Improved assessment of functional severity of coronary artery stenosis by analysis of combined intracoronary pressure and,flow velocity signals,

F. Nolte ; J.A.E. Spaan

University of Amterdam

Others  :  https://pure.uva.nl/ws/files/2009213/138336_thesis.pdf

瑞士|英语

来源: UvA-DARE (Digital Academic Repository)

【 摘 要 】

Coronary artery disease (CAD) accounts for almost 2 million deaths per year within the EU. CAD is often characterized by focal,narrowing of epicardial arteries, limiting coronary arterial flow and myocardial perfusion. Treatment of critical lesions,by percutaneous coronary intervention (PCI) can be lifesaving and improve quality of life. Optimal diagnosis, including the,state of the coronary microcirculation, can highly improve the outcome of PCI and prevent treatment when not needed. Additionally,,pressure and flow velocity measurements can provide further insights into the coronary physiology of patients. Ultimately,,these developments bear great potential to lead to improved, personalized patient care. This thesis recommends the combined,assessment of intracoronary pressure and flow velocity in daily clinical practice enabling 1) the derivation of functional,indices of stenosis severity that do not require maximal vasodilation of the coronary microcirculation and 2) the assessment,of HMR for optimal decision making of revascularization therapy. These measurements are best to be obtained at a more distal,measurement location. Additionally, diagnostics and treatment decision stand to benefit from the development of models that,integrate information obtained from invasive and non-invasive methods to assess myocardial perfusion and predict treatment,outcomes.,