fractional flow reserve (FFR) in patients with atrial fibrillation (AF) requiring ablation. The study population consisted of 151 patients who underwent CTCA before AF ablation (AF group), and a control group of 151 patients from the outpatient clinic who underwent CTCA without any history of AF (non-AF group), matched for age, sex, BMI, and angina symptomatology. All study patients underwent CTCA with subdivision of coronary lesion type into severe (≥ 70% luminal narrowing), moderate (50% ≤ luminal narrowing < 70%), and mild stenosis (< 50% luminal narrowing).

Impact of ramus coronary artery on computed tomography derived fractional flow reserve (FFR ) in no apparent coronary artery disease.

Background: The ramus artery contributes to the development of turbulence, which may influence computed tomography (CT) derived fractional flow reserve (FFR ) even without coronary artery disease (CAD). The relationship between ramus-induced turbulence and FFR is unclear.

Method And Results: A total of 120 patients with <20% coronary stenosis assessed by both FFR and invasive coronary angiography were evaluated.

Impact of coronary bifurcation angle on computed tomography derived fractional flow reserve in coronary vessels with no apparent coronary artery disease.

Objectives: Computed tomography (CT) derived fractional flow reserve (FFR) decreases from the proximal to the distal part due to a variety of factors. The energy loss due to the bifurcation angle may potentially contribute to a progressive decline in FFR. However, the association of the bifurcation angle with FFR is still not entirely understood.

Effects of left ventricular mass on computed tomography derived fractional flow reserve in significant obstructive coronary artery disease.

Background: In significant obstructive coronary artery disease (SOCAD), a mismatch in assessment of severity of coronary artery stenosis may occur between invasive coronary angiography (ICA) and computed tomography (CT) derived fractional flow reserve (FFR). The present study aimed to identify the factors giving an FFR > 0.80 and leading to an underestimation of coronary artery severity in SOCAD vessels.

Long term effects of surgical and transcatheter aortic valve replacement on FFR in patients with severe aortic valve stenosis.

The long-term variations of fractional flow reserve derived from coronary computed tomography (FFR) after surgical (SAVR) or transcatheter (TAVR) aortic valve replacement in patients with severe aortic valve stenosis (AS) have not been investigated. A total of 25 patients with isolated, severe AS underwent coronary computed tomography with 3-vessel FFR analysis (Heartflow Inc.-Redwood City, California, USA) and measurement of total coronary volume (V), left ventricular mass (M) and their ratio (V/M) before and 6 months after SAVR or TAVR.

Impact of vascular morphology and plaque characteristics on computed tomography derived fractional flow reserve in early stage coronary artery disease.

Background: Computed-tomography (CT) derived fractional-flow-reserve (FFR) gradually may decrease from proximal to distal vessels even without apparent coronary artery disease (CAD). It may be unclear whether the decrease in FFR at the distal coronal artery is physiological or due to stenosis. We decided to study predictive factors of an FFR decline below the pathological value of 0.

Guiding Myocardial Revascularization by Algorithmic Interpretation of FFR Pullback Curves: A Proof of Concept Study.

Coronary artery disease distribution along the vessel is a main determinant of FFR improvement after PCI. Identifying focal from diffuse disease from visual inspections of coronary angiogram (CA) and FFR pullback (FFR-PB) are operator-dependent. Computer science may standardize interpretations of such curves.