Search results for "Coronary flow"
showing 10 items of 17 documents
Coronary Artery Shape and Flow Changes Induced by Myocardial Bridging.
1993
Changes in coronary shape and blood flow induced by myocardial bridging were analyzed in a 56-year-old patient with symptoms of unstable angina after the exclusion of other heart disease. Coronary angiography demonstrated a 1.8-cm long myocardial bridge in the middle part of the left anterior descending coronary artery. In systole, an eccentric compression of the artery occurred, resulting in a stenosis that occupied 86% of the diameter and 96% of the area. Intraluminal ultrasound was performed with a 20-MHz transducer in a 4.8-Fr catheter sheath (Boston Scientific Corp.) connected to an ultrasound console (Diasonics Inc.). A side saddle catheter was introduced into the left anterior descen…
Evidence of impaired coronary flow reserve and elevated microvascular resistances in a case of recurrent left apical ballooning.
2011
A 56-year old man was admitted for precordial pain associated with dyspnea and evidence of myocardial ischemia on ECG and cardiac ultrasound. His previous history included an episode of left apical ballooning five years before. At angiography, no evidence of significant epicardial coronary artery disease was manifest. Interestingly, both coronary flow reserve and the index of microvascular resistances were abnormal, showing evidence of impaired microvascular function. This is the first report providing direct evidence of microvascular dysfunction in a patient with (recurrent) apical ballooning.
Myocardial contrast echocardiography in biopsy-proven primary cardiac amyloidosis.
2008
Abstract Cardiac vasculature is affected in 88-90% of patients with primary cardiac amyloidosis (CA). Myocardial contrast echocardiography (MCE) relies on the ultrasound detection of microbubble contrast agents that are solely confined to the intravascular space, and are therefore useful in the evaluation of flow in the microvasculature. This is the first case report describing the use of MCE during vasodilator stress to evaluate coronary flow reserve in a patient with biopsy-proven primary CA and angiographically normal coronaries. Qualitative MCE demonstrated delayed replenishment of microbubbles during peak stress; quantitative analysis was consistent with a reduction in total myocardial…
Left ventricular non-compaction cardiomyopathy in children: Is segmental fibrosis the cause of tissue Doppler alterations and of EF reduction?
2009
Noncompaction of the ventricular myocardium (LVNC) is a rare congenital cardiomyopathy resulting from an arrest in normal endomyocardial embryogenesis. In 2002 Jenni et al. [Jenni R, Wyss CA, Oechslin EN, Kaufmann PA. Isolated ventricular noncompaction is associated with coronary microcirculatory dysfunction. J Am Coll Cardiol 2002; 39:450-454.] reported a microvascular dysfunction in 12 patients affected by non compaction: areas of restricted myocardial perfusion have been documented by scintigraphy, suggesting a reduction of Coronary flow reserve. McMahon et al reported in a recent article a reduction of TD velocities in children with noncompaction of the left ventricle, compared with nor…
Impaired Fractional and Coronary Flow Reserve
2016
A FFR <0.80/0.75 witnesses the existence of a high-grade epicardial stenosis. In this setting, the CFR is usually also impaired since even a maximal dilation of the peripheral resistances cannot compensate for the increased epicardial resistances.
Koronare Bypassdiagnostik mit CT und MRT - eine Bestandsaufnahme
2004
The limited lifetime and the correlation between graft occlusion and recurring symptoms underline the need for repeated imaging of coronary artery bypass grafts. CT and MRI allow for non-invasive imaging of coronary bypasses with high accuracies concerning the patency of these vessels. Multidetector CT seems to be the CT technique of choice, especially after the introduction of 16 slice CT scanners for morphologic assessment of coronary artery bypass grafts. Compared with MRI, CT is a robust technique for assessment of cardiac anastomoses, native coronary arteries, and for the detection of graft stenoses. MRI, however, is able to deliver functional information about the grafts and the recip…
Cardiovascular Imaging Techniques in Systemic Rheumatic Diseases
2018
The risk of cardiovascular (CV) events and mortality is significantly higher in patients with systemic rheumatic diseases than in the general population. Although CV involvement in such patients is highly heterogeneous and may affect various structures of the heart, it can now be diagnosed earlier and promptly treated. Various types of assessments are employed for the evaluation of CV risk such as transthoracic or transesophageal echocardiography, magnetic resonance imaging (MRI), and computed tomography (CT) to investigate valve abnormalities, pericardial disease, and ventricular wall motion defects. The diameter of coronary arteries can be assessed using invasive quantitative coronarograp…
A Normal Fractional and Coronary Flow Reserve
2016
Fractional flow reserve (FFR) and coronary flow reserve (CFR) provide different and complementary information on vascular physiology. The two tests provide information, respectively, on the epicardial and total vascular resistances. Typically, a FFR <0.75 is also associated with an impaired CFR (<2); exceptions, however, exist.
Quantitative Coronary Angiography and Digital Densitometric Perfusion Measurements?How to Assess the Success of Intracoronary Balloon Dilatation
1988
Densitometric evaluation of digital subtraction angiocardiograms allows the assessment of local myocardial perfusion before and after pharmacological stimulation of coronary flow reserve during the catheterization procedure. This report deals with a case of a severe stenosis of the left coronary artery in which PTCA was regarded successful based on an appropriate increase in luminal diameter while an intima and media dissection at the dilatation site was documented. The perfusion measurements, however, pointed out a clear impairment of poststenotic myocardial perfusion after PTCA.
Echocardiographic assessment of coronary microvascular dysfunction: Basic concepts, technical aspects, and clinical settings
2021
Abstract Coronary flow reserve is the capacity of the coronary circulation to augment the blood flow in response an increase in myocardial metabolic demands and has a powerful prognostic significance in different clinical situations. It might assess with invasive and noninvasive technique. Transthoracic echocardiography Doppler is an emerging diagnostic technique, noninvasive, highly feasible, safe for patient and physician, without radiation, and able to detect macrovascular and microvascular anomalies in the coronary circulation. This review aims to describe the benefit and limits of echocardiographic assessment of coronary flow reserve.