Morton J. Kern’s research while affiliated with California State University, Long Beach and other places

... Radiation exposure is an occupational hazard in cardiology that merits consideration as the sophistication and duration of interventional procedures has increased in recent years. As image-guided structural interventions rise, the risk extends beyond interventional cardiologists to imaging specialists (1). A previous British Cardiovascular Society editorial has described the deleterious effects of radiation and strategies for reduction (2). ...

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Beating the rays: innovations in radiation protection

... FFR and instantaneous wave-free ratio (iFR) are physiological tools that can assist in revascularization decisions in patients with SIHD. 2 FFR is defined by the ratio of pressure during maximal blood flow distal to a coronary lesion (Pd) compared with pressure during normal, physiological blood flow through an artery (Pa). 2,29 This process is done by passing a pressure sensing guidewire through a stenotic lesion while administering a continuous drug (adenosine) to obtain maximal hyperemia. 29 In contrast, iFR similarly compares Pd to the Pa, however only during the diastolic "wave-free" period of the cardiac cycle, negating the need for adenosine. ...

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Review and Key Takeaways of the 2021 Percutaneous Coronary Intervention Guidelines

... Older age is linked to a decrease in coronary flow reserve and an increase in microvascular resistance under hyperemia, which may lead to an underestimation of stenosis severity by FFR [28,29]. Also, the absence of estrogens in postmenopausal women is thought to be related to the development and progression of microvascular dysfunction [30]. ...

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Influence of sex on the functional assessment of myocardial ischemia

... This simulator concept was achieved by considering the cardiology student requirements to increase their coronary cannulation skills as described for concept suitability from the curriculum, since the ability to perform examinations and construct a clinical interpretation of invasive diagnostic tests of coronary artery disease that starts from puncture to coronary artery cannulation is one of the cardiologist's competencies that requires repetitive training [22]. This study provided a simulator for coronary artery cannulation learning that was easy to use, safe, and cost effective from CT scan data. ...

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CT-Derived 3D Printing for Coronary Artery Cannulation Simulator Design Manufacturing

... grafting of an internal mammary artery distal to a subclavian stenosis 3 or attributed to unligated side branches of the mammary artery, although the latter mechanism remains controversial because coronary flow occurs during diastole whereas side branches perfuse during systole. 4 This group accounts for 86 of the 514 results (17%). 3. Symptoms associated with cardiac tumors have been attributed to coronary steal in a small number of cases series, albeit without supporting hemodynamics, making up 9 of the 514 results (2%). ...

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Coronary Steal: Mechanisms of a Misnomer

... Post TAVR, large discrepancies between catheter derived and TTE gradients may be observed occasionally 46,47 . The higher TTE gradients may be due to the underexpansion of the prosthesis, in particular for self-expandable models. ...

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Interventional imaging – a modern Telemacheia

... Потреба у використанні судинорозширювальних речовин для індукції гіперемії може сприйматися як обмежувальний фактор для вимірювання ФРК і може перешкоджати запровадженню цього методу в рутинну клінічну практику. У літературі описано два альтернативні методи вимірювання тиску, які не засновані на гіперемії [12]. По-перше, пропонують оцінювати відношення Рd/Рa (Рd -дистальний коронарний тиск; Рa -проксимальний коронарний тиск) без гіперемії. ...

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The role of fractional flow reserve in determining tactics of revascularization in patients with ischemic heart disease

... Multi-vessel lesions were defined as a stenosis of ≥50% in at least two coronary vessels >2.0 mm in diameter. [12] Follow-up and outcomes All patients' information for in-hospital and 30-day mortality was collected. Patients were scheduled for outpatient clinics at 3 months and 1 year after discharge, with additional follow-ups conducted via instant messenger WeChat (Tencent, Shenzhen, China), telephone contact and text messages every 3 months. ...

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Association between coronary artery stenosis and myocardial injury in patients with acute pulmonary embolism: A case-control study

... The shape and position of each individual loop in the PV diagram is largely determined by the intrinsic properties of the myocardium (inotropism and lusitropism) and extrinsic hemodynamic conditions (preload and afterload). Ventricular preload, reflecting the maximal sarcomere stretch just before the isovolumetric contraction [10], is best indexed by the End-Diastolic Volume (EDV) in a PV loop [11]. Ventricular afterload refers to the maximal myocardial wall tension during systole and translates into the pressure that the ventricle must overcome to eject blood into the aorta or pulmonary artery. ...

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Left Ventricular Unloading in Extracorporeal Membrane Oxygenation: A Clinical Perspective Derived from Basic Cardiovascular Physiology

... Invasive monitoring from arterial and central venous catheters, as well as pulmonary artery catheters, provides the measurement of arterial pressure, intracardiac filling pressures, arterial and venous blood gases, and cardiac index (invasive arterial and venous blood pressure monitoring, venous pressure monitoring, right heart catheterization [thermodilution, continuous cardiac output, mixed venous oximetry], transpulmonary thermodilution [PICCO, LIDCO], Fick method). Additionally, in some cases, it is necessary to assess intra-abdominal pressure to evaluate organ perfusion pressures [23][24][25][26]. Notably, no single method of hemodynamic monitoring itself will improve the patient's prognosis: it must implicate proper therapeutic decisions. ...

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Mechanical circulatory support. An expert opinion statement from the Association of Intensive Cardiac Care and Association of Cardiovascular Interventions of the Polish Cardiac Society