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Related Concept Videos

Pathophysiology of Cardiac Performance01:29

Pathophysiology of Cardiac Performance

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Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
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Coronary Circulation01:21

Coronary Circulation

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The heart, an organ critical to survival, gets nourishment not from the blood it pumps but from a separate circulation system known as coronary circulation. This is the shortest circulation in the body and is responsible for supplying the heart with the nutrients it needs to function effectively.
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
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Blood Studies for Cardiovascular System I: Cardiac Biomarkers01:20

Blood Studies for Cardiovascular System I: Cardiac Biomarkers

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Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
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Ischemic Heart Disease: Overview01:17

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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...
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Related Experiment Video

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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Coronary Physiology: Delivering Precision Medicine?

Laura Maitre-Ballesteros1, Laurent Riou2, Stephanie Marliere1

  • 1Department of Cardiology, University Hospital, 38000 Grenoble Alpes, France.

Reviews in Cardiovascular Medicine
|July 30, 2024
PubMed
Summary

Coronary physiological assessment, including fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR), aids in managing coronary artery disease (CAD). These methods evaluate epicardial lesions and microcirculation for precision medicine in chronic coronary syndrome.

Keywords:
coronary microcirculation dysfunctioncoronary physiology assessmentprecise medicine

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiovascular Physiology

Background:

  • Coronary physiological assessment is crucial for evaluating epicardial coronary lesions.
  • Fractional flow reserve (FFR) is the established gold standard for guiding revascularization decisions.
  • Emerging indexes now allow for comprehensive assessment of both epicardial and microvascular coronary function.

Purpose of the Study:

  • To review available epicardial and microvascular indexes for coronary physiological assessment.
  • To discuss the demonstrated contributions of these indexes in managing coronary artery disease (CAD).
  • To explore the potential role of coronary physiology in precision medicine, particularly for chronic coronary syndrome.

Main Methods:

  • Review of clinical evidence and established guidelines on coronary physiological assessment.
  • Analysis of current epicardial and microvascular indexes used in cardiac catheterization laboratories.
  • Synthesis of data on the application of these indexes in patient management.

Main Results:

  • Fractional flow reserve (FFR) remains the gold standard for epicardial lesion assessment.
  • Indexes like instantaneous wave-free ratio (iFR) offer alternative approaches for revascularization decisions.
  • Newer indexes enable detailed evaluation of coronary microcirculation, complementing epicardial assessment.

Conclusions:

  • Coronary physiological assessment provides a comprehensive evaluation of the entire coronary tree.
  • These assessments facilitate precision medicine strategies for patients with coronary artery disease (CAD).
  • The application of these indexes is particularly relevant for optimizing the management of chronic coronary syndrome.