What does this research mean for the field?

As stenosis worsens, hyperaemic flow decreases from 45 to 19 cm/s, while resting flow remains stable due to reduced microvascular resistance. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

The aim is to analyze pressure and flow velocity relationships in human coronary arteries to improve stenosis evaluation.

May 1, 2015European Heart JournalOpen Access

Coronary pressure and flow relationships in humans: phasic analysis of normal and pathological vessels and the implications for stenosis assessment: a report from the Iberian–Dutch–English (IDEAL) collaborators

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Key result

Worsening stenosis cuts hyperaemic flow ~58% while resting flow remains stable via reduced MVR.

Why the study?

How do coronary flow velocity, trans-stenotic pressure gradient, and microvascular resistance change with progressive stenosis severity under resting and hyperaemic conditions in humans?

Population

301 patients undergoing 567 simultaneous intracoronary pressure and flow velocity assessments for coronary…

Comparison

Invasive physiological assessment of coronary… vs Comparison across strata of stenosis severity.

Design

Cross-sectional

Authors

SNSukhjinder NijjerInterventional Cardiology GWGuus A. de WaardCardiac Imaging SSSayan SenInterventional Cardiology

Discussion

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Implication

Supports resting pressure indices via preserved flow; extends animal data to humans but leaves open prospective validation.

Key Points

The aim is to analyze pressure and flow velocity relationships in human coronary arteries to improve stenosis evaluation.
Analyzed 567 simultaneous intracoronary pressure and flow velocity measurements from 301 patients.
Evaluated coronary flow velocity, trans-stenotic pressure gradient, and microvascular resistance during resting and hyperaemic states.
Assessed stenosis severity using fractional flow reserve and quantitative coronary angiography.
Hyperemic flow significantly decreased from 45 to 19 cm/s with worsening stenosis severity (Ptrend < 0.001).
Resting flow remained consistent, unaffected by stenosis severity (Ptrend > 0.05).
Trans-stenotic pressure gradient increased with stenosis severity (Ptrend < 0.001 for both rest and hyperemia).
Microvascular resistance decreased with stenosis severity at rest (Ptrend < 0.001), but remained unchanged during hyperemia.

Structured PICO

How do coronary flow velocity, trans-stenotic pressure gradient, and microvascular resistance change with progressive stenosis severity under resting and hyperaemic conditions in humans?

Population

301 patients undergoing 567 simultaneous intracoronary pressure and flow velocity assessments for coronary artery disease.

Intervention

Invasive physiological assessment of coronary flow velocity, trans-stenotic pressure gradient (TG), and microvascular resistance (MVR) during baseline (rest) and hyperaemic conditions.

Comparator

Comparison across strata of stenosis severity (from unobstructed angiographic normal vessels to those with FFR ≤ 0.50).

Outcome

Changes in coronary flow velocity, trans-stenotic pressure gradient (TG), and microvascular resistance (MVR) across the whole cardiac cycle and diastolic wave-free period.surrogate

Resting coronary flow is maintained across progressive stenosis severities via compensatory microvascular auto-regulation, supporting the physiological validity of using resting pressure indices for stenosis assessment.

Cite This Study

Nijjer et al. (2015) studied this question. As stenosis worsens, hyperaemic flow decreases from 45 to 19 cm/s (Ptrend < 0.001), while resting flow remains stable due to reduced microvascular resistance.

synapsesocial.com/papers/696bdcb250a360e9ca119887 https://doi.org/10.1093/eurheartj/ehv626

Topics

Coronary artery disease Percutaneous coronary intervention Coronary CT angiography

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Coronary pressure and flow relationships in humans: phasic analysis of normal and pathological vessels and the implications for stenosis assessment: a report from the Iberian–Dutch–English (IDEAL) collaborators

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Coronary pressure and flow relationships in humans: phasic analysis of normal and pathological vessels and the implications for stenosis assessment: a report from the Iberian–Dutch–English (IDEAL) collaborators

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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