CAD - Coronary Blood Flow Flashcards
Systole or Diastole: redistributes perfusion from subendocardial to he subepicardial lates of the heart
- SYSTOLE
lower pressure limit of autoregulation
70mmHg
What are the major determinants of myocardial oxygen consumption?
- Heart rate
- systolic pressure (myocardial wall stress)
- LV conractility
termed as the ability to increase flow above the resting value in response to pharmacologic vasodilation
- CORONARY FLOW RESERVE
resting coronary blood flow: 0.7-1.0 ml/min/g
Subepicardial flow occurs throughout the cardiac cycle. T/F?
TRUE - maintain until pressure coronary pressure drops below 25mmHg
for subendocardial flow - limit is 40mmHg
Factors that can reduced coronary flow reserve
- decreased diastolic time available for subendothelial perfusion (in tachycardia)
- compressive determinants of diastolic perfusion are increased (preload)
- increase hemodynamic determinants of oxygen consumption (HR, contractility, systolic pressure)
- reductions in arterial supply (anemia and hypoxia)
Site of metabolic and regulation in the coronary circulation?
pre- Arterioles and arterioles
Indications for Coronary angiography?
- symptomatic with high pretest probability
- suspected of ACS
- intermediate or high-risk findings on non-invasive testing
complications of coronary angiography: death
0.1 - 0.14 %
Adjunctive diagnostic testing in the cathlab
physiology (FFR and iFR)
imaging - IVUS and OCT
Clinical study associated with the used of FFR
FAME - angiographically-guidedly PCI vs FFR-guided PCI
FAME 2 - FFR-guided PCI vs OMT alone
favorable in FFR-guided PCI
Clinical study associated with the used of iFR
DEFINE-FLAIR
***iFR - instantaneous wave-free ratio
Clinical study associated with the used of iFR
SWEDEHEART
Class I indication for iFR/FFR
intermediate-grade stenosis- especially if symptomatic
