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http://dx.doi.org/10.1016/j.ahj.2019.04.012 | DOI Listing |
JAMA Cardiol
September 2025
Department of Cardiology, Inselspital University Hospital of Bern, University of Bern, Bern, Switzerland.
Importance: Right anomalous aortic origin of a coronary artery (R-AAOCA) is a rare congenital condition increasingly diagnosed with the growing use of cardiac imaging. Due to dynamic compression of the anomalous vessel, invasive fractional flow reserve (FFR) during a dobutamine-atropine volume challenge (FFR-dobutamine) is considered the reference standard. A reliable alternative method is needed to reduce extensive invasive testing, but it remains uncertain whether noninvasive imaging can accurately assess the hemodynamic relevance of R-AAOCA.
View Article and Find Full Text PDFEClinicalMedicine
October 2025
Department of Cardiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Background: The benefits of physiology-guided management in acute coronary syndrome (ACS) remain inconclusive due to limited evidence. In our FAVOR III China trial, a quantitative flow ratio (QFR)-based physiology-guided strategy versus standard angiography guidance improved the 1-year primary outcome among participants with coronary artery disease (CAD). We aimed to investigate, in a prespecified analysis, the outcomes of QFR-based physiological guidance in the FAVOR III China participants with low-risk ACS.
View Article and Find Full Text PDFClin Res Cardiol
September 2025
Department of (Interventional) Cardiology, Thoraxcenter, Erasmus University Medical Center, Room Rg-628, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
Background: Fractional flow reserve (FFR) for non-culprit lesions (NCLs) in patients with ST-elevation myocardial infarction (STEMI) can be influenced by temporary changes in microvascular resistance. Angiography-derived vessel fractional flow reserve (vFFR) has been tested as a less-invasive alternative.
Aims: The FAST STEMI II study aimed to assess the diagnostic performance of acute-setting vFFR vs.
Catheter Cardiovasc Interv
September 2025
Royal North Shore Hospital, St Leonards, Australia.
Background: Invasive coronary physiology including fractional flow reserve (FFR), instantaneous wave-free ratio (iFR), and coronary flow reserve (CFR) are guideline-endorsed tools to guide the management of coronary artery disease (CAD). Complex factors impact and confound these assessments, and discordance between modalities complicates clinical management. iEquate is a prospective observational trial that combines multi-modality coronary physiology and optical coherence tomography (OCT) to identify the determinants of pressure-wire derived myocardial ischemia and iFR-FFR discordance.
View Article and Find Full Text PDFInt J Cardiol
September 2025
Department of Biomedical Engineering, University of Cincinnati, Veterans Affairs Medical Center, Cincinnati, OH, USA. Electronic address:
Introduction: Pressure-based fractional flow reserve (FFR) and flow-based coronary flow reserve (CFR) assess the functional status of coronary artery disease (CAD) during cardiac catheterization. Complex hemodynamics may not be adequately explained by either pressure or flow alone. Consequently, pressure-drop coefficient (CDP, the ratio between pressure-drop across a stenosis and distal dynamic pressure) that combines both pressure and flow measurements has been developed to distinguish between epicardial stenosis (ES) and microvascular disease (MVD).
View Article and Find Full Text PDF