| Influence of hemodynamic conditions on fractional flow reserve: parametric analysis of underlying model. | |
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MedLine Citation:
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PMID: 12234798 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Pressure-based fractional flow reserve (FFR) is used clinically to evaluate the functional severity of a coronary stenosis, by predicting relative maximal coronary flow (Q(s)/Q(n)). It is considered to be independent of hemodynamic conditions, which seems unlikely because stenosis resistance is flow dependent. Using a resistive model of an epicardial stenosis (0-80% diameter reduction) in series with the coronary microcirculation at maximal vasodilation, we evaluated FFR for changes in coronary microvascular resistance (R(cor) = 0.2-0.6 mmHg. ml(-1). min), aortic pressure (P(a) = 70-130 mmHg), and coronary outflow pressure (P(b) = 0-15 mmHg). For a given stenosis, FFR increased with decreasing P(a) or increasing R(cor). The sensitivity of FFR to these hemodynamic changes was highest for stenoses of intermediate severity. For P(b) > 0, FFR progressively exceeded Q(s)/Q(n) with increasing stenosis severity unless P(b) was included in the calculation of FFR. Although the P(b)-corrected FFR equaled Q(s)/Q(n) for a given stenosis, both parameters remained equally dependent on hemodynamic conditions, through their direct relationship to both stenosis and coronary resistance. |
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Authors:
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Maria Siebes; Steven A J Chamuleau; Martijn Meuwissen; Jan J Piek; Jos A E Spaan |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American journal of physiology. Heart and circulatory physiology Volume: 283 ISSN: 0363-6135 ISO Abbreviation: Am. J. Physiol. Heart Circ. Physiol. Publication Date: 2002 Oct |
Date Detail:
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Created Date: 2002-09-17 Completed Date: 2002-10-17 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 100901228 Medline TA: Am J Physiol Heart Circ Physiol Country: United States |
Other Details:
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Languages: eng Pagination: H1462-70 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Academic Medical Center, University of Amsterdam, The Netherlands. m.siebes@amc.uva.nl |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Coronary Circulation
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physiology* Coronary Stenosis / diagnosis, physiopathology* Humans Models, Cardiovascular* Vascular Resistance / physiology |
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