Impact of right atrial pressure as venous pressure on fractional flow reserve calculation in patients with hemodialysis. H. Takashima1 , A. Kurita1, Y. Toda2 , A.
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Physiology, haemodynamics and microcirculation
Pd/Pa vs. FFR was 0.97. Taken together, these "extreme" (≥0.94 and ≤0.84) Pd/Pa values allowed the prediction of a "positive" or "negative" FFR in 86 (61%) lesions. Conclusions: Resting Pd/Pa values are strongly correlated with FFR values. "Extreme" Pd/Pa values (observed in more than half of the lesions) allow an accurate prediction of the FFR result. Considering these results, the need to induce pharmacological maximal hyperemia in those patients may be arguable, particularly in the presence of contra-indications or side effects related to adenosine and in patients with multivessel/multilesion disease.
P3969 | BEDSIDE Reduced cerebral vasoreactivity in severe aortic stenosis I. Scuric 1 , A. Lovrencic-Huzjan 2 , F. Baborski 1 , D. Cerovec 1 , Z.A. Korda 3 , M. Predrijevac 3 . 1 Special Hospital for Medical Rehabilitation Krapinske Toplice, Krapinske Toplice, Croatia; 2 University Hospital "Sisters of Mercy", University Department of Neurology, Zagreb, Croatia; 3 Magdalena - Specialized Hospital for Cardio-Vasculary Surgery and Cardiology, Krapinske Toplice, Croatia Aim: To assess cerebral vasoreactivity in patients with severe aortic stenosis using breath holding test. Subjects and methods: Twenty patients with severe aortic stenosis diagnosed according to European Society of Cardiology guidelines were included. Their mean age was 68±9 years and 60% were female. Average peak gradient on aortic valve was 100±19 mmHg, and mean gradient 58±12 mmHg, average EF 60±10. Breath holding test was performed in supine position according to standardized procedure to determine cerebral vasoreactivity to hypercapnia. Mean blood flow velocities (MBFV) on both middle cerebral arteries were recorded using DWL Doppler-Box TCD and breath holding index (BHI) was calculated. Results: We found that the patients with severe aortic stenosis have significantly reduced cerebral vasoreactivity expressed through breath holding index (BHI; 0.68±0.42). Severely reduced vasoreactivity with BHI less than 0.70 was found in 60% of patients, moderate (BHI from 0.70 to 1.03) in 25% and only 15% had normal values of BHI greater than 1.03. Males had slightly greater mean BHI than females (0.75±0.46 vs. 0.66±0.36, p=0.6), but the difference was not statistically significant. There was also no significant difference in mean BHI when left and right MCA were compared (0.63±0.37 vs 0.70±0.46, p=0.6).
(Pd-RAP)/ (Pa-RAP). We assessed various hemodynamic values and compared classical FFR with modified FFR. Physiological significance was defined as FFR value less than 0.80. Results: A total of 16 left anterior descending, 9 left circumflex, and 3 right coronary arteries were evaluated. In all lesions, reference vessel diameter was 2.5±0.7 mm and diameter stenosis was 53±12%. During hyperemic condition, RAP, Pa, and Pd were 9±3 mmHg, 85±19 mmHg, and 67±17 mmHg, respectively. Modified FFR was significantly lower than classical FFR (0.77±0.09 vs. 0.79±0.09, p0.80 moved into
