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Related Concept Videos

Ischemic Heart Disease: Overview01:17

Ischemic Heart Disease: Overview

Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and narrowing...
Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...

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Related Experiment Video

Updated: Jun 8, 2026

Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
08:35

Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction

Published on: August 17, 2022

Microvascular dysfunction in chronic total coronary occlusions.

G S Werner1, M Ferrari, B M Richartz

  • 1Clinic for Internal Medicine III, Friedrich-Schiller-University Jena, Erlanger Allee 101, Jena, Germany. gerald.werner@med.uni-jena.de

Circulation
|September 6, 2001
PubMed
Summary
This summary is machine-generated.

Microvascular dysfunction affects over half of patients with chronic total coronary occlusions (TCOs), particularly those with diabetes or hypertension. Combining coronary flow velocity reserve (CFVR) and fractional flow reserve (FFR) is crucial for accurate assessment after TCO angioplasty.

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Coronary Artery Disease

Background:

  • Microvascular dysfunction is characterized by reduced coronary flow reserve without epicardial stenosis.
  • This study investigated the prevalence and impact of microvascular dysfunction in chronic total coronary occlusions (TCOs).

Purpose of the Study:

  • To determine the prevalence of microvascular dysfunction in TCOs.
  • To assess the relationship between microvascular dysfunction and regional myocardial function.
  • To evaluate the utility of coronary flow velocity reserve (CFVR) and fractional flow reserve (FFR) in TCOs.

Main Methods:

  • Recanalization and stenting of TCOs in 42 patients.
  • Coronary flow velocity reserve (CFVR) measured by intracoronary Doppler.
  • Fractional flow reserve (FFR) recorded in a subset of 27 patients.
  • CFVR reassessed after 24 hours in 21 patients.

Main Results:

  • 55% of patients exhibited reduced CFVR (<2.0).
  • In a subgroup, 52% showed reduced CFVR with a non-significant FFR (>=0.75), indicating microvascular dysfunction.
  • Microvascular dysfunction was more prevalent in patients with diabetes and/or hypertension.
  • CFVR and FFR were poorly correlated (r=0.03).

Conclusions:

  • Microvascular dysfunction is common in TCOs (55%), irrespective of regional myocardial function.
  • Diabetes and hypertension are associated with increased microvascular dysfunction.
  • Neither CFVR nor FFR alone is sufficient for assessing angioplasty outcomes in TCOs; combined assessment is recommended.