A5026927701- Cardiac Imaging and Diagnostics
- Coronary Interventions and Diagnostics
- Acute Myocardial Infarction Research
- Cardiovascular Disease and Adiposity
- Cardiovascular Function and Risk Factors
- Advanced MRI Techniques and Applications
- Cardiovascular Health and Disease Prevention
- Cerebrovascular and Carotid Artery Diseases
- Cardiac Valve Diseases and Treatments
- Advanced X-ray and CT Imaging
- Cardiac electrophysiology and arrhythmias
- Antiplatelet Therapy and Cardiovascular Diseases
- Atrial Fibrillation Management and Outcomes
- Medical Imaging Techniques and Applications
- Nitric Oxide and Endothelin Effects
- Venous Thromboembolism Diagnosis and Management
- Cardiac, Anesthesia and Surgical Outcomes
- Thermoregulation and physiological responses
- Hemodynamic Monitoring and Therapy
- Cardiovascular and exercise physiology
- Cardiac and Coronary Surgery Techniques
- Pulmonary Hypertension Research and Treatments
- Chemotherapy-induced cardiotoxicity and mitigation
- Cardiac Ischemia and Reperfusion
- Cardiac Arrhythmias and Treatments
Radboud University Nijmegen
2022-2025
Radboud University Medical Center
2022-2025
Amsterdam Neuroscience
2022-2024
Amsterdam University Medical Centers
2019-2024
Vrije Universiteit Amsterdam
2019-2024
University of Amsterdam
2020-2024
Yale University
2024
Amsterdam UMC Location Vrije Universiteit Amsterdam
2013-2023
Erasmus MC
2022
Noordwest Ziekenhuisgroep
2022
Clinical reads of coronary computed tomography angiography (CTA), especially by less experienced readers, may result in overestimation artery disease stenosis severity compared with expert interpretation. Artificial intelligence (AI)-based solutions applied to CTA overcome these limitations.This study the performance for detection and grading stenoses using artificial intelligence-enabled quantitative (AI-QCT) analyses core lab-interpreted CTA, lab (QCA), invasive fractional flow reserve...
The aim of this study was to compare Doppler flow velocity and thermodilution-derived indexes determine the optimal thermodilution-based diagnostic thresholds for coronary reserve (CFR). majority clinical data flow-based are derived from measurements, correspondence with indices remain unclear. An international multicenter registry conducted among patients who had measurements using both thermodilution techniques in same vessel during procedure. Physiological 250 vessels (in 149 patients)...
Background: Coronary microvascular dysfunction (CMD) is an important contributor to angina syndromes.Recently, two distinct endotypes were identified using combined assessment of coronary flow reserve (CFR) and minimal resistance (MR), termed structural functional CMD. Aims:We aimed assess the relevance CFR MR in patients with no obstructive arteries.Methods: Patients chronic syndromes (CCS) non-obstructive artery disease (fractional [FFR] ≥0.80) selected (N=1,102).Functional CMD was defined...
The microvascular resistance reserve (MRR) was introduced as a means to characterize the vasodilator capacity of coronary microcirculation while accounting for influence concomitant epicardial disease and impact administration potent vasodilators on aortic pressure. This study aimed evaluate diagnostic prognostic performance MRR.A total 1481 patients with stable symptoms clinical indication angiography were included from global ILIAS Registry. MRR derived function flow (CFR) divided by...
Our understanding of human coronary physiological behaviour is derived from animal models. We sought to describe across a large collection invasive pressure and flow velocity measurements, provide better the relationships between these parameters evaluate rationale for resting stenosis assessment.Five hundred sixty-seven simultaneous intracoronary assessments 301 patients were analysed velocity, trans-stenotic gradient (TG), microvascular resistance (MVR). Measurements made during baseline...
The study sought to determine the coronary flow characteristics of angiographically intermediate stenoses classified as discordant by fractional reserve (FFR) and instantaneous wave-free ratio (iFR).Discordance between FFR iFR occurs in up 20% cases. No comparisons have been reported FFR/iFR unobstructed vessels.Baseline hyperemic velocity (CFR) were compared across 5 vessel groups: FFR+/iFR+ (108 vessels, n = 91), FFR-/iFR+ (28 24), FFR+/iFR- (22 22), FFR-/iFR- (208 154), an group (201...
Percutaneous coronary intervention (PCI) of nonculprit vessels among patients with ST-segment elevation myocardial infarction (STEMI) is associated improved clinical outcome compared culprit vessel-only PCI. Fractional flow reserve (FFR) and are hyperemic indices used to guide revascularization. Recently, instantaneous wave-free ratio was introduced as a nonhyperemic alternative FFR. Whether these can be in the acute setting STEMI continues investigated.To assess value hemodynamic from index...
Coronary microvascular resistance is increasingly measured as a predictor of clinical outcomes, but there no accepted gold-standard measurement. We compared the diagnostic accuracy 2 invasive indices resistance, Doppler-derived hyperemic (hMR) and thermodilution-derived index microcirculatory (IMR), at predicting dysfunction. A total 54 patients (61 ± 10 years) who underwent cardiac catheterization for stable coronary artery disease (n = 10) or acute myocardial infarction 44) had...
Background In the absence of obstructive coronary stenoses, abnormality noninvasive stress tests (NIT) in patients with chronic syndromes may indicate myocardial ischemia nonobstructive arteries (INOCA). The differential prognosis INOCA according to presence microvascular dysfunction (CMD) and incremental prognostic value CMD intracoronary physiologic assessment on top NIT information remains unknown. Methods Results From international multicenter registry (ILIAS [Inclusive Invasive...
Noninvasive stress testing is commonly used for detection of coronary ischemia but possesses variable accuracy and may result in excessive health care costs. This study aimed to derive validate an artificial intelligence-guided quantitative computed tomography angiography (AI-QCT) model the diagnosis that integrates atherosclerosis vascular morphology measures (AI-QCTISCHEMIA) evaluate its prognostic utility major adverse cardiovascular events (MACE). A post hoc analysis CREDENCE (Computed...
Abstract Aims Continuous thermodilution is a novel technique to quantify absolute coronary flow and microvascular resistance (MVR). Notably, intracoronary infusion of saline elicits maximal hyperaemia, obviating the need for adenosine. The primary aim this study was validate continuous in humans by comparing invasive measurements [15O]H2O positron emission tomography (PET). As secondary goal, MVR were compared between obtained with without Methods results Twenty-five patients underwent...
Stress imaging has been the standard for diagnosing functionally significant coronary artery disease. It is unknown whether novel, atherosclerotic plaque measures improve accuracy beyond stenosis invasive fractional flow reserve (FFR) measurement.To compare diagnostic of comprehensive anatomic (obstructive and nonobstructive plaque) vs functional estimating vessel-specific FFR.Controlled clinical trial with a multicenter derivation-validation cohort patients referred nonemergent angiography....
Coronary function testing in patients with ischemia and nonobstructive coronary arteries (INOCA) commonly includes assessment of adenosine-mediated vasodilation acetylcholine spasm provocation. The purpose this study was to evaluate the diagnostic value additional endothelial for diagnosis vasomotor dysfunction INOCA.In retrospective cohort study, we included INOCA who underwent clinically indicated comprehensive testing. Endothelial defined as a <50% increase blood flow, determined by...
Deep learning frameworks have been applied to interpretation of coronary CTA performed for artery disease (CAD) evaluation.
A total of 40% to 50% patients with ST-segment-elevation myocardial infarction develop microvascular injury (MVI) despite angiographically successful primary percutaneous coronary intervention (PCI). We investigated whether hyperemic resistance (HMR) immediately after PCI predicts MVI at cardiovascular magnetic resonance and reduced blood flow positron emission tomography (PET).Sixty were included in this prospective study. Immediately PCI, intracoronary pressure-flow measurements performed...
Microvascular injury (MVI) after coronary ischemia-reperfusion is associated with high morbidity and mortality. Both ischemia reperfusion are involved in MVI, but to what degree these phases contribute unknown. Understanding the etiology essential for development of new potential therapies.Rats were divided into 3 groups receiving either 30 minutes ischemia, 90 or followed by 60 reperfusion. Subsequently hearts ex-vivo perfused a Langendorff-model. Fluorescence electron microscopy was used...
Background: Despite successful restoration of epicardial vessel patency with primary percutaneous coronary intervention, microvascular injury occurs in a large proportion patients ST-segment–elevation myocardial infarction, adversely affecting clinical and functional outcome. Ticagrelor has been reported to increase plasma adenosine levels, which might have protective effect on the microcirculation. We investigated whether ticagrelor maintenance therapy after revascularized infarction is...
Objectives Early detection of microvascular dysfunction after acute myocardial infarction (AMI) could identify patients at high risk adverse clinical outcome, who may benefit from adjunctive treatment. Our objective was to compare invasively measured coronary flow reserve (CFR) and hyperaemic resistance (HMR) for their predictive power long-term outcome cardiac magnetic resonance (CMR)-defined injury (MVI). Methods Simultaneous intracoronary Doppler velocity pressure measurements acquired...
The relationship between fractional flow reserve (FFR), resting full-cycle ratio (RFR), instantaneous wave-free (iFR), distal pressure/aortic pressure (Pd/Pa), and plaque burden as well phenotype requires further elucidation. In this single-center cohort study, patients with suspected coronary artery disease who underwent invasive angiography, including routine hyperemic (FFR) nonhyperemic (Pd/Pa iFR or RFR) interrogation computed tomography angiography were prospectively enrolled. Computed...