Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease最新文献

{"title":"Cardiac Myosin Inhibitors as a Novel Treatment Option for Obstructive Hypertrophic Cardiomyopathy: Addressing the Core of the Matter","authors":"Ahmad Masri, I. Olivotto","doi":"10.1161/JAHA.121.024656","DOIUrl":"https://doi.org/10.1161/JAHA.121.024656","url":null,"abstract":"mid- ventricular, and post- SRT phenotypes. Patients with heart failure with preserved ejection fraction also represent a future target for CMIs given their mechanism of action. Finally, in the minority of patients who present or progress to end- stage disease (defined as a left ventricular ejection fraction ≤50%), CMIs and SRT are contraindicated and/or not beneficial, and standard of care therapies are not typically effective. In these scenarios, advanced heart failure therapies are required. CMs indicates cardiac myosin inhibitors; G−, genotype negative; G+, genotype positive; HFpEF, heart failure with preserved ejection fraction; ICD, internal cardioverter defibrillator; LVAD, left ventricular assist device; nHCM, non- obstructive hypertrophic cardiomyopathy; NYHA, New Yok Heart Association; oHCM, obstructive hypertrophic cardiomyopathy; P−, phenotype negative; P+, phenotype positive; and SRT, septal reduction therapies.","PeriodicalId":17189,"journal":{"name":"Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87994923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Future Role of New Negative Inotropic Agents in the Era of Established Surgical Myectomy for Symptomatic Obstructive Hypertrophic Cardiomyopathy","authors":"B. Maron, M. Maron, M. Sherrid, E. Rowin","doi":"10.1161/JAHA.121.024566","DOIUrl":"https://doi.org/10.1161/JAHA.121.024566","url":null,"abstract":"Indeed, initially, HCM was a disease for which management was based largely on pharmacotherapy (eg, betablockers; verapamil), as well as infrequent highrisk surgical procedures.4 However, predominantly nonpharmacologic innovations over the last 20 to 25 years have dramatically adjusted patient expectations for longevity and good quality of life, including reversibility of heart failure with surgical myectomy (and its selective alternative alcohol septal ablation).3,5,6 In the present commentary we discuss the effective treatment modalities currently available for HCMrelated heart failure due to left ventricular (LV) outflow obstruction, anticipating the emergence of new medications for symptomatic patients, and the role such therapies may have with respect particularly to timehonored surgical myectomy.","PeriodicalId":17189,"journal":{"name":"Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84874822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fractional Flow Reserve Versus Instantaneous Wave‐Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study","authors":"T. Kovárník, Matsuo Hitoshi, A. Král, S. Jerabek, D. Zemánek, Y. Kawase, H. Omori, T. Tanigaki, J. Pudil, A. Vodzinská, M. Branny, R. Štípal, P. Kala, J. Mrózek, M. Porzer, T. Grézl, Kamil Novobílský, O. Mendiz, K. Kopřiva, M. Mates, M. Chvál, Zhi Chen, Pavel Martásek, A. Linhart","doi":"10.1161/JAHA.121.021490","DOIUrl":"https://doi.org/10.1161/JAHA.121.021490","url":null,"abstract":"Background The FiGARO (FFR versus iFR in Assessment of Hemodynamic Lesion Significance, and an Explanation of Their Discrepancies) trial is a prospective registry searching for predictors of fractional flow reserve/instantaneous wave‐free ratio (FFR/iFR) discrepancy. Methods and Results FFR/iFR were analyzed using a Verrata wire, and coronary flow reserve was analyzed using a Combomap machine (both Philips‐Volcano). The risk polymorphisms for endothelial nitric oxide synthase and for heme oxygenase‐1 were analyzed. In total, 1884 FFR/iFR measurements from 1564 patients were included. The FFR/iFR discrepancy occurred in 393 measurements (20.9%): FFRp (positive)/iFRn (negative) type (264 lesions, 14.0%) and FFRn/iFRp (129 lesions, 6.8%) type. Coronary flow reserve was measured in 343 lesions, correlating better with iFR (R=0.56, P<0.0001) than FFR (R=0.36, P<0.0001). The coronary flow reserve value in FFRp/iFRn lesions (2.24±0.7) was significantly higher compared with both FFRp/iFRp (1.39±0.36), and FFRn/iFRn lesions (1.8±0.64, P<0.0001). Multivariable logistic regression analysis confirmed (1) sex, age, and lesion location in the right coronary artery as predictors for FFRp/iFRn discrepancy; and (2) hemoglobin level, smoking, and renal insufficiency as predictors for FFRn/iFRp discrepancy. The FFRn/iFRp type of discrepancy was significantly more frequent in patients with both risk types of polymorphisms (endothelial nitric oxide synthaser+heme oxygenase‐1r): 8 patients (24.2%) compared with FFRp/iFRn type of discrepancy: 2 patients (5.9%), P=0.03. Conclusions Predictors for FFRp/iFRn discrepancy were sex, age, and location in the right coronary artery. Predictors for FFRn/iFRp were hemoglobin level, smoking, and renal insufficiency. The risk type of polymorphism in endothelial nitric oxide synthase and heme oxygenase‐1 genes was more frequently found in patients with FFRn/iFRp type of discrepancy. Registration URL: https://clinicaltrials.gov; Unique identifier: NCT03033810.","PeriodicalId":17189,"journal":{"name":"Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease","volume":"110 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77187285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IV Sotalol Use in Pediatric and Congenital Heart Patients: A Multicenter Registry Study","authors":"Lindsey E Malloy-Walton, Nicholas H. Von Bergen, S. Balaji, P. Fischbach, Jason M. Garnreiter, S. Y. Asaki, J. Moak, Luis A Ochoa, Philip M. Chang, Hoang H. Nguyen, Akash Patel, C. Kirk, A. Sherman, Jennifer N. Avari Silva, J. Saul","doi":"10.1161/JAHA.121.024375","DOIUrl":"https://doi.org/10.1161/JAHA.121.024375","url":null,"abstract":"Background There is limited information regarding the clinical use and effectiveness of IV sotalol in pediatric patients and patients with congenital heart disease, including those with severe myocardial dysfunction. A multicenter registry study was designed to evaluate the safety, efficacy, and dosing of IV sotalol. Methods and Results A total of 85 patients (age 1 day–36 years) received IV sotalol, of whom 45 (53%) had additional congenital cardiac diagnoses and 4 (5%) were greater than 18 years of age. In 79 patients (93%), IV sotalol was used to treat supraventricular tachycardia and 4 (5%) received it to treat ventricular arrhythmias. Severely decreased cardiac function by echocardiography was seen before IV sotalol in 7 (9%). The average dose was 1 mg/kg (range 0.5–1.8 mg/kg/dose) over a median of 60 minutes (range 30–300 minutes). Successful arrhythmia termination occurred in 31 patients (49%, 95% CI [37%–62%]) with improvement in rhythm control defined as rate reduction permitting overdrive pacing in an additional 18 patients (30%, 95% CI [19%–41%]). Eleven patients (16%) had significant QTc prolongation to >465 milliseconds after the infusion, with 3 (4%) to >500 milliseconds. There were 2 patients (2%) for whom the infusion was terminated early. Conclusions IV sotalol was safe and effective for termination or improvement of tachyarrhythmias in 79% of pediatric patients and patients with congenital heart disease, including those with severely depressed cardiac function. The most common dose, for both acute and maintenance dosing, was 1 mg/kg over ~60 minutes with rare serious complications.","PeriodicalId":17189,"journal":{"name":"Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84901463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age‐Related Associations of Low‐Density Lipoprotein Cholesterol and Atherosclerotic Cardiovascular Disease: A Nationwide Population‐Based Cohort Study","authors":"H. N. Jung, Min-Ju Kim, Hwi Seung Kim, W. Lee, S. Min, Ye-Jee Kim, C. Jung","doi":"10.1161/JAHA.121.024637","DOIUrl":"https://doi.org/10.1161/JAHA.121.024637","url":null,"abstract":"Background The relationship between low‐density lipoprotein cholesterol (LDL‐C) and atherosclerotic cardiovascular disease (ASCVD) according to age remains undetermined. Thus, this study aimed to investigate the age‐related association of LDL‐C and ASCVD. Methods and Results Data from the Korean NHIS‐HEALS (National Health Insurance Service‐National Health Screening Cohort) were analyzed. Individuals previously diagnosed with cardiovascular disease or taking lipid‐lowering drugs were excluded. Age‐specific association between LDL‐C and ASCVD was calculated using adjusted Cox proportional hazards models. During a median follow‐up of 6.44 years for 285 119 adults, ASCVD developed in 8996 (3.2%). All age groups showed positive associations between LDL‐C and ASCVD risk, mostly with statistical significance from LDL‐C of 160 mg/dL onward. ASCVD risk did not differ significantly between the age groups (P for interaction=0.489). Correspondingly, subgroup analysis in type 2 diabetes exhibited no difference in the age‐specific association of LDL‐C and ASCVD (P for interaction=0.784). Conclusions The study demonstrated that people aged ≥75 years with higher LDL‐C at baseline still presented increased ASCVD risk, which was not significantly different from the younger groups. These findings support the importance of managing LDL‐C for the prevention of primary ASCVD in the growing elderly population.","PeriodicalId":17189,"journal":{"name":"Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87637419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex‐Related Differences in Clinical Features and In‐Hospital Outcomes of Type B Acute Aortic Dissection: A Registry Study","authors":"Toshiyuki Takahashi, H. Yoshino, K. Akutsu, T. Shimokawa, H. Ogino, T. Kunihara, M. Usui, Kazuhiro Watanabe, M. Kawata, H. Masuhara, Manabu Yamasaki, Takeshi Yamamoto, K. Nagao, M. Takayama","doi":"10.1161/JAHA.121.024149","DOIUrl":"https://doi.org/10.1161/JAHA.121.024149","url":null,"abstract":"Background The association between female sex and poor outcomes following surgery for type A acute aortic dissection has been reported; however, sex‐related differences in clinical features and in‐hospital outcomes of type B acute aortic dissection, including classic aortic dissection and intramural hematoma, remain to be elucidated. Methods and Results We studied 2372 patients with type B acute aortic dissection who were enrolled in the Tokyo Acute Aortic Super‐Network Registry. There were fewer and older women than men (median age [interquartile range]: 76 years [66–84 years], n=695 versus 68 years [57–77 years], n=1677; P<0.001). Women presented to the aortic centers later than men. Women had a higher proportion of intramural hematoma (63.7% versus 53.7%, P<0.001), were medically managed more frequently (90.9% versus 86.3%, P=0.002), and had less end‐organ malperfusion (2.4% versus 5.7%, P<0.001) and higher in‐hospital mortality (5.3% versus 2.7%, P=0.002) than men. In multivariable analysis, age (per year, odds ratio [OR], 1.06 [95% CI, 1.03–1.08]; P<0.001), hyperlipidemia (OR, 2.09 [95% CI, 1.13–3.88]; P=0.019), painlessness (OR, 2.59 [95% CI, 1.14–5.89]; P=0.023), shock/hypotension (OR, 2.93 [95% CI, 1.21–7.11]; P=0.017), non–intramural hematoma (OR, 2.31 [95% CI, 1.32–4.05]; P=0.004), aortic rupture (OR, 26.6 [95% CI, 14.1–50.0]; P<0.001), and end‐organ malperfusion (OR, 4.61 [95% CI, 2.11–10.1]; P<0.001) were associated with higher in‐hospital mortality, but was not female sex (OR, 1.67 [95% CI, 0.96–2.91]; P=0.072). Conclusions Women affected with type B acute aortic dissection were older and had more intramural hematoma, a lower incidence of end‐organ malperfusion, and higher in‐hospital mortality than men. However, female sex was not associated with in‐hospital mortality after multivariable adjustment.","PeriodicalId":17189,"journal":{"name":"Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79569896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparisons of Prehospital Delay and Related Factors Between Acute Ischemic Stroke and Acute Myocardial Infarction","authors":"C. Yoon, Hoonji Oh, Juneyoung Lee, J. Rha, S. Woo, Won Kyung Lee, Han-Young Jung, B. Ban, Jihoon Kang, B. Kim, W. Kim, C. Yoon, Heeyoung Lee, Seong-Hwan Kim, Sung Hun Kim, E. Kang, A. Her, J. Cha, Dae-Hyun Kim, Moo-Hyun Kim, J. Lee, H. Park, K. Kim, R. Kim, Nack-Cheon Choi, Jinyong Hwang, Hyun-Woong Park, K. Park, SangHak Yi, J. Cho, N. Kim, K. Choi, Yongcheol Kim, Juhan Kim, Jae-Young Han, J. Choi, S. Kim, J. Choi, Jei Kim, S. Jee, M. Sohn, Si-Wan Choi, Dong-Ick Shin, Sang Yeub Lee, J. Bae, K. Lee, H. Bae","doi":"10.1161/JAHA.121.023214","DOIUrl":"https://doi.org/10.1161/JAHA.121.023214","url":null,"abstract":"Background Prehospital delay is an important contributor to poor outcomes in both acute ischemic stroke (AIS) and acute myocardial infarction (AMI). We aimed to compare the prehospital delay and related factors between AIS and AMI. Methods and Results We identified patients with AIS and AMI who were admitted to the 11 Korean Regional Cardiocerebrovascular Centers via the emergency room between July 2016 and December 2018. Delayed arrival was defined as a prehospital delay of >3 hours, and the generalized linear mixed‐effects model was applied to explore the effects of potential predictors on delayed arrival. This study included 17 895 and 8322 patients with AIS and AMI, respectively. The median value of prehospital delay was 6.05 hours in AIS and 3.00 hours in AMI. The use of emergency medical services was the key determinant of delayed arrival in both groups. Previous history, 1‐person household, weekday presentation, and interhospital transfer had higher odds of delayed arrival in both groups. Age and sex had no or minimal effects on delayed arrival in AIS; however, age and female sex were associated with higher odds of delayed arrival in AMI. More severe symptoms had lower odds of delayed arrival in AIS, whereas no significant effect was observed in AMI. Off‐hour presentation had higher and prehospital awareness had lower odds of delayed arrival; however, the magnitude of their effects differed quantitatively between AIS and AMI. Conclusions The effects of some nonmodifiable and modifiable factors on prehospital delay differed between AIS and AMI. A differentiated strategy might be required to reduce prehospital delay.","PeriodicalId":17189,"journal":{"name":"Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77192233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fallacy of Median Door‐to‐ECG Time: Hidden Opportunities for STEMI Screening Improvement","authors":"M. Y. Yiadom, Wu Gong, B. Patterson, C. Baugh, A. Mills, N. Gavin, S. Podolsky, G. Salazar, B. Mumma, M. Tanski, Kelsea Hadley, Caitlin Azzo, S. Dorner, A. Ulintz, Dandan Liu","doi":"10.1161/JAHA.121.024067","DOIUrl":"https://doi.org/10.1161/JAHA.121.024067","url":null,"abstract":"Background ST‐segment elevation myocardial infarction (STEMI) guidelines recommend screening arriving emergency department (ED) patients for an early ECG in those with symptoms concerning for myocardial ischemia. Process measures target median door‐to‐ECG (D2E) time of 10 minutes. Methods and Results This 3‐year descriptive retrospective cohort study, including 676 ED‐diagnosed patients with STEMI from 10 geographically diverse facilities across the United States, examines an alternative approach to quantifying performance: proportion of patients meeting the goal of D2E≤10 minutes. We also identified characteristics associated with D2E>10 minutes and estimated the proportion of patients with screening ECG occurring during intake, triage, and main ED care periods. We found overall median D2E was 7 minutes (IQR:4–16; range: 0–1407 minutes; range of ED medians: 5–11 minutes). Proportion of patients with D2E>10 minutes was 37.9% (ED range: 21.5%–57.1%). Patients with D2E>10 minutes, compared to those with D2E≤10 minutes, were more likely female (32.8% versus 22.6%, P=0.005), Black (23.4% versus 12.4%, P=0.005), non‐English speaking (24.6% versus 19.5%, P=0.032), diabetic (40.2% versus 30.2%, P=0.010), and less frequently reported chest pain (63.3% versus 87.4%, P<0.001). ECGs were performed during ED intake in 62.1% of visits, ED triage in 25.3%, and main ED care in 12.6%. Conclusions Examining D2E>10 minutes can identify opportunities to improve care for more ED patients with STEMI. Our findings suggest sex, race, language, and diabetes are associated with STEMI diagnostic delays. Moving the acquisition of ECGs completed during triage to intake could achieve the D2E≤10 minutes goal for 87.4% of ED patients with STEMI. Sophisticated screening, accounting for differential risk and diversity in STEMI presentations, may further improve timely detection.","PeriodicalId":17189,"journal":{"name":"Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90833872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between the Acidemia, Lactic Acidosis, and Shock Severity With Outcomes in Patients With Cardiogenic Shock","authors":"J. Jentzer, B. Schrage, P. Patel, K. Kashani, G. Barsness, D. Holmes, S. Blankenberg, P. Kirchhof, D. Westermann","doi":"10.1161/JAHA.121.024932","DOIUrl":"https://doi.org/10.1161/JAHA.121.024932","url":null,"abstract":"Background Lactic acidosis is associated with mortality in patients with cardiogenic shock (CS). Elevated lactate levels and systemic acidemia (low blood pH) have both been proposed as drivers of death. We, therefore, analyzed the association of both high lactate concentrations and low blood pH with 30‐day mortality in patients with CS. Methods and Results This was a 2‐center historical cohort study of unselected patients with CS with available data for admission lactate level or blood pH. CS severity was graded using the Society for Cardiovascular Angiography and Intervention (SCAI) shock classification. All‐cause survival at 30 days was analyzed using Kaplan‐Meier curves and Cox proportional‐hazards analysis. There were 1814 patients with CS (mean age, 67.3 years; 68.5% men); 51.8% had myocardial infarction and 53.0% had cardiac arrest. The distribution of SCAI shock stages was B, 10.8%; C, 30.7%; D, 38.1%; and E, 18.7%. In both cohorts, higher lactate or lower pH predicted a higher risk of adjusted 30‐day mortality. Patients with a lactate ≥5 mmol/L or pH <7.2 were at increased risk of adjusted 30‐day mortality; patients with both lactate ≥5 mmol/L and pH <7.2 had the highest risk of adjusted 30‐day mortality. Patients in SCAI shock stages C, D, and E had higher 30‐day mortality in each SCAI shock stage if they had lactate ≥5 mmol/L or pH <7.2, particularly if they met both criteria. Conclusions Higher lactate and lower pH predict mortality in patients with cardiogenic shock beyond standard measures of shock severity. Severe lactic acidosis may serve as a risk modifier for the SCAI shock classification. Definitions of refractory or hemometabolic shock should include high lactate levels and low blood pH.","PeriodicalId":17189,"journal":{"name":"Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease","volume":"118 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85835221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Fractional Flow Reserve/Instantaneous Wave‐Free Ratio Discordance Can Provide Coronary Clarity","authors":"D. Tehrani, A. Seto","doi":"10.1161/JAHA.122.026118","DOIUrl":"https://doi.org/10.1161/JAHA.122.026118","url":null,"abstract":"unctional evaluation of coronary artery stenoses using fractional flow reserve (FFR) is considered the gold standard given its relation to clinical outcomes.","PeriodicalId":17189,"journal":{"name":"Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85166080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}