8 results on '"van 't Veer M"'
Search Results
2. Basics of Coronary Thermodilution.
- Author
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Candreva A, Gallinoro E, van 't Veer M, Sonck J, Collet C, Di Gioia G, Kodeboina M, Mizukami T, Nagumo S, Keulards D, Fournier S, Pijls NHJ, and De Bruyne B
- Subjects
- Coronary Vessels diagnostic imaging, Humans, Microcirculation, Treatment Outcome, Vascular Resistance, Coronary Circulation, Thermodilution
- Abstract
Coronary microvascular dysfunction is a highly prevalent condition in both obstructive and nonobstructive coronary artery disease. Intracoronary thermodilution is a promising technique to investigate coronary microvascular (dys)function in vivo and to assess its most important metric: microvascular resistance. Here, the authors provide a practical review of bolus and continuous thermodilution for the measurement of coronary flow and microvascular resistance. The authors describe the basic principles of indicator-dilution theory and of coronary thermodilution and detail the practicalities of their application in the catheterization laboratory. Finally, the authors discuss contemporary clinical applications of coronary thermodilution-based microvascular assessment in humans and future perspectives., Competing Interests: Funding Support and Author Disclosures Drs. Kodeboina, Fournier, Di Gioia, and Sonk are supported by a research grant from CardioPaTh. Dr. Di Gioia is supported by the STAR program of Compagnia di San Paolo. Dr. Collet has received institutional consultancy fees from HeartFlow and Philips Volcano. Dr. van ’t Veer has received speaker fees from Abbott. Dr. Pijls has received institutional research grants from Abbott and Hexacath; has received consultancy fees from Abbott, Opsens, and GE; and holds minor equity positions in Philips, ASML, and HeartFlow. Dr. De Bruyne has received institutional consulting fees from Abbott Vascular, Boston Scientific, Opsens, and Siemens; has received institutional grant support from Abbott Vascular, Boston Scientific, Biotronik, and Medtronic; and holds equity positions in Philips, Siemens, GE, Bayer, HeartFlow, Edwards Lifesciences, and Ceyliad. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2021. Published by Elsevier Inc.)
- Published
- 2021
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3. Intra-aortic balloon pump counterpulsation in extensive myocardial infarction with persistent ischemia: The SEMPER FI pilot study.
- Author
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van Nunen LX, van 't Veer M, Zimmermann FM, Wijnbergen I, Brueren GRG, Tonino PAL, Aarnoudse WA, and Pijls NHJ
- Subjects
- Aged, Cause of Death, Female, Heart Failure physiopathology, Heart Failure therapy, Humans, Male, Middle Aged, Netherlands, Patient Readmission, Pilot Projects, Prospective Studies, Risk Factors, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction mortality, ST Elevation Myocardial Infarction physiopathology, Time Factors, Treatment Outcome, Coronary Circulation, Hemodynamics, Intra-Aortic Balloon Pumping adverse effects, Intra-Aortic Balloon Pumping mortality, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention mortality, ST Elevation Myocardial Infarction therapy
- Abstract
Objectives: This study aimed to prospectively investigate intra-aortic balloon pump counterpulsation (IABP) support in large myocardial infarction complicated by persistent ischemia after primary percutaneous coronary intervention (PCI)., Background: Use of IABP is suggested to be effective by increasing diastolic aortic pressure, thereby improving coronary blood flow. This can only be expected with exhausted coronary autoregulation, typical in acute myocardial infarction complicated by persistent ischemia. In this situation, augmented diastolic pressure is expected to increase myocardial oxygenation., Methods: One hundred patients with large STEMI complicated by persistent ischemia after primary PCI were randomized to treatment with or without IABP therapy on top of standard care. IABP support was initiated following primary PCI, immediately after inclusion. Primary end point was all-cause mortality, need for (additional) mechanical hemodynamic support, or readmission for heart failure within 6 months., Results: Mean age was 63 ± 10 years, 76% were male. Mean systolic and diastolic blood pressure were 120 ± 25 mmHg and 73 ± 17 mmHg. Mean heart rate was 75 ± 18 mmHg. Before PCI, mean summed ST-deviation was 21 ± 8 mm with only minimal ST-resolution after PCI. One patient in the IABP group reached the primary end point versus four patients in the control group (2% vs. 8%; p = 0.16). After primary PCI, resolution of ST-deviation was significantly more pronounced in the IABP group (73 ± 17%) compared to the control group (56 ± 26%; p < 0.01)., Conclusions: In this pilot study, in patients with large STEMI and persistent ischemia after primary PCI, use of IABP showed a nonsignificant decrease in mortality, necessity for (additional) mechanical hemodynamic support or readmission for heart failure at 6 months, and resulted in more rapid ST-resolution., (© 2019 Wiley Periodicals, Inc.)
- Published
- 2020
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4. Novel monorail infusion catheter for volumetric coronary blood flow measurement in humans: in vitro validation.
- Author
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van 't Veer M, Adjedj J, Wijnbergen I, Tóth GG, Rutten MC, Barbato E, van Nunen LX, Pijls NH, and De Bruyne B
- Subjects
- Humans, Cardiac Catheterization instrumentation, Cardiac Catheters, Coronary Circulation
- Abstract
Aims: The aim of this study is to validate a novel monorail infusion catheter for thermodilution-based quantitative coronary flow measurements., Methods and Results: Based on the principles of thermodilution, volumetric coronary flow can be determined from the flow rate of a continuous saline infusion, the temperature of saline when it enters the coronary artery, and the temperature of the blood mixed with the saline in the distal part of the coronary artery. In an in vitro set-up of the systemic and coronary circulation at body temperature, coronary flow values were varied from 50-300 ml/min in steps of 50 ml/min. At each coronary flow value, thermodilution-based measurements were performed at infusion rates of 15, 20, and 30 ml/min. Temperatures and pressures were simultaneously measured with a pressure/temperature sensor-tipped guidewire. Agreement of the calculated flow and the measured flow as well as repeatability were assessed. A total of five catheters were tested, with a total of 180 measurements. A strong correlation (ρ=0.976, p<0.0001) and a difference of -6.5±15.5 ml/min were found between measured and calculated flow. The difference between two repeated measures was 0.2%±8.0%., Conclusions: This novel infusion catheter used in combination with a pressure/temperature sensor-tipped guidewire allows accurate and repeatable absolute coronary flow measurements. This opens a window to a better understanding of the coronary microcirculation.
- Published
- 2016
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5. Absolute coronary blood flow measurement and microvascular resistance in ST-elevation myocardial infarction in the acute and subacute phase.
- Author
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Wijnbergen I, van 't Veer M, Lammers J, Ubachs J, and Pijls NH
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- Aged, Blood Flow Velocity, Feasibility Studies, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, No-Reflow Phenomenon etiology, No-Reflow Phenomenon physiopathology, Predictive Value of Tests, Regional Blood Flow, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction physiopathology, Time Factors, Treatment Outcome, Coronary Circulation, Coronary Vessels physiopathology, Microcirculation, Microvessels physiopathology, No-Reflow Phenomenon diagnosis, Percutaneous Coronary Intervention adverse effects, ST Elevation Myocardial Infarction therapy, Thermodilution methods, Vascular Resistance
- Abstract
Background/purpose: In a number of patients with acute myocardial infarction (AMI), myocardial hypoperfusion, known as the no-reflow phenomenon, persists after primary percutaneous intervention (PPCI). The aim of this study was to evaluate the feasibility and safety of a new quantitative method of measuring absolute blood flow and resistance within the perfusion bed of an infarct-related artery. Furthermore, we sought to study no-reflow by correlating these measurements to the index of microvascular resistance (IMR) and the area at risk (AR) as determined by cardiac magnetic resonance imaging (CMR)., Methods: Measurements of absolute flow and myocardial resistance were performed in 20 patients with ST-segment elevation myocardial infarction (STEMI), first immediately following PPCI and then again after 3-5days. These measurements used the technique of thermodilution during a continuous infusion of saline. Flow was expressed in ml/min per gram of tissue within the area at risk., Results: The average time needed for measurement of absolute flow, resistance and IMR was 20min, and all measurements could be performed without complication. A higher flow supplying the AR correlated with a lower IMR in the acute phase. Absolute flow increased from 3.14 to 3.68ml/min/g (p=0.25) and absolute resistance decreased from 1317 to 1099 dyne.sec.cm-5/g (p=0.40) between the first day and fifth day after STEMI., Conclusions: Measurement of absolute flow and microvascular resistance is safe and feasible in STEMI patients and may allow for a better understanding of microvascular (dys)function in the early phase of AMI., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
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6. Multicenter core laboratory comparison of the instantaneous wave-free ratio and resting Pd/Pa with fractional flow reserve: the RESOLVE study.
- Author
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Jeremias A, Maehara A, Généreux P, Asrress KN, Berry C, De Bruyne B, Davies JE, Escaned J, Fearon WF, Gould KL, Johnson NP, Kirtane AJ, Koo BK, Marques KM, Nijjer S, Oldroyd KG, Petraco R, Piek JJ, Pijls NH, Redwood S, Siebes M, Spaan JAE, van 't Veer M, Mintz GS, and Stone GW
- Subjects
- Blood Pressure, Coronary Angiography, Coronary Stenosis physiopathology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Predictive Value of Tests, ROC Curve, Retrospective Studies, Severity of Illness Index, Cardiac Catheterization methods, Coronary Circulation physiology, Coronary Stenosis diagnosis, Coronary Vessels physiopathology, Fractional Flow Reserve, Myocardial physiology, Rest physiology
- Abstract
Objectives: This study sought to examine the diagnostic accuracy of the instantaneous wave-free ratio (iFR) and resting distal coronary artery pressure/aortic pressure (Pd/Pa) with respect to hyperemic fractional flow reserve (FFR) in a core laboratory-based multicenter collaborative study., Background: FFR is an index of the severity of coronary stenosis that has been clinically validated in 3 prospective randomized trials. iFR and Pd/Pa are nonhyperemic pressure-derived indices of the severity of stenosis with discordant reports regarding their accuracy with respect to FFR., Methods: iFR, resting Pd/Pa, and FFR were measured in 1,768 patients from 15 clinical sites. An independent physiology core laboratory performed blinded off-line analysis of all raw data. The primary objectives were to determine specific iFR and Pd/Pa thresholds with ≥90% accuracy in predicting ischemic versus nonischemic FFR (on the basis of an FFR cut point of 0.80) and the proportion of patients falling beyond those thresholds., Results: Of 1,974 submitted lesions, 381 (19.3%) were excluded because of suboptimal acquisition, leaving 1,593 for final analysis. On receiver-operating characteristic analysis, the optimal iFR cut point for FFR ≤0.80 was 0.90 (C statistic: 0.81 [95% confidence interval: 0.79 to 0.83]; overall accuracy: 80.4%) and for Pd/Pa was 0.92 (C statistic: 0.82 [95% confidence interval: 0.80 to 0.84]; overall accuracy: 81.5%), with no significant difference between these resting measures. iFR and Pd/Pa had ≥90% accuracy to predict a positive or negative FFR in 64.9% (62.6% to 67.3%) and 48.3% (45.6% to 50.5%) of lesions, respectively., Conclusions: This comprehensive core laboratory analysis comparing iFR and Pd/Pa with FFR demonstrated an overall accuracy of ~80% for both nonhyperemic indices, which can be improved to ≥90% in a subset of lesions. Clinical outcome studies are required to determine whether the use of iFR or Pd/Pa might obviate the need for hyperemia in selected patients., (Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
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7. Autoregulation of coronary blood flow in the isolated beating pig heart.
- Author
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Schampaert S, van 't Veer M, Rutten MC, van Tuijl S, de Hart J, van de Vosse FN, and Pijls NH
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- Animals, Hemodynamics, Swine, Coronary Circulation, Coronary Vessels physiology, Heart physiology, Homeostasis
- Abstract
The isolated beating pig heart model is an accessible platform to investigate the coronary circulation in its truly morphological and physiological state, whereas its use is beneficial from a time, cost, and ethical perspective. However, whether the coronary autoregulation is still intact is not known. Here, we study the autoregulation of coronary blood flow in the working isolated pig heart in response to brief occlusions of the coronary artery, to step-wise changes in left ventricular loading conditions and contractile states, and to pharmacologic vasodilating stimuli. Six slaughterhouse pig hearts (473 ± 40 g) were isolated, prepared, and connected to an external circulatory system. Through coronary reperfusion and controlled cardiac loading, physiological cardiac performance was achieved. After release of a coronary occlusion, coronary blood flow rose rapidly to an equal (maximum) level as the flow during control beats, independent of the duration of occlusion. Moreover, a linear relation was found between coronary blood flow and coronary driving pressure for a wide variation of preload, afterload, and contractility. In addition, intracoronary administration of papaverine did not yield a transient increase in blood flow indicating the presence of maximum coronary hyperemia. Together, this indicates that the coronary circulation in the isolated beating pig heart is in a permanent state of maximum hyperemia. This makes the model excellently suitable for testing and validating cardiovascular devices (i.e., heart valves, stent grafts, and ventricular assist devices) under well-controlled circumstances, whereas it decreases the necessity of sacrificing large mammalians for performing classical animal experiments., (© 2013, Copyright the Authors. Artificial Organs © 2013 Wiley Periodicals, Inc. and International Center for Artificial Organs and Transplantation.)
- Published
- 2013
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8. Instantaneous wave-free ratio or fractional flow reserve without hyperemia: novelty or nonsense?
- Author
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Pijls NH, Van 't Veer M, Oldroyd KG, Berry C, Fearon WF, Kala P, Bocek O, Witt N, De Bruyne B, and Pyxaras S
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- Female, Humans, Male, Adenosine, Coronary Angiography methods, Coronary Circulation physiology, Coronary Stenosis diagnosis, Coronary Vessels physiopathology, Severity of Illness Index, Vascular Resistance physiology
- Published
- 2012
- Full Text
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